Complementary Interventions in the "New Normal?"

The articles of this issue of Nursing Clinics of North America on Complementary and Alternative Medicine, Part I: Therapies were begun before the COVID-19 pandemic but were written during the pandemic. As such, some of the information warrants updating when describing how these interventions should be put into practice. It is important to follow the Centers for Disease Control and Prevention (CDC) Guidelines as well as any local, state, or regional guidelines. As mutable and different as these guidelines are, it would have been impossible to keep up with the standards during the development and publication of this issue. It is recommended that before implementing interventions, you check with your local officials for methods in which the current guidelines and recommendations should be implemented. We have many new standards in our nursing practice as a result of the pandemic. We also have many new standards in some areas as well, such as “social distancing,” the use of gloves, and the wearing of masks to name a few. For optimal safety, please refer to your local agencies, to the CDC, and to organizations devoted to these specific interventions for the safest practice.

Stephen D. Krau, PhD, RN, CNE, Editor

This issue was not designed to be an instruction manual in these interventions, although some articles have helpful information about how to begin some of these interventions. Many of the patients for whom we care utilize alternative therapies on a regular basis. A recent study by Taylor and colleagues interviewed US veterans for their use of Complementary and Integrative Health (CIH) practices. The Veteran’s Health Administration is the largest health care system in the United States. The subjects consisted of 530,216 veterans with chronic musculoskeletal pain. More than one-fourth (27%) of younger veterans with chronic musculoskeletal pain used any CIH therapy. It was found that 15% used meditation, 7% used yoga, 6% had engaged in acupuncture, 5% had engaged in chiropractic interventions, 4% used guided imagery, 3% used biofeedback, 2% had used tai chi, while massage was a method used by 2%, and 0.2% had engaged in in hypnosis. The use of CIH therapies has increased tremendously over the last decade, and many health care organizations suggest variant alternative therapies in reducing pain, due to the overdependence on pharmacologic interventions for reducing pain.

As the use of complementary and alternative interventions increases in the United States, it is not unusual for nurses in practice to encounter patients who have used these interventions for any number of reasons. This issue of Nursing Clinics of North America introduces some of the many interventions that nurses may discover in their patients’ histories. It is important to more fully understand the patient’s health care needs, beliefs, and thoughts to better grasp the patient’s trajectory. As part of this understanding, it is crucial to have some rudimentary knowledge of these interventions. This knowledge will enhance the nurse’s comprehension of the patient’s perception of health, their focus, thereby improving the link between the patient and the caregiver.

These articles are not a complete inventory of alternative therapies by any means, and this is also not a “how-to” issue; our goal is to familiarize the nurse with some alternative therapies of which the nurse may be unaware or not understand. There are organizations and certification programs for many of these alternative therapies that provide health care providers with knowledge and skills to become experts in these interventions, should one decide to pursue a specific intervention further. With the growing number of persons using these therapies, the purpose of this issue is to introduce the nurse to the basic ideas, principles, methods, and potential outcomes for these interventions. In March 2021, Part II will publish and address herbal supplements and vitamins, and I invite you to read both issues for a greater understanding of alternative and complementary medicine.