Regional Use of Complementary and Alternative Therapies by Critical Care Nurses

Abstract

Critical care settings are unique environments having high-tech equipment with numeric displays and alarms, medically complex high-acuity patients, and worried, hovering family members. Critical care units are staffed by nurses and frequented by the numerous diverse members of the healthcare teams. The frequent intrusions for consultation and intervention, the lights, noise, and disruption and pressures of multiple time-sensitive protocols and emergency events may be overstimulating to patients and nurses alike. The stress experienced as a result may over time take a toll on the health of the staff and professionals routinely exposed to intensive critical care environments. Stress may have particular adverse psychologic and physiologic effects on nurses who are assigned 8to 12-hour shifts on the unit with the responsibility to care for patients who are desperately ill. Indeed, although the presence of stress in ICU settings has been noted and decried in healthcare literature for nearly as long as they have existed, well over three decades [1,2], recent literature attests to its persistence to the present day [3–5]. Understaffing may be stressful to critical care nurses and was found to be among the leading reasons given by nurses as a cause to leave nursing [6]. In light of the current nursing shortage, stress will continue to be a part of critical care practice settings for the foreseeable future. That there is a need for methods to deal with psychologic and physiologic stress is undeniable. Nurse use of complementary and alternative therapies (CAT) is one approach taken to counter the untoward effects of stress. CAT has been the topic of increased public interest and use in recent years [7–11]. The use of CAT in healthcare and for the care of hospitalized patients is also receiving increasing attention [12,13]. CAT may be generally defined as the use of nonallopathic remedies that typically fall outside of those used within the scope of traditional healthcare practices; however, many CAT are well accepted nursing interventions [14]. Although CAT is used for a wide variety of reasons and indications, one of its known uses is to combat or alleviate the effects of stress. Numerous CAT may be used for the purpose of self-care [15]. CAT has the potential for managing job-related stress and its adverse psychologic and physiologic effects on nurses in critical care. Furthermore, the personal use of CAT by nurses may increase the use of these therapies for patients in professional practice. This article summarizes the literature documenting the stress of the critical care environment and the use of CAT by the public and by nurses. The personal use of CAT and correlates of personal use by critical care nurses from a national survey of members of the American Association of Critical-Care Nurses (AACN) are described, and implications for research and practice are presented.