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Integrative Nursing Newsletter Archives

 

BMC Integrative Nursing Newsletter

Winter 2018 Issue

Table of Contents


Stories that Heal

AnxietyBy Donna Karo, RN, 7N NP

Last summer, I was fortunate to care for a homeless woman who suffered with anxiety, depression and bipolar disease. This patient, in a previous life had been a successful business woman and scholar, who understood the damage her lifestyle was having on her body. Her heart rate and blood pressure were elevated consistently and her anxiety was out of control. Several medication adjustments had been made but her vital signs remained difficult to manage.

As her discharge date approached, her anxiety elevated. She asked if she could remain in the hospital a little while longer and expressed concern regarding the difficulty in remaining compliant with her medications while homeless.  

I explained that extending her hospital stay, due to anxiety, was not an option. But as an adjunct to conventional treatments, there were other effective remedies which were natural and holistic, treating not just the symptoms, but the underlying causes.  

We began to use basic relaxation techniques. My patient agreed to use the ‘relaxation station’ on our in-house televisions to assist her in reaching a deep state of relaxation. Her vital signs were checked before and after each session and after two days of this therapy she admitted that she felt more relaxed than she had in years. She spent ten minutes taking slow deep breaths with eyes closed, listening to the station. Her vital signs showed a marked improvement with her systolic BP decreasing from 160’s to low 140’s.  

This patient used her own inner ability to help manage the symptoms of her anxiety. As clinicians, it important for us as nurses to address patients’ mental health needs by offering them non-pharmacologic interventions and educating them about how to use them for self-care. 

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Practicing Gratitude

By Carol Conley RN, DNP, NEA-BC, CENP, Nursing Director of Campus Integration

I Am Grateful HeartThese are rather extraordinary times at BMC. Amidst much change, it is more important than ever to care for yourself. One way to do this is to actively "practice gratitude". Research has shown that when people take the time to intentionally reflect upon things they are thankful for, they actually experience "more positive emotions, feel more alive, sleep better, express more kindness and compassion and even have stronger immune systems" (Carpenter, Happify, 2018). There are many ways to "practice" gratitude. One idea that has gained popularity is to start a "gratitude jar" (check it out on Pinterest!).  

Any time you experience a moment of gratitude, write it on a piece of paper and put it in your jar. My daughter began doing this last year and at the end of the year she emptied her jar and was able to remember, again, all the things that she had reflected upon in the prior year. She then began a new jar for 2018. Another idea is to keep a gratitude journal or write a letter to someone for whom you are thankful. 

People who practice gratitude regularly will say that they record small moments as well as larger, more meaningful ones. So, instead of writing, "I appreciate my husband", mix it up a bit by thinking of specific act such as, "my husband cleared the snow off my car and warmed it up for me." Showing appreciation for colleagues during the work day is another way to show gratitude and make others know how much you appreciate big and small gestures. You will see that one of the new BMC screensavers is "Show kindness". 

As nurses, we have the opportunity to positively impact others in profound ways at the times they are most vulnerable. Surely this is one thing we can all be grateful for. Incorporating gratitude into your daily routine and your life is one small way you can proactively manage the chaos and uncertainty around you. I encourage you to give it a try!

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Get Ready for BMC's 8th Annual Integrative Nursing Conference: Nourish the Heart, Rejuvenate the Soul

By Charlotte Cuneo, MSN, RN, CCAP

The Integrative Nursing Council has been working diligently to plan the 8th Annual Integrative Nursing Conference: Nourish the Heart, Rejuvenate the Soul which will take place on May 11, 2018 at Lombardo’s in Randolph, Massachusetts. It is taking shape to be what we hope will be a beneficial and enjoyable day for all nurses who attend.

Register for BMC's 8th Annual Integrative Nursing Conference: Nourish the Heart, Rejuvenate the SoulOur keynote Billy Rosa, MS, AGPCNP-BC, ACHPN, AHN-BC, CCRN-CMC is a dynamic speaker with a diverse nursing background. He was a staff nurse, then became a nurse practitioner, a nurse educator and is currently enrolled in a nursing PhD program.  He will speak on two topics:  1) Compassion in a Time of Change: Spirituality in Action and 2) Universal Compassion: From Self to Planet. Mr. Rosa presents a unique perspective, drawing on his diverse roles in nursing practice. He recently co-authored a book titled “A Handbook for Caring Science” with Jean Watson, scheduled to be released this summer. His vision was to create an encyclopedia type resource for caring science practitioners and students. Several BMC nurses and I heard Billy Rosa speak last year at the Second International Integrative Nursing Conference and he was inspiring. In fact, Jean Watson stood at the end of his presentation raised her glass in a toast, and announced “Billy, you are our future!”

The concept of "Heartmath" and its use to manage stress will be presented by expert instructors, Teresa M. Buchanan, MBA, RN and Patricia M. Reilly, MSN, RN. Ms. Buchanan states that "HearthMath is a resiliency program which participants are taught practical tools, strategies and practices that strengthen resiliency, improve decision-making, and increase well-being, mental clarity and emotional stability." 

Expert health coach Nina Manolson, MA, NBCHWC will discuss "Shifting Into Body-Love: Learn the Body-Love Map."  Nina works with clients to "create peace within oneself, so you can live in a body you love, and have more energy to live the life you truly want."

In the morning and afternoon, we will have two 10 minute 'movement' sessions led by BMC’s own nurses: Lisa Furdon, RN, RYT and Nneka Nwokeji, BSN, RN. Ms. Furdon will lead a gentle seated/standing yoga and Ms. Nwokeji will lead a Nigerian dance!

In addition to informative presentations, there will be educational and merchandise vendors, AND raffle prizes! 

This conference will "nourish" your mind, body and spirit. We hope you will be able to join us this spring, as part of our Nurses’ Week celebration. The conference is sponsored by the Anna Ross Committee of the Massachusetts Memorial Hospital Nurses’ Alumnae, Inc. and the Boston Medical Center Nursing Department.

Register early at bucme.org/integrativenursing (You will be asked to create an account and then you will register immediately after that is completed.)

References:
https://www.heartmath.org/support/faqs/heartmath-system-faqs/

http://ninamanolson.com

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The Basics of Meditation

By Marilyn Vachon, RN, 6 West Menino Pavilion

The mind is wild, it constantly thinks – that’s its job. Life is full of ups and downs, excitement and failure, anxiety and happiness. That’s just part of life. Meditation helps us to be more open to whatever life throws at us. It allows the mind to feel the emotions attached to all those ups and downs, without letting them control our minds.

We never know what the next moment will bring, so enjoy the one you’re in now. We all want to be comfortable, pain-free, and without worry or fear. When we feel unwanted emotions, we want to push them down and avoid them. We feed them by letting them control us and they continue to grow. We may feed them with eating, shopping, smoking, drinking, exercising too much, watching TV... just to feel better. These are temporary fixes.

MeditationSo let’s learn to meditate. Start where you are. Try to sit at the same time each day. Dedicate a small space for yourself. Commit to at least 10 minutes. It does get easier. You may actually like it. You can even do it waiting for an appointment, on the bus, train, or even in an Uber.

Sit up tall so that you feel lifted with your heart open. Sit cross-legged on a comfortable cushion or chair, with your hands resting comfortably on your lap. Use a timer. 

Breathe in to your heart center. Feel your breath enter every part of your body. Tell yourself “Breathing in, I know I am breathing in,” “Breathing out, I know I am breathing out.” Allow your breath to keep your mind still.

Stabilize your mind. Just let the thoughts come. But don’t let them carry you away. When you find yourself thinking too much just say “thinking” and come back to your breath. During meditation, we don’t need to label our thoughts as “good” or “bad.” Be kind and gentle with your mind.

Keep coming back. The more we practice the easier it becomes. You will be able to return to the breath throughout your day when those strong emotions surface
 
Meditation helps us to be more awake to our lives each and every moment just as it is. We learn to relax with the unpredictable “what ifs”. We stop reacting when things don’t go the way we wanted them to. We learn to see these occurrences as opportunities for spiritual growth. It won’t make life’s challenges disappear, it just helps us pass through them a lot easier in a more open and loving way. 

“Be intimate with your emotions and they no longer control your life,” says Pema Chodron. “They will always be there, you will just be in control of your reactions to them.”

“Meditation helps us to intercept the fixation we have with our emotions in a non-aggressive, gentle, friendly way and invite loving kindness for ourselves and others.”

References:
Chodron, Pema.  How to Meditate.  Sounds True, Inc., Boulder, CO, 2013.

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Integrative Council Highlights: What are we up to?

 

 

  • The 8th Annual Integrative Nursing Conference:  Nourish the Heart, Rejuvenate the Soul will be held at Lombardo’s in Randolph on May 11, 2018.  There will be educational and merchandise vendors as well as raffles so please come prepared!  Please register to gain knowledge and RELAX at the same time….
     
  • Update on Aromatherapy Nurse Tank Project:  Progress is being made on authoring a first draft of a policy and procedure for aromatherapy at BMC.  Stay tuned for more information.
     
  • Reiki Classes:  Reiki is an ancient, hands on healing practice. Illness or disease results from a disruption in the body’s energy. Reiki supports the individual's energy to become balanced and receptive to healing. Working on calendar for future classes.  

    Reiki Refresher is rescheduled for March 13, Tuesday, 9:00 a.m. - 1:00 p.m. Contact Christine at [email protected] if you are interested in attending. If you are a Reiki Master Teacher please contact [email protected] if you are interested in helping teach the classes.
     
  • Information about the Quarterly Integrative Nursing Newsletter, including How to Access, Print and Submit Articles:
    The Newsletter is published quarterly in the following months:  February, May, August, and November.  

    Submissions to the Newsletter are welcome!  Do you have a patient story about how you cared for someone, addressing their needs, mind-body-spirit? Do you have any unit-based projects about holistic/integrative nursing?  Please contact [email protected] to get more information about how to submit an article.  This is a newsletter for nurses, authored by nurses!

    The Newsletter is sent to all BMC Nurses; you may also access the newsletter by following these steps:
    1. Go to the BMC Intranet webpage
    2. Go the Departments tab and click on the Nursing Department
    3. Look on the left hand side of the page for the section labeled:  ‘Shared Governance/Councils’ and click on the “Integrative Nursing” label
    4. Click on the ‘Newsletters’ section
    5. Select the newsletter you are interested in reading.

    To Print the Newsletter:
    1. Click on the URL link underneath the main header of the newsletter.  This bring you to the newsletter in its entirety.  
    2. Go to “File” tab in upper left hand corner and
    3. Select “print” In the drop down box.  Then click on “print” within that box and your newsletter will be printed.

  • Are you interested in joining the Integrative Nursing Council?
    Not all nursing units are currently represented on the council yet!  Membership responsibilities include:

    * Attending a monthly 3 hour paid time meeting on the first Thursday of the month from 7:30 a.m. - 10:30 a.m. (NO meetings in July and August)
    * Communicating council activities to the nursing staff on your unit
    * Bringing your staff’s concerns, ideas and suggestions to the council about integrative care for self and patient.

    Talk to your manager to find out if your unit is represented on the council. If so, find your unit rep, get council information and give them feedback. If you do not have a unit representative, ask to become your unit's integrative nursing council rep!

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Upcoming Events

Educational Programs:

  • Supporting Nurse Resiliency in the Workplace, Part I, 7:00 a.m. - 3:30 p.m.
    Dates: March 19, April 18, May 21, June 13

    Boston Medical Center grants 6.25 nursing contact hours to nurses who complete this program. You must stay for the entire program, participate in the activity, and complete this evaluation form. This program has no commercial support. Faculty and planners have no vested interests, and there are no conflicts of interest. There will be no discussion of off label uses of drugs. Boston Medical Center is an approved provider of continuing nursing education by American Nurses Association, Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Calendar​​​​​Please sign up in Healthstream.  Directions on how to register: 

1. Log into Healthstream
2. Click on "Catalog"
3. In the search bar, type "Nurse Resiliency"
4. Click on "Info"
5. Click "Choose Class"
6. Click on "Register" for the date you want

If you have problems with this process, please contact Lisa Falanga or Iris Bonet for assistance.

  • Supporting Nurse Resiliency Part II, Times and Dates to be announced. Actively determining content, time frame, etc. for Part II.

  • Reiki Refresher, March 13 9:00 a.m. - 1:00 p.m. Email [email protected] for more information.

  • Future Reiki Classes, time TBA.

  • The 8th BMC Annual Integrative Nursing Conference, May 11, 2018, Lombardo's, Randolph, Massachusetts.

    Join like-minded colleagues to network and explore the concept of compassion - for ourselves, others and our planet.  Keynote:   Billy Rosa, MS, AGPCNP-BC, ACHPN, AHN-BC, CCRN-CMC: Nurse, Nurse Practitioner, Educator, Author

    The application to award contact hours has been submitted to ANA Massachusetts. ANA Massachusetts is accredited as an approver of nursing continuing education by the American Nurses Credentialing Center’s Commission on Accreditation.

    This conference is supported by the Anna Ross Committee of the Massachusetts Memorial Hospital Nurses’ Alumnae, Inc. Faculty and planners have no vested interests, and there are no conflicts of interest. There will be no discussion of off label uses of drugs.

    Boston Medical Center is an approved provider of continuing nursing education by American Nurses Association, Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

    To register please go to:  http://bucme.org/integrativenursing

Self-Care Options in Moakley Building Basement:

  • Self CareYoga classes
    Tuesdays, 6:00 p.m. - 7:15 p.m. & Thursdays, 4:30 p.m. - 5:45 p.m.
    Instructor:  Betsy Simmons, MPH, RYT

  • Body/Mind Awareness Class for patients and staff
    Wednesdays, 4:00 p.m. - 6:00 p.m.
    Instructor: Bob David
    Call 617-638-7540 for more information

    The class offers a variety of exercises involving stretching, movement, music, meditation, and mindfulness techniques, with the aim of:  (1) increasing body awareness, flexibility, strength, coordination, and pain relief, and (2) dealing more effectively with thoughts and feelings that affect peace of mind and healing.  You may join at any point and attend whatever parts you like.  

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BMC TVRemember a Valuable Resource for Patients and Staff: The Guided Imagery Channel 74

Please remember that our guided imagery channel (channel 74 on BMC televisions) is available to patients and staff. The channel’s 30-minute guided imagery videos are narrated in English or Spanish and will help ease anxiety and stress, while promoting rest and sleep.

In addition to being available on the patient televisions, the guided imagery channel can be accessed on your computer at any time at BMC or at home. To access the Guided Imagery Channel, visit the Quick Links section on the Nursing Intranet website to access the site and get the BMC password.

Also, the C.A.R.E channel (channel 3 on patient televisions) features stunning nature imagery with soothing instrumental music and is also available via the website above.

Beginning on the Newton Pavilion, there will be signs posted in each patient room pointing out the availability of the C.A.R.E. and the Guided Imagery channels in the four most commonly used languages here at BMC: English, Spanish, Haitian Creole and Portuguese. Please point these resources out to your patients once they have been posted!

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Fall 2017 Issue

Table of Contents

 


Prepare for Surgery, Heal Faster

By Nicole Kramer, MSN, CNS, RN, CAPA, Menino PACU 

Peggy Huddleston’s mind-body technique helps one prepare for surgery by reducing anxiety before surgery. It has been documented that it helps patients use 23-50% less pain medication and heal faster.

The technique consists of learning and repeating affirmations before, during and after surgery, which send love and acceptance to the body and promotes relaxation and healing. In addition to self-affirmations, the patient must ask their surgical team to repeat these affirmations to them during surgery.

Huddleston’s book and CD is available for anyone wishing to use this mind-body technique. The CD is helpful for the patient to listen in the days prior to surgery.  

The steps in the process are as follows:

  • Step one shows you how to use visualization to turn your worries about surgery into positive healing imagery.
     
  • Step two is listening to Huddleston’s relaxation CD which contains affirmations.
     
  • Step three shows you how to ask friends and family to wrap you with their thoughts in a blanket of love.
     
  • Step four explains healing statements during surgery.
     
  • Step five teaches you how to request healing statements and your legal right to request them.

These mind-body techniques also help insomnia, headaches, chronic pain, immune system for cancer and autoimmune disease.

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Building Resilience:  Equanimity, Optimism and Perseverance

By Carol Conley RN, DNP, NEA-BC, CENP, Nursing Director of Campus Integration

Learning about the many components of integrative therapies and application of these practices in your personal life can actually help you to become more resilient. Resilience is simply defined as the ability to bounce back from difficulties. Some people are naturally more resilient than others but did you know you can actually improve your resilience by focusing on a few key areas?

The first of these is equanimity. This is the practice of self-control that is based on calmness which creates composure. Some people are just naturally calm while others have to intentionally build in practices which will help them to be calm.  This is where integrative therapies can be very useful. The practice of guided imagery, meditation or brief mindfulness activities can all be helpful in creating a feeling of calm. The use of essential oils such as lavender can have a calming effect. Just the practice of slowing down and deepening your breath can have a profound effect on your well-being. So, if you are not naturally calm, consider trying a few of these practices and see what might work for you. Actively paying attention to how you are feeling so that you take steps to avoid allowing your stress to escalate is important.

  • Get good at “body listening”, so you are the first to know when you are “losing it”.
  • Take steps to address H-A-L-T ( hungry, angry, lonely, tired)

The second trait of people who are highly resilient is optimism. Like equanimity, there are some people who naturally look at the world with a “rosy glow.” But if you are someone who views the glass as always half empty, here are some suggestions to improve your outlook:

  • Avoid negative people, you are shaped by those around you!
  • Practice gratitude: begin each day by considering something you are grateful for
  • Positive affirmation: pat yourself on the back regularly!
  • Expect regular failure so you are neither surprised nor undone by it!
  • Learn the art of reframing:  insoluble problems are just opportunities masquerading in disguise
  • Confront irrational expectations
    • Wanting a life free from problems and demands
    • Wanting everyone to like you
    • Expecting perfection
  • Cultivate friends and collegial support

The third quality of resilient people is perseverance. This is the ability to drive and move forward in adverse situations. By cultivating equanimity and optimism, you are creating the foundation which will enable you to persevere. It also takes courage, determination and energy. Through self-care practices, you can build your capacity to improve your resilience. The resiliency day offered here at BMC monthly is a great opportunity to learn more about self-care and those activities you can build into your routine to help develop and sustain the resiliency necessary for balance in the demanding work of patient care.

References
Fosnaugh, J., Geers, A. L., & Wellman, J. A. (2009). Giving off a rosy glow: The manipulation of an optimistic orientation. The Journal of Social Psychology, 149(3), 349-364.
Stagman-Tyrer, D. (2014). Resiliency and the nurse leader: The importance of equanimity, optimism, and perseverance. Nursing Management, 45(6), 46-50.

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Stories Heal

By Nicole Kramer, MSN, CNS, RN, CAPA, Menino PACU 

An example of using Reiki, an energy healing technique reviewed in a previous newsletter issue, and the Peggy Huddleston technique is as follows: A 26 year old female, preop for a resection of a renal mass on her kidney was very anxious. When I arrived, there was a request by anesthesia to administer Reiki in the hopes of calming her down. She was sobbing at the time and appeared overwhelmed. The patient also had prepared for surgery by learning and practicing Peggy Huddleston’s techniques. 

I explained to the patient who I was, what Reiki is and its benefits. I also reminded the patient to use Peggy Huddleston’s positive imagery and statements that she had done previously before surgery. The patient’s sister, who was with her, encouraged her to try Reiki and told her how much she was loved and supported, which is also part of Huddleston’s technique. The patient agreed, and I began Reiki treatment. The patient closed her eyes and took deep breaths. After five minutes, she sighed and began breathing slower. By the end of the fifteen minute treatment, the patient dosed off. The sister was at the bedside, amazed how her sister was calmer after the session. 

The anesthesiologist returned and was surprised that the patient was better. She was ready to administer sedation, but decided not to give it due to the patient’s relaxed state. I whispered in the patient’s ear that they were done with the Reiki treatment. She opened her eyes and giggled saying she felt calm. The anesthesiologist proceeded to place the IV and soon took the patient into the OR. Before leaving, the patient said thank you. Her sister went to the family waiting room and was also grateful.

 As per Huddleston’s protocol, the patient’s healing statements were repeated to her by the OR staff during surgery. Once the patient was out of surgery, she was in a more relaxed state, and therefore required less pain medication and time in the recovery room. 

References
http://healfaster.com/

Prepare for Surgery, Heal Faster | A Guide of Mind-Body Techniques.
Andrew T. Weil, MD, Author
Spontaneous Healing Director, Program in Integrative Medicine College of Medicine, University of Arizonahealfaster.com

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BMC Peer Connection Program Launches

By Carol Mostow, LICSW

What is Peer Connection?
Peer Connection is a Boston Medical Center program formed by clinicians to support their colleagues and other staff in the wake of stressful patient related events and is based on national models. To date, a multidisciplinary team of 61 members have been trained to provide emotional support and resources to colleagues coping with stressful patient related events.
 
When to get support?
The 2nd victim phenomenon describes what can happen to caregivers, especially when the first ‘victim,’ the patient, may experience an adverse event, not respond to our best efforts, or even when inevitably the complexity of illness and care is impacted due to imperfect systems and our own limitations. Even when our care is the best, there may be plenty of situations that are particularly challenging. For example, a patient may remind us of a family member, a child, and they may be angry or unhappy with us. It is essential for our own welfare, and that of our team, our family, and ultimately our patients as well, that we notice and get support for these challenges.  
 
Why bother getting support -- isn’t this just the price of being in healthcare?
All healthcare providers become accustomed to witnessing and handling more stress, suffering and tragedy than most others ever encounter. However, we too are merely mortal. It is documented in the literature that this kind of work takes a toll on us too, especially if we don’t pay attention to the impact it is having on us and others.
 
The good news is that all employees benefit when this kind of support is normalized. Sue Scott, RN from the University of Missouri demonstrates that such programs improve patient safety outcomes. When we have each other's back and are there for each other when times are hard, we feel more confident that we can turn to each other and get support to solve problems together. This in turn, helps us give better care and we feel better too!
  
How can we normalize support?
We need everybody to raise awareness about the benefits of peer support. We all can help bring about culture change and check in regarding emotional impacts of care giving as well. Please reach out whenever needed and encourage your colleagues to do so.
 
When an event impacts your entire team, consider whether a group debriefing from the working well clinician or social work might also be helpful. If a colleague or peer supporter reaches out to you because of a challenging event, this isn’t because you are weak, it’s because we look out for each other. Exceptional care for our patients requires exceptional support for each other.   
 
Do I have time for this?  
The average contact with a peer supporter is 1 -2 chats that are 20 minutes or less. Feeling better is worth it!
 
Who are the peer supporters and how do we find them?  
Feel free to contact any of the nurses, attendings or residents on the intranet peer supporter list.

The following are the trained peer supporters from Nursing:

  • Latonya Baker
  • Kate Baudin
  • Charlotte Cuneo
  • Janine Hardman
  • Liz LeBlanc
  • Pat Lyons
  • John Tocio
  • Bridgette Vento
  • Deborah Whalen
  • Patti Whynot

You may also contact the program at [email protected] or 617-638-7910 for assistance. During the week, calls will be answered within 24 hours. Urgent support and a full list of BMC mental health resources can be found on the intranet.
         
Finally, any peer supporter who learns about a stressful patient related event may reach out to staff who might be impacted just to check in. 
 
If you have questions, concerns or comments about this program, please contact the program office, a peer supporter, nursing champion Diane Hanley MS, RN-BC, EJD, or program champion Carol Mostow LICSW.
 
For more information go the BMC Nursing website and locate the graphic which links to the Peer Connection website: http://internal.bmc.org/peerconnection/

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Clinical Aromatherapy at BMC

By Charlotte Cuneo, MSN, RN, CCAP

AromatherapyDoctor.comHave you ever heard advice given to those who are trying to sell their homes and make them more appealing? For example, baking chocolate chip cookies usually makes a house enticing for those who like sweets. The smell of pine at Christmas time is also a sure sign of the season. These "smells" or aromas often may evoke emotions, positive and negative. In fact, Jane Buckle, PhD, RN, who is a noted authority on clinical aromatherapy, states: "Smell can have instant effect, working at the physical, psychological and molecular levels. Sometimes just thinking about a smell can be as powerful as the smell itself."
                           
What, then, is "aromatherapy"?  Per Buckle, aromatherapy is "...the use of essential oils for therapeutic or medical purposes." She states further that "...an essential oil is the distillate from an aromatic plant. They are found in flowers, leaves, bark, wood, roots, seed and peels of many plants. It is the chemistry of an essential oil that determines its therapeutic properties."

Essential oils (EOs) can be used therapeutically in a variety of ways: topically, internally and by inhalation. Nurses generally deal with the topical and inhalation method of administration. As with all integrative therapies, nurses must complete education and training in order to practice these techniques per the Massachusetts Nurses’ Advisory Ruling on Holistic Nursing and Complementary Integrative Health Approaches.

There is evidence to support that essential oils can help us in a variety of ways: alter mood, assist with stress management, combat infection, manage nausea and vomiting and/or irritable bowel symptoms, reduce pain and inflammation, assist with managing cough and respiratory conditions and manage skin conditions. 

One of the approved Nurse Tank projects was to bring aromatherapy to BMC for use with patients. We started with a two day educational program about Clinical Aromatherapy for Hospitals and the ‘M’ technique. Kathy Duffy, a nurse and instructor from Jane Buckle’s staff, shared her expertise on these topics with the group.

The attendees learned about clinical aromatherapy including the chemistry of EOs, techniques for use of EOs, safety, storage and disposal guidelines of/for EOs, policy and procedures, and how to safely use 6 essential oils. They also learned the skill of providing hand and arm, and leg and foot ‘M’ technique.  

The ‘M’ Technique is a registered method of gentle, structured touch originated by Jane Buckle. Each movement and sequence is done in a set pattern, at a set pressure and set speed, which never change. The 'M' technique works on skin receptor sites that send signals to the brain. Recipients have described it as nurturing, relaxing, and a stress reducer.

EOs suited to help your recipient’s concerns may be incorporated into the carrier oil applied when performing the ‘M’ technique. This has the potential to increase the technique’s positive effects.
The first step in implementing Clinical Aromatherapy at BMC is to establish a policy and procedure for use of essential oils here. Once this document has been written, submitted and approved, we will move forward with the use of clinical aromatherapy in targeted areas by nurses who have completed this training. Stay tuned to learn the progress of this Nurse Tank project!

References
Buckle, J. Clinical Aromatherapy, 2nd edition. Churchill Livingstone, 2003
http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing-practice/advisory-rulings/holistic-nursing-and-complementary-therapies.html
http://www.rjbuckle.com/m-technique.html
Limbic System of the Brain image/graphic sourced from: AromatherapyDoctor.com

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Integrative Council Highlights: What are We Up To?

  • Integrative Nursing Shines at Quality Day Poster Session on October 18
    Two posters were selected for display related to Integrative Nursing:

    1. Establishing an Integrative Nursing Council: The process, council work and benefits to nurses and patients.

    2. Supporting Nurse Resiliency in the Workplace:  A program for nurses designed to provide nurses with the tools to support coping and resiliency.
     
  • Save the Date!
    The 8th Annual BMC Integrative Nursing Conference will be on Friday, May 11, 2018 at Lombardo's, Randolph. We are currently researching speakers and vendors. Please talk to your representatives if you have ideas or suggestions!
     
  • Reiki Classes
    Reiki is an ancient, hands on healing practice. Illness or disease results from a disruption in the body’s energy. Reiki supports the individual's energy to become balanced and receptive to healing.

    November and December Reiki 1 classes currently full.  We are working the schedule for future classes. We are also working on an abbreviated Reiki refresher course of those certified in the past. Stay tuned for more information.

    If you are a Reiki Master Teacher, please contact [email protected] if you are interested in helping teach the classes.
  • Aromatherapy at BMC
    See article in this issue about Nurse Tank Aromatherapy education held in September.

 

Are you interested in Joining the Integrative Nursing Council?

Not all nursing units are currently represented on the council yet! 

Membership responsibilities include:

  • Attending a monthly 3 hour paid time meeting on the first Thursday of the month from 7:30 a.m. -10:30 a.m.
    (No meetings in July or August)
  • Communicating council activities to the nursing staff on your unit
  • Bringing the staff's concerns, ideas and suggestions to the council about integrative care for self and patient

From our newsletter you can see projects and initiatives we are working on. If you would like to join us please check with your manager to see if there is an opening to represent your unit on the council! Please contact [email protected] if you have any questions.

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Upcoming Events

Educational Programs:

  • Supporting Nurse Resiliency in the Workplace, Part I, 7:00 a.m. - 3:30 p.m.
    Dates: November 15, December 18. (Dates starting in January to be announced soon.)

    Boston Medical Center grants 6.25 nursing contact hours to nurses who complete this program. You must stay for the entire program, participate in the activity, and complete this evaluation form. This program has no commercial support. Faculty and planners have no vested interests, and there are no conflicts of interest. There will be no discussion of off label uses of drugs. Boston Medical Center is an approved provider of continuing nursing education by American Nurses Association, Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

​​​​​Please sign up in Healthstream.  Directions on how to register: 

1. Log into Healthstream
2. Click on "Catalog"
3. In the search bar, type "Nurse Resiliency"
4. Click on "Info"
5. Click "Choose Class"
6. Click on "Register" for the date you want

If you have problems with this process, please contact Lisa Falanga or Karen Proctor for assistance.

  • Supporting Nurse Resiliency Part II, Times and Dates to be announced.

  • 8th BMC Annual Integrative Nursing Conference, May 11, 2018, Lombardo's, Randolph, MA.
    Stay tuned for details.
     

Self-Care Options in Moakley Building Basement:

  • Yoga classes
    Tuesdays, 6:00 p.m. - 7:15 p.m. & Thursdays, 4:30 p.m. - 5:45 p.m.
    Instructor:  Betsy Simmons, MPH, RYT

  • Tai Chi/QiGong-Stretching and movement class for patients and staff
    Wednesdays, 4:00 p.m. - 5:00 p.m.
    Instructor:  Ramel Rones
    Call 617-638-7540 for more information

  • Mindfulness/Meditation for patients and staff
    Wednesdays, 5:00 p.m. - 6:00 p.m.
    Instructor: Bob David
    Call 617-638-7540 for more information

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Remember a Valuable Resource for Patients and Staff: The Guided Imagery Channel 74

Please remember that our guided imagery channel (channel 74 on BMC televisions) is available to patients and staff. The channel’s 30-minute guided imagery videos are narrated in English or Spanish and will help ease anxiety and stress, while promoting rest and sleep.

In addition to being available on the patient televisions, the guided imagery channel can be accessed on your computer at any time at BMC or at home. To access the Guided Imagery Channel, visit the Quick Links section on the Nursing Intranet website to access the site and get the BMC password.

Also, the C.A.R.E channel (channel 3 on patient televisions) features stunning nature imagery with soothing instrumental music and is also available via the website above.

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BMC Integrative Newsletter

Summer 2017 Issue

Table of Contents


Stories Heal

By Nneka Nwokej, RN, Float Pool

CloudsMr. Don, a homeless man with terminal illness, became tired of life. Has been refusing to participate in his plan of care. As I walked to his room--Are you Dr. Kevorkian, he asked? No, my name is Nneka, your nurse. "Get away from me, I need Dr. Kevorkian.” Silence in the room. I looked up and saw Oprah Winfrey's show was on-- Are you watching Oprah show?  Do you like it, I asked?

Get away from me- I need Dr. Kevorkian now!  After a while, he soberly said, I don't know anything anymore, If God is out there, I don't know. God, surely is out there and He knows exactly what you are passing through, I said.

This statement humbled him to the point that he allowed me to shave and give him a haircut for the first time since admission.  Before this time, nobody could touch him, he was very unkempt, his room was a mess and sometimes verbally abusive to staff.

After that statement "God, surely is out there and He knows exactly what you are passing through,'' his countenance changed and he became more humane, even allowed me to cut his hair, shave his beard and make his bed. He became lively for the period I was with him, thus I saw in him a man who is willing to fight for his dear life again.

The medical team and his family could not recognize him anymore. The family could not hide their appreciation by giving me a hug.

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From “Mind full” to “Mindful”

By Carol A. Conley, RN, DNP, CENP, NEA-BC, Nursing Director of Campus Integration

“Though outer events may be difficult, the key to your happiness lies in how your mind responds to them”  Barbara Ann Kipfer, author of Self meditation

Have you ever felt as though your work day is a series of relentless tasks?  It can be so easy to get caught up in the stress of the day!  One way to cope with stress and anxiety is to cultivate mindfulness.  Mindfulness is about being in touch with the present moment and being open to experiences as they come.

mmindfulHere are some simple tips for incorporating mindfulness:

  • Breathing
    Take a moment to breathe from your belly rather than your chest and try to breathe in through your nose and out through your mouth.  Just a few of these intentional breaths can have a calming effect and help you to stay grounded in the moment.
  • Center before you enter
    As you move from one patient encounter to the next, you will be stopping momentarily to use hand sanitizer. A helpful tip is that when you are cleansing your hands, think about stepping humbly through each doorway, open door, open mind.
  • Privileged presence
    Reflect on what got you here.  As nurses, we are privileged to be present with patients and families during many of the defining moments of their lives.  This can be viewed as a burden, but you can also choose to reflect on this as a gift.  You have the opportunity to share your caring and compassion in a way that will hold significant importance for those individuals with whom you interact.  Jean Watson, the nursing theorist who advanced the theory of human caring, talks about “transpersonal caring in which the one caring is fully present and embraces the spirit of another.”  Her research has shown that these moments provide benefit to the recipient and can be equal to the benefit to the care giver.  You should never underestimate the impact your caring can have to another, and back to you!
  • Gratitude
    Remind yourself of the things in your life you are grateful for—either make a mental list or write them down.  Reflecting on this list can be helpful when you are feeling stressed.
  • Affirmation
    Recall the moments when you have done good for others.  Remember how good it felt, and try to feel it as vividly as possible. Now, radiate these giving, kind, compassionate sensations towards yourself.
  • Appreciation
    You can reduce stress and positively impact your environment through regular acknowledgement of the inspirational things your peers do on a daily basis.  When you witness an inspirational act- take a moment to appreciate the value of our work as nurses and advance the culture of caring on your unit with a thank you.  Fostering a positive and supportive team environment can do wonders for reducing the overall stress level for everyone!

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Be In the Know

By Donna Karo, RN
  • chi gongPracticing 20 minutes of Chi Gong breathing exercises daily re-establishes natural biorhythms, harmonizes the nervous and endocrine systems, switches the autonomous nervous system from the stressful sympathetic to the restorative parasympathetic mode and infuses the entire body with oxygen enriched blood and invigorating vital energy. (Complete Book of Chinese Health Healing, Daniel Reid)
  • For women experiencing hot flashes limiting or avoiding caffeine, alcohol, spicy foods, sugary or salty foods, hot liquids and large meals may be helpful.  As well, avoid smoking which constricts blood vessels which can intensify or prolong a hot flash. (Healing with Homeopathy, Wayne B Jonas, MD & Jennifer Jacobs, MD, MPH)
  • The Chinese believe that mulberries cleanse and increase the production of blood cells. Mulberries also protect the cardiovascular system and detoxify the liver.(Guide to Alternative Health, Jane Brody, Denise Grady)
  • Artemisinin derived from the wormwood plant paired with iron killed 98 percent of breast cancer cells over 16 hours, in several studies! (Naturalnews.com)
  • Dandelion (Taraxacum officinale) -- In the 16th century, dandelion became a very versatile herb used in the removal of freckles and liver spots, fevers, contagious diseases, liver and stomach ailments and even the three-day malaria . (http://www.gallowglass.org/jadwiga/herbs/easterneuropeherbs.html)
  • The nutritious leaves of the Moringa oleifera tree are an excellent ingredient for making teas filled with potent antioxidants. Moringa leaves can be steeped in hot water for several minutes in a traditional tea-making process. The leaves release an abundance of nutrients and antioxidants into the hot water, creating a refreshing and flavorful tea, full of beneficial compounds that promote energy and wellness.  (Heather, 7North) (https://www.moringasource.com/pages/moringa-tea-benefits)

Note:  None of the above remedies are recommended without prior approval from a physician. 

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Supporting Nurse Resiliency in the Workplace featuring the Breathe, Move, Connect Program: A Workshop for ALL BMC Nurses

By Charlotte Cuneo, MSN, RN, CCAP

2017 Healthy NurseA famous quote by the American author, Charles R. Swindoll, “Life is 10 percent what happens to you, and 90 percent how you react to it,” supports the idea that building resilience can help us to improve the ways we manage stress on a daily basis. How you deal with a difficult situation and how you move forward determines your ‘resiliency,’ or how you bounce back.  Resiliency can be strengthened through practice and is a vital resource for all nurses.

As nurses, we are well aware of the stressors that exist in the medical setting.  These stressors, in addition to the constant state of flux in our BMC environment with upcoming structural and geographical changes, call upon our resiliency skills daily to stay afloat and thrive!  

In a timely fashion, the American Nurses’ Association (ANA), has declared 2017 the Year of the Healthy Nurse.  ANA defines a healthy nurse as “someone who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, personal and professional well-being. Nurses are ideally positioned to be the best role models, educators, and advocates for health, safety and wellness.”

A key part of the formula for health and resiliency is self-care.  The Supporting Nurse Resiliency Program, Part 1 provides the participant with the necessary knowledge and tools to identify their response to stressors and develop habits that promote resiliency.  Since it began in November 2016, 159 BMC nurses have attended this 8 hour program!  Attendance at the full day and completion of a program evaluation provides the nurse attendee with 6.25 contact hours.

With a variety of speakers, the topics presented include:

  • The Human Stress Response, Grounding Techniques-Beth Milaszewski
  • Compassion Fatigue-Carol Conley
  • Reflections on nursing, our values and how they influence our care-Nicole Lincoln
  • Self-Care: Its Importance; Resiliency Techniques-Charlotte Cuneo
  • Music and its Benefits-Moises Fernandez Via
  • Breath Module-Betsy Simmons
  • Move Module-Betsy Simmons
  • Make Plans/Choose a “Buddy”/Set Goals to Use Resiliency Tools-Charlotte Cuneo

Participants attend a ‘health fair’ which allows them to sample some holistic therapies and BMC resources which promote employee wellness.  Samplings often include massage machines, aromatherapy and ‘m’ technique (application of oils in a structured method of touch), pet therapy, music, and lunch is included for all.

ALL BMC nurses are encouraged to attend the BMC Nurse Resiliency program. Evaluations from nurses who have attended the program have been outstanding!! Word of mouth recommendations have kept this program full to capacity each month it is offered. Please take the time to login to Healthstream and sign-up for an upcoming date if you have not attended yet. You will NOT be disappointed!!  Dates for fall 2017 appear in this issue’s Upcoming Events column.  We feel fortunate that BMC leadership continues to support this fabulous program, and look forward to seeing you there!

As Chris Wilson, MSN, RN-BC, ANPD President observes “There is no single best way to manage stress, but it is imperative that we find healthy options that work for ourselves.”

http://www.anpd.org/blog/ana-year-of-the-healthy-nurse---april-2017-combating-stress
https://www.goodreads.com/author/quotes/5139.Charles_R_Swindoll
https://www.wsna.org/nursing-update/2017/ana-designates-2017-as-year-of-the-healthy-nurse

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Upcoming Events

Educational Programs:

  • Supporting Nurse Resiliency in the Workplace, Part I, 7-3:30p, Dates:  September 25, October 23, November 15. December 18. 

    Boston Medical Center grants 6.25 nursing contact hours to nurses who complete this program. You must stay for the entire program, participate in the activity, and complete this evaluation form. This program has no commercial support. Faculty and planners have no vested interests, and there are no conflicts of interest. There will be no discussion of off label uses of drugs. Boston Medical Center is an approved provider of continuing nursing education by American Nurses Association, Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Calendar​​​​​Please sign up in Healthstream.  Directions on how to register: 

1. Log into Healthstream
2. Click on “Catalog”
3. In search bar, type “Nurse Resiliency”
4. Click on “Info”
5. Click “Choose Class”
6. Click on “Register” for the date you want

If you have problems with this process, please contact Lisa Falanga or Karen Proctor for assistance.

  • Supporting Nurse Resiliency Part II, Times and Dates to be announced.

7th Annual Conference, New England Holistic Nursing: Enhancing Our Culture of Caring for Self, Patients, and Environment.  September 14, 15. Kennebunkport Me. http://www.anselm.edu/Documents/Holistic%20Brochure%202017-WEB-Rev(0).pdf

Self-Care Options in Moakley Building Basement:

  • Yoga classes:  Tuesdays, 6-7:15pm & Thursdays, 4:30-5:45pm, Instructor:  Betsy Simmons, MPH, RYT

  • Wednesdays, 4-5p:  Tai Chi/QiGong-Stretching and movement class for patients and staff, Instructor:  Ramel Rones.  Call 617-638-7540 for more information

  • Wednesday, 5-6p:  Mindfulness/Meditation for patients and staff, Instructor: Bob David. Call 617-638-7540 for more information

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The Guided Imagery Channel is a Great Resource to Promote Relaxation for Patients AND Staff!

WavesPlease remember that our guided imagery channel (channel 74 on BMC televisions) is available to patients and staff. The channel’s 30-minute guided imagery videos are narrated in English or Spanish and will help ease anxiety and stress, while promoting rest and sleep.

In addition to being available on the patient televisions, the guided imagery channel can be accessed on your computer at any time at BMC or at home. To access the Guided Imagery Channel, visit the Quick Links section on the Nursing Intranet website. Further, the C.A.R.E channel (channel 3 on patient televisions) features stunning nature imagery with soothing instrumental music and is also available via the website above.

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BMC Integrative Nursing Newsletter

Spring 2017 Issue

Table of Contents


 


Stories Heal: The Healing Power of Nutmeg

By Marcia Merten, RN, IV teamNutmeg

In my role at BMC, I am exposed to many patients in a shift.  One recent experience stands out for me.

I was called to a patient bedside one evening.  As I entered the room, my attention immediately went to his face and head.  On his head from temple to temple was a large piece of tape.  What appeared to be a nut was neatly tucked under the tape on the top of his head.  Despite myself,  my eyes grew wide with childlike curiosity as I peered around his head and under the tape. He was aphasic and not able to communicate with me,  and I was left with my questions running around my imagination. I silently honored this ritual that I knew nothing about, performed my duties and left the room.

I came to find out that the family had placed a piece of nutmeg on his head because of its healing properties and the belief that it would help heal his condition.

I was humbled to be witness, and hold the space for another person, their cultures and belief system.  I also was reminded of something very important. Using traditional medicine practices, integrative and holistic modalities, prayer and belief systems, we all hold the power to activate our own bodies  healing process , and that can look very different from person to person.

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Humble Notes on Integrative Care

By Nneka Nwokej, RN, Float Pool Footsteps in sand

 I:    Inspiration - when a patient or someone looks at us and says.....because of you, "I did not give up, I feel better today or you are my angel.”
 
N:   “Never ignore a person that loves you because one day you might wake up from your sleep and realize that you lost the moon while counting the stars...”  Anonymous
 
T:   "Tears and prayers too, they travel to God when we can't speak."  Psalm 56:8
 
E:   Enjoy the free nature of sunlight, smile at yourself, have time to smell flowers
 
G:   God is faithful, Amazing, Awesome and first of all. God is Love.
 
R:   “Remember, let your smile change the world, but don't let the world change your smile…”  Unknown
 
A:   "A flower does not think of competing with the flower next to it, it just blooms...”  Unknown
 
T:   “Try not to promise when you are happy, don't reply when you are angry and don't decide when you're sad.” Unknown.
 
I:    “If someone doesn't appreciate your presence make them appreciate your absence...” Unknown
 
V:   Victory is easy with team work.
 
E:    Encourage each other when we feel down.
 
C:   “Cast all your fear and anxiety on Him because He care for you...”  1st Peter 5:7
 
A:   “Always seek God's will in all that you do and He will direct your path…”  Proverb 3:6
 
R:   “Respect people who find time for you in their busy schedule...But love people who never look at their schedule when you need them.”  Unknown
 
E:    Exceptional care without exception!

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Be In the Know: Introduction to Reiki Therapy

By Nicole L. Kramer, MSN, CNS, RN, CAPA, Menino PACU 

Reiki Therapy

Reiki is a vibrational, healing energy technique most commonly facilitated by light contact which is believed to stabilize the biofield and support the body’s ability to heal itself. The Reiki practitioner gently places his/her hands on or above the person allowing Reiki energy to flow though a universal energy all around and within us. The body soaks up Reiki energy like a plant absorbs water. 2  

Practitioners and patients often feel a sensation when Reiki is given. Reiki means “universal life energy” in Japanese. The therapy was developed in Japan from a technique described in 3000-year-old Tibetan scripture. Reiki is passed on from masters to students though a laying of hands called an attunement. This process opens a recipient’s channels to facilitate the flow of Reiki for treating oneself and others. 7

Reiki energy encourages one to let go of all tension, anxiety, fear or other negative feelings. Some people drift off to sleep, have visions or other mystical experiences. At the end of a treatment, one feels refreshed, with a more positive, balanced outlook.

Reiki therapy, in conjunction with music, has the potential to reduce anxiety, alleviate pain, increase relaxation, and improve patient satisfaction. 6 Reiki helps patients become more relaxed and allow healing to begin. “Complementary therapies like Reiki, an energy field therapy, have been reported to decrease anxiety and promote relaxation; thus, easing distress and facilitating health and feelings of well-being. Reiki complements conventional medical treatment”. 5

References:
 
1. Mansour, A., Beuche, M., Laing, G., Leis, A.,& Nurse, J.(1999). A Study to test the Effectiveness of Placebo Reiki Standardization Procedures Developed for a Planned Reiki Efficacy Study. The Journal of Alternative and Complementary Medicine Vol. 5 No. 2 153-164.
 
2. Miles, P. & Gala, T. (2003). Reiki-Review of a biofield therapy: History, theory, practice and research. Alternative Therapies Vol. 9, No. 2, pp 62-72.
 
3. http://nccam.nih.gov/news/camstats/2007 date accessed 4/15/17
 
4. Olsen, K., Hanson, J., & Michaud, M. (2003). A Phase II trial of Reiki for the Management of Pain in Advanced Cancer Patients. Journal of Pain and Symptom Management Vol. 26, No. 5, 990-997
 
5. Potter, P. ( 2007). Breast biopsy and distress: Feasibility of testing a Reiki Intervention. Journal of Holistic Nursing (25:4) 238-248.
 
6. Richards, T., Johnson, J., Sparks., A. & Emerson, H. (2007).The effect of music therapy on patients’ perception and manifestation of pain, anxiety, and patient satisfaction. Med Surg Nursing, Vol. 16 (1), pp 7-15. 
 
7. Vitale, A. (2006).The use of selected energy touch modalities as supportive nursing interventions Are we there yet? Holist Nurs Pract; 20 (4) pp 191-196.

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Charlotte's Web: The Roots of Integrative Nursing & Florence Nightingale

By Charlotte Cuneo, MSN, RN, CCAP

During the month of Nurses’ Week, it is fitting to review facts about Florence Nightingale, who, according to noted author and holistic nursing expert Barbara Dossey, is “like a fiery comet…(who) streaked across the skies of 19th century England and transformed the world with her passage.  She was a towering genius of both intellect and spirit and her legacy resonates today as forcefully as during her lifetime..”  She lived to be 90 years of age and contributed much to the nursing profession both scientifically and holistically.  Her writings and clinical observations are still relevant today.

Nurses’ Week is celebrated close to her date of birth.  In fact, the American Holistic Nurses’ Association (AHNA) encourages every nurse around the world to pause and observe a moment of silence on May 12 at noon, in celebration of Florence Nightingale (1820-1910), the founder of modern nursing.  For those of you who will be attending the BMC Integrative Nursing conference, we will pause at noon to honor our profession’s founder.Charlottes Web & Florence Nightengale

Born to a prominent family, Florence rebelled and did not become a socialite, but instead pursued a career in nursing, much to her family’s dismay.  She cared for wounded soldiers in the Crimean War and made many clinical observations about the need for cleanliness and fresh air to help the soldiers heal.

In 1854 during this war, Florence soon led a group of several dozen nurses to serve in British military hospitals in Constantinople. The following year, Nightingale came down with Crimean Fever. Florence Nightingale was called The Lady With the Lamp for her compassionate nursing of British soldiers, even during the night. "Nightingale transformed the poorly ventilated, vermin-infested Barrack Hospital in Scutari [,Turkey] into a clean, well-managed facility, and within six months the death rate fell from 40 to 2 percent."

Caring for the whole person, “mind-body-spirit,” is thought to have its roots in Florence Nightingale’s teachings and practices. In fact, the word ‘heal’ comes from the Greek word halos which means to ‘be or become whole’ or ‘restoring balance and harmony.’  She believed in “care that focused on unity, wellness, and the interrelationship of human beings, events and environment.”
 
"Florence Nightingale recognized the importance of caring for the whole person and encouraged interventions that enhanced individuals' abilities to draw upon their own healing powers. She considered touch, light, aromatics, empathetic listening, music, quiet reflection, and similar healing measures as essential ingredients to good nursing care."  Well before present day approaches to holistic care, Florence recognized the value of many of the integrative care therapies cited in the Massachusetts Nurse Practice Act Advisory Ruling 9801 on Holistic Nursing and Complementary/Alternative Therapies!
 
Pertinent to us locally, Linda Richards was an American nurse who was trained in Boston and eventually went to work with and learn from Florence in England.  In fact, Linda returned to the United States and became the first nurse to lead the Boston City Hospital Training School for nurses, using much of what she learned in England as the basis for the school’s curriculum. There is a bust of Florence Nightingale, and an account of Linda Richard's professional relationship with Florence in a corridor leading to the BU Medical School overlooking Vose Hall.

According to Wikipedia, “Nightingale was a prodigious and versatile writer. In her lifetime, much of her published work was concerned with her nursing knowledge.”  The Boston University Howard Gottlieb Archival Research Center has one of the largest collections of Florence Nightingale’s letters and has joined with several British establishments to digitize or convert Florence’s writings into computer-friendly material.   Replicas of Florence’s writings will be displayed at the May 12th BMC conference.

Florence’s “Notes on Nursing” was first published in England in 1859 and in America in 1860.  The full text of Florence's Notes on Nursing is hyperlinked below under References.  The book clearly establishes her vision of nursing as a genuine natural healing practice, concerned with preventative medicine,   As nurses, we owe Florence a debt of gratitude for guiding us to become the profession we are today!
 
References:
 
http://www.ahna.org/Home
 
American Nurses’ Association Scope and Standards of Practice, Holistic Nursing, 2nd edition., Silver Spring, Maryland,  2013.
 
Dossey, B.M. ( 2010). Florence Nightingale: Mystic, visionary healer (Commemorative Edition). Philadelphia, PA: F. A. Davis.
 
Dossey, B.M., Selanders, L.C., Beck, D.-M., & Attewell, A. ( 2005). Florence Nightingale today: Healing, leadership, global action. Silver Spring, MD: Nursebooks.org
 
http://hgar-srv3.bu.edu/web/florence-nightingale
 
http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing-practice/advisory-rulings/holistic-nursing-and-complementary-therapies.html
 
http://naturalhealthperspective.com/tutorials/notes-on-nursing.html
 
https://en.wikipedia.org/wiki/Florence_Nightingale

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Pearl's Pearls

By Pearl Cunningham, MBA, RN, BSN, CNOR, NEA-BCPearls

In 2010, the National Institutes of Health (NIH) defined pain as a significant public health problem.  Chronic pain is a biopsychosocial condition that effects over 100 million Americans. It continues to be the main reason people seek medical care in the country.  It is one of the leading causes of medical appointments, disability, extended hospital stays and re-admission after surgery.  Managing pain is complex for patients and health care providers.  Many struggle with helping patients manage pain effectively, particularly when dealing with the dual crises of pain and opioid dependence (Mackey, 2014).   

In January of 2017, The Joint Commission revised their 2001 standards pertaining to pain management.  Any strategy must be based on clinical guidelines that are evidence-based and customized, with minimal amount of risk.  The patient should be a full participant in the development and implementation of their treatment plan (The Joint Commission, 2017).   

The Integrative Nursing Council acts as a resource to nurses who provide integrative nursing practices in their clinical areas. We have been asked to convene a task force comprised of practice experts to recommend a comprehensive pain management strategy that is holistic, interprofessional, and multimodal in its approach.  An integrative approach can offer hope, and add safe, complementary and alternative medical therapies to help ease pain (Woodbury, 2016).

The task force will meet after the regular Integrative Nursing Council meeting on the first Thursday of the month.    If you have any questions about the task force, please contact Pearl Cunningham.

References:

The Joint Commission, (2017). Proposed Acute Pain Assessment and Management Standards Hospital Accreditation Program

Mackey, S. (2014). National pain strategy task force: The strategic plan for the IOM pain report: President's message. Pain Medicine, 15(7), 1070-1071. doi:10.1111/pme.12490
Woodbury, A., Soong, S. N., Fishman, D., & García, P. S. (2016). Complementary and    alternative medicine therapies for the anesthesiologist and pain practitioner: A narrative review. Canadian Journal of Anesthesia/Journal Canadien d'Anesthésie, 63(1), 69-85. doi:10.1007/s12630-015-0506-9

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Recent and Upcoming Events

  • Three BMC nurses represented us at the Second International Integrative Nursing Symposium in Tucson AZ: Charlotte Cuneo and Annie Massed presented a poster on the process for establishing our very own BMC integrative nursing council and its initial work and future goals. Nicole Lincoln presented a breakout session about a novel approach to advanced care planning.Calendar
  • Supporting Nurse Resiliency in the Workplace, featuring the Breathe, Move, Connect Program, Part 1. 7-3:30p, Dates: May 24, June 14. Please sign up in Healthstream. Dates for the fall beginning in September to be announced!
     
  • Supporting Nurse Resiliency Part II, May 18, 11a-3p; June 22, 10a-2p.  (must first attend Part I listed above)  Please contact Charlotte Cuneo to register. Dates will be announced for the fall.
     
  • 7th Annual Integrative Nursing Conference: Weaving Integrative Therapies into Our Tapestry of Caring.  Currently wait list for BMC Nurses. If you are registered and unable to attend please call (617) 638-4605 or email [email protected] in order to free up space for those on the waiting list.  Website:  http://bucme.org/live/2114
     
  • Yoga class with Lisa Furdon, RN-Dates and times to be announced.

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New Guided Imagery Channel Now Available for Patients and Staff!

Guided ImageryA new guided imagery channel (channel 74 on BMC televisions) is now available to patients and staff. The channel’s 30-minute guided imagery videos are narrated in English or Spanish and will help ease anxiety and stress, while promoting rest and sleep. Merriam Webster defines guided imagery as "any of various techniques (as a series of verbal suggestions) used to guide another person or oneself in imagining sensations and especially in visualizing an image in the mind to bring about a desired physical response (such as a reduction in stress, anxiety, or pain)."

In addition to being accessible on the patient televisions, the guided imagery channel can be accessed on your computer at any time. To access the Guided Imagery Channel, visit the Quick Links section on the Nursing Intranet website. Further, the C.A.R.E channel (channel 3 on patient televisions) features stunning nature imagery with soothing instrumental music and is also available via the website above.

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