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Educate patients before using technique
The nurse manager of cardiac surgery at Mercy San Juan Hospital in Sacramento, CA, promotes the use of therapeutic touch with patients pre- and postoperatively in the cardiac intensive care unit. Nurses there have found it assists with general relaxation and some pain relief. At times, they have seen changes in the heart monitors as a result of using therapeutic touch.
Cardiac surgery patients are not the only ones to receive therapeutic touch. Mercy Healthcare Sacramento offers therapeutic touch as a staff development course so patients on every unit can benefit from this complementary therapy. "We have taught therapeutic touch to between 200 and 300 nurses and other health care provi ders within the Mercy system. They use it to varying degrees in their clinical practice," says Marcia Taylor-Carlile, RN, CDE, team leader for healthy member/healing environment in Strategic Learning Development at Mercy. (To learn how to incorporate complementary therapies into a health care setting, see article on p. 42.)
Therapeutic touch is being incorporated as a complementary therapy into more and more health care settings. It is being used in clinics, hospitals, hospice, and home health to enhance well-being, reduce stress, accelerate the healing process, reduce pain, and provide physical and mental relaxation. While some patients ask for therapeutic touch, most are introduced to it by nurses who have embraced the technique.
Kate Dean-Haidet, RN, MSN, CS, a psycho therapist and clinical nurse specialist in adult psychiatric mental health in Columbus, OH, uses therapeutic touch with her clients who suffer from depression and anxiety. "I found that what might have happened in the therapeutic relationship was happening sooner. Issues were being dealt with more quickly and clients were getting better faster," she says.
Therapeutic touch is based on the premise that a human being comprises physical, mental, emotional, and spiritual energy fields. This paradigm holds that when a person is diseased, his or her energy is blocked, depleted, or unbalanced. The therapeutic touch practitioner uses a series of hand movements to release blockages and rebalance the patient’s energy flow. (For more information about how therapeutic touch works, see article on p. 41.)
It is important to have policies and procedures in place that govern the use of therapeutic touch with patients, says Taylor-Carlile. Because some patients might be uncomfortable with the procedure, it’s important to provide education beforehand. "Our philosophy is to explain the basics of therapeutic touch and how it may assist the patient with anxiety or pain management issues before offering it. We don’t require a written consent, but we do ask our nursing staff to do verbal consenting with the patient and or family," she says. (For information on training in therapeutic touch, see article above.)
Although many consumers are seeking complementary therapies and have become well-informed about many modalities, they aren’t as familiar with therapeutic touch. Judi Cantone, MSN, RN, an educator at the Hospital of the University of Pennsylvania in Philadelphia, finds that 99% of the patients she mentions therapeutic touch to haven’t heard of the technique. When a clinical specialist on a unit asks Cantone to see a patient for the purpose of performing therapeutic touch, she gets physician approval first. Before working with the patient, Cantone explains the process and asks the patient for permission to use therapeutic touch.
It’s important to tell the patient that more than one treatment might be advisable, says Linda Turner, RN, MN, clinical nurse specialist for pain management at Vancouver Hospital in British Columbia, Canada. "The patient also needs to understand that in order to heal itself, the body needs all the basic requirements, such as good nutrition, adequate sleep, and stress reduction. One of the functions of holistic treatment is to put all the components together to heal a person quickly. There are no magic cures," Turner says.
Patients need to know that therapeutic touch is not an intervention like massage where they must take off their clothes. It’s very brief, usually lasting no longer than 20 minutes. Also, patients need to know that the practitioner doesn’t necessarily touch their body. "The practitioner may be working in what we think of as blank space, and that is perplexing for people," says Dean-Haidet.
Give the patient a brochure on therapeutic touch, suggests Donna Anderson, RN, MS, MAN, CS-FNP, program coordinator and nurse practitioner in the Pain Management Resource Center at St. Luke’s Hospital in Duluth, MN. The brochure Anderson created provides patients with a definition of therapeutic touch, explains the process, and lists the benefits. (For more about therapeutic touch, see the resource box on p. 42.)
Anderson advises staff to develop a relationship with a patient before offering the technique. "I find it is best to have an established relation ship with the individual so there is some trust involved," explains Anderson. Before handing a patient a brochure, she offers a simple overview of the therapeutic touch process and explains that its effectiveness has been documented.
Although a lot of research has been done and is currently under way to validate the effectiveness of therapeutic touch, many people in the health care field are skeptical. "Since we have not up to this point been able to measure the human energy field that surrounds the body, there are a lot of naysayers around this technique," says Taylor-Carlile. She notes that humans have always had brain waves, but scientists only discovered how to measure brain waves relatively recently.
"I am a practitioner and have been using therapeutic touch for a number of years, so I know that it works. I know that it induces the relaxation response," says Taylor-Carlile.