MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

In a recent Editorial, I wrote: “Complementary and alternative medicine (CAM) is popular, and many nurses seem to be embracing it in the hope of helping their patients…But despite its popularity, CAM has remained a highly controversial area: the evidence-base is often unconvincing or non-existent. For most forms of CAM, we thus know too little to claim with confidence that they generate more good than harm. In the interest of our patients, it might, therefore, be wise to exercise caution and be aware of some of the fallacies which can easily mislead us.”

Yet, my calls for caution seem to fall on nurses’ deaf ears. This is at least what a new article on this subject implies.

This paper investigated how frequently nurses include CAM in their clinical practice. In so doing, its authors investigated nurses’ knowledge of and attitudes towards CAM as well as their ability to communicate the risks and benefits of these therapies with patients. For this purpose, a review was conducted in five stages: (1) identification of research question(s), (2) locate studies, (3) selection of studies, (4) charting of data, and (5) collating, summarising, and reporting of results.

Fifteen papers met the inclusion criteria for the review, among which 53·7% referenced how frequently nurses include CAM in their practice. The researchers found that 66·4% of nurses had positive attitudes towards CAM; however, 77·4% did not possess a comprehensive understanding of the associated risks and benefits. In addition, nearly half of the respondents (47·3-67·7%) reported feeling uncomfortable discussing CAM therapies with their patients.

The authors concluded that the lack of knowledge about complementary and alternative medicine among nurses is a cause for concern, particularly in light of its widespread application. Findings from this study suggest that health care professionals need to promote evidence informed decision-making in complementary and alternative medicine practice and be knowledgeable enough to discuss complementary and alternative medicine therapies. Without involvement of complementary and alternative medicine communication on the part of our profession, we may put our patients at risk of uninformed and without medical guidance.

I think I understand why many nurses feel attracted by CAM; if nothing else, it offers the opportunity to exercise compassion and empathy in patient care – and these are qualities that are often badly needed in routine practice. But it would be important (not just for nurses but for all health care professionals) to realise that compassion is best when it is paired with evidence-based care and effective treatments rather than with quackery and unproven therapies.

3 Responses to Many nurses employ alternative medicine but few understand it

  • They are primarily attracted to CAM because they believe that it may compensate for the deficits of non-CAM treatments, just like how some doctors, patients and medical researchers feel. This has less to do with compassion than personal perspective on the best way to manage incurable diseases.

    • “personal perspective on the best way to manage incurable diseases”
      That’s possibly pitching it a bit strong, as to me that’s a roundabout way of saying “arrogance” and I doubt that’s the real problem in the majority of cases.

  • Frustrating in my Uni we try and promote “evidence-based care and effective treatments” but if we suggest CAM and TCM are not effective we will be accused of disrespect and sanctioned for misconduct. Makes it difficult!

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