Heather Cochran, RN, and Tyrell Lewis-Jones, a patient care technician, teach their mock patient, Carrie Marvill, MSN, RN, AOCNS, about the program
If you’re a fan of health and wellness blogs and magazines, you may have noticed that over the last few years, complementary therapies have become just as ubiquitous as exercise and nutrition tips. From testimonials about crystal healing, to recipes for herbal balms and teas, alternatives for standard treatments have experienced a surge in popularity – both among the public and in the healthcare field. While some approaches fall in the realm of pseudoscience, others like aromatherapy have made their way into hospitals as legitimate pain and anxiety management methods, including at Pennsylvania Hospital.
Aromatherapy is thought to work by stimulating the smell receptors in the nose, which then send messages through the nervous system to the limbic system, the emotion center of the brain. Whether inhaled or applied to the skin, aromatic essential oils have earned a reputation for reducing stress, soothing soreness, improving sleep quality, and more. When Bonita Ball, MSN RN, NE-BC, CCRN-K, began considering how to improve patient satisfaction and pain management at PAH, integrative therapies, and particularly aromatherapy, immediately came to mind. Under the direction of the Nursing Executive Board and the Pain Resource Nurse Committee, Ball developed a quality improvement program centered on combining both conventional and complementary approaches on 7 Scheidt.
Though the terms “alternative” or “complementary” medicine can prompt some leery reactions, when Ball introduced her program idea, she had “100 percent buy-in from everyone on the team, which was key.” She reached out to Susan Kristiniak, DHA, MSN, the health system’s associate director of Palliative Care who spearheaded HUP’s aromatherapy program, and together, they developed a two-hour, competency-based education program.
“I’m excited to say that all of our Hematology/Oncology employees have been trained,” Ball said. “The main barrier to integrative therapies is a lack of knowledge, so after the two-hour training with Susan, there is also a level of in-house training.”
The pilot program is initially geared toward Hematology/Oncology patients receiving chemotherapy. Starting with one of the most vulnerable patient populations offers the opportunity to measure the effectiveness of aromatherapy as a complementary therapy that can help ameliorate some of the unpleasant effects of conventional cancer treatments. Three essential oils were chosen for their relevance: lavender, which can soothe anxiety and promote relaxation, and ginger and peppermint, both of which can settle nausea.
Before offering the lip-balm sized “sniffers” to a patient, a nurse first needs to assess them for any allergies, sensitivities, or cardiac issues that could cause complications, as well as carefully go through the informational brochure with them. If the patient is cleared, they receive their sniffers in a small bag they can keep by their bedside and take home with them between treatments. The sniffers are easy to use without supervision, but patients are encouraged to utilize them in front of staff so the effects of the program can continue to be monitored and recorded.
At a recent Service Directors meeting, Ball and Lauren Ellis, MSN, RN, CEN, noted that during the trial period, 98 Hematology/Oncology patients met the requirements, and 66 eligible patients ultimately took part. Of the participants, 50 patients – 75 percent – experienced a noticeable sense of relief from nausea and/or anxiety after using the sniffers, while the remaining 16 reported that they felt no difference. None experienced a negative reaction.
The program also includes another feature: a lavender hand massage. One patient in particular has been thrilled with both programs, noting that the sniffers provide immediate relief, and because the smell of the lavender hand lotion does not fade for a while, she continuously feels a sense of relief as she eats or touches her face throughout the day. For her, the only improvement would be if the massage extended to her feet and back!
“I practice yoga regularly, and as someone with an understanding of pressure points, the hand massage is so helpful,” she said. “I could feel the relief wash from those spots all the way down to my legs, and the smell sticks around. It feels like the days move more quickly when I use the aromatherapy.”
These early successes have sparked Ball to propose the expansion of the program to additional patient groups, including new mothers and those with sickle cell anemia. As more data is collected and more staff and patients are exposed to complementary therapies, Ball hopes that a holistic healing process becomes a staple of care at Penn Medicine.
“Healing is all-inclusive. As nurses, we say that we take care of the whole patient – body, mind, and spirit. This is essential with our unit’s patient population because they’re often dealing with a terminal illness or devastating news,” Ball said. “But it’s important for all patients throughout Pennsy and the health system that their care providers split their focus on the emotional and spiritual parts of healing, in addition to the physical. The ultimate goal of these integrative therapies is to supplement their treatment and give a better overall experience.”
Read more about PAH’s new aromatherapy program on the Penn Medicine News Blog.