Pulse
The Healing Touch
Today’s emergency patients want more than just acute care. Fortunately for them, two Twin Cities hospitals are listening.
David Hale, M.D., Ph.D., was nearly at wit’s end when a woman suffering from migraines showed up yet again in the emergency department at Woodwinds Hospital in Woodbury. The woman had become an ER regular, and Hale, the hospital’s emergency department site director, was running out of options. “She kept getting pain medication, and she would leave groggy and then return the next day or a few days after with the same pain,” he recalls. “We were just not reaching this patient, and it made me feel a little helpless.”
Then Hale remembered how acupuncture had helped him cope with low-back pain three years ago—and how some of his colleagues in other departments were using aromatherapy and other complementary and alternative medicine (CAM) modalities to relieve patients’ discomfort. Last year, Hale arranged for the woman to receive healing touch, a form of therapy that uses light touch to energize and relax the patient.
The treatment worked, and the woman markedly reduced her visits to the emergency department. The experience prompted Hale to change his approach to care. Within weeks of watching the woman benefit from healing touch, Hale began routinely incorporating CAM in the Woodwinds emergency department. No one knows exactly how many emergency departments are using CAM therapies, but one thing is for certain: Patients are asking for it. According to the National Center for Complementary and Alternative Medicine, 36 percent of adults in the United States are using some form of CAM. Interestingly, patients who have been hospitalized in the last year are among the heaviest users of these therapies nationwide.
“The quest to adopt [CAM] is consumer-driven,” says Lori Knutson, R.N, director of the Institute for Health and Healing at Abbott Northwestern Hospital in Minneapolis, which offers CAM in its emergency department. “They are very savvy about what is available to them beyond conventional medicine.” However, it’s up to providers to know when these therapies are appropriate. Hale is quick to point out that CAM should never be used as a replacement for acute care. “Patients are asking for it, sure, but we are not going to avoid acute care of a femur fracture, for example. It’s not all or nothing. It’s part of the overall care we provide.”
Knutson agrees. “When a patient arrives in the ER, it tends to be for an acute condition, so that person is obviously going to receive more immediate medical attention for the injuries and illnesses that are life-threatening.” She says CAM providers are typically called in to help manage pain, anxiety, and nausea and vomiting.
In those situations, CAM has been effective. Hale and his emergency department colleagues have successfully used guided imagery, music therapy, and aromatherapy to manage low-back pain and pain from acute injury. For pain associated with hip and femur fractures, acupuncture has proved invaluable. And healing touch has worked well for patients with chronic back pain, headaches, and fibromyalgia.
According to one study conducted by Woodwinds staff, 75 percent of surgical patients who used healing therapies (for example, healing touch and aromatherapy) experienced some reduction in pain, nausea, and stress; 25 percent noted significant decreases.
Critics contend that using CAM in the emergency room slows down operations. Hale couldn’t disagree more. “If someone has a dislocated shoulder, for example, I can work with that patient using guided imagery and music therapy and have that shoulder relocated faster than a nurse can get IV pain medication in,” he says.
The biggest advocates of CAM in the emergency department are those who have benefited from it, including the woman who was suffering from migraines—and racking up large emergency room bills. Shortly after receiving healing touch, Hale says, she began taking courses at Woodwinds to learn how to use it to manage her pain on her own.
Hale acknowledges that some physicians say they need evidence-based data demonstrating the effectiveness of CAM therapies before they’re willing to incorporate them into their practices. Others contend that positive outcomes are purely a placebo effect. “Maybe it is,” Hale says. “But does it really matter? Patients are feeling better. They walk out on their own. They tell us that they were able to function normally and go about their day without being too sleepy. They can concentrate. They can work. They are happy. Ultimately, in my mind, that’s what’s important.” —J. Mettner