Task: Complementary and Alternative Medicine Discussion

Sample 1 Running head: REIKI IN THE NURSING PROFESSION 1 2 According to The International Center for Reiki Training, Reiki is “a Japanese technique for stress reduction and relaxation that also promotes healing”. I began my exploration of Reiki in hopes of determining the potential benefits to patients with certain illnesses or chronic conditions, and the possibility of incorporating Reiki in my nursing practice to improve patient outcomes. While the benefits to patients appear to be many, what really stood out to me was the benefit to the nurse/Reiki practitioner in terms of increasing his or her capacity for caring, compassion, and healing, as well as reducing the burnout that is commonly associated with the nursing profession. This paper will look at the history and practice of Reiki, its relation to nursing care theories, and nursing implications associated with the integration of Reiki and nursing practice. Reiki means Universal Energy or Life Force. There is some conflict between Eastern and Western versions as to the history of Reiki. The prevalent Western version indicates that Reiki was initially practiced by Tibetan Buddhist monks over 2500 years ago, and that the practice was rediscovered by Japanese physician, Dr. Mikao Usui, in the late 1800s. Dr. Usui is said to have healed many people, including himself, using Reiki therapy. Prior to his death, Dr. Usui passed the “keys of Reiki” (a term he used to describe the activation and channeling of the healing life energy) to another Japanese physician, Dr. Churgiro Hayashi. Dr. Hayashi used Reiki in combination with his medical practice in Tokyo, and subsequently initiated Madame Hawayo Takata into Reiki (Whelan & Wishnia, 2003). Madame Takata lived in Hawaii, and was of Japanese descent. She traveled to Japan in 1935, seeking treatment for her failing health. A physician directed her to Dr. Hayashi’s clinic, where she was treated and gradually healed with Reiki. She was subsequently initiated into First and Second Degree Reiki, and returned to Hawaii where she began her own practice. A few 3 years later, Dr. Hayashi visited Madame Takata in Hawaii, and initiated her as a Reiki Master. By the time of her death in 1980, Madame Takata had trained and initiated 22 Reiki masters. Not only was Madame Takata the first woman and non-Japanese citizen to obtain this level of Reiki, but she is credited with bringing Reiki to the Western world (Whelan & Wishnia, 2003). Reiki therapy came to the United States mainland in the early 1970s (Potter, 2003). The Eastern version of Reiki history indicates that Dr. Usui founded the Usui Healing Method Society in Tokyo. Dr. Usui was the first president. Today many versions of Reiki are practiced around the world (Whelan & Wishnia, 2003). The International Center for Reiki Training states that Reiki is a “spiritually guided life force energy”, administered by a trained practitioner who channels the energy to the client. The practice of Reiki is based on the idea that disease results from an imbalance or a blockage of the universal life energy, and Reiki practitioners act as “conduits” for this healing energy by placing their hands over specific areas, energy centers, of the body (Whelan & Wishnia, 2003). Task: Complementary and Alternative Medicine Discussion

This facilitates self-healing by releasing the blockage of energy. Reiki practitioners go through three levels (degrees) of training. In the First Degree, beginners learn the history of Reiki and basic instruction regarding hand positions. They receive attunements (spiritual rituals) from a Reiki master, which activate their practice at this level. In the Second Degree, additional attunements are received, including the capacity to practice distant Reiki. The Third Degree, or Master level, prepares the practitioner to teach Reiki. This training lasts approximately one year, with the practitioner working as an apprentice with a Reiki Master (Whelan & Wishnia, 2003). Modern Reiki practitioners include the study of the chakras in relation to the energy lines, called meridians. The chakras, or “spinning energy centers”, are the points at which the 4 meridians intersect. They act as a wheel, distributing energy throughout the body (Whelan & Wishnia, 2003). There are seven chakras – the root chakra, the navel chakra, the solar plexus chakra, the heart chakra, the throat chakra, the third eye chakra, and the crown chakra – each influencing different body functions. The hand positions used by Reiki practitioners cover all of the major chakras (“Reiki treatment,” 2009). Reiki therapy is administered by a practitioner laying his/her hands over specific areas of the body. The client is typically clothed. Reiki treatments can be administered to a few specific body positions, but it is traditional to give a whole treatment, which covers all of the body positions and lasts about one hour. Western Reiki practitioners commonly use a set of 12 body positions. Reiki is usually very relaxing and beneficial to both the client and the practitioner (“Reiki treatment,” 2009). Reiki is used to facilitate relaxation and pain relief, and promotes health by stimulating the body’s natural ability to heal itself (Barnett, 2009). Reiki and Therapeutic Touch (TT) are often compared to one another as being similar in practice, but there are some important distinctions in the underlying philosophies and the way practitioners are trained, according to an article by Pamela Potter (2003). Potter describes how Reiki is passed from master to student through attunement, whereas TT is a technique learned from an experienced practitioner. In addition, she describes the intention of Reiki as allowing the flow of energy by releasing blockage, whereas TT directs the flow. In her article, Potter states her belief that self-Reiki is important in preparing practitioners to administer Reiki to others. Through her own practice of Reiki, Potter indicates that the quality of her “ability to assess and treat people…became less directive, more intuitive, and more like prayer”. A review of the website “ClinicalTrials.gov” reveals six clinical trials of Reiki therapy that were recently completed in the areas of stress, prostate cancer, chemotherapy-induced 5 peripheral neuropathy, fibromyalgia, AIDS, painful neuropathy, and cardiovascular risk factors, as well as one ongoing study of Reiki as part of an individualized intervention for patients with colorectal cancer. A wealth of articles was also found relating to the self-care of nurses and other healthcare providers through the use of mind-body and energy therapies, such as Reiki. Task: Complementary and Alternative Medicine Discussion

The following articles address the concepts of burnout and compassion fatigue among healthcare professionals, and the nursing implications associated with addressing these concerns. Burnout is an issue that is frequently discussed in the healthcare profession. DiazRodriguez et al. (2011) describe burnout as “a work-related mental health impairment comprising three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment”. The authors report nurses are at increased risk for burnout due to the highstress demands of their profession, and indicate that burnout is usually associated with a decrease in job performance, increase in stress-related health problems, and ultimately lower patient satisfaction with the care received by those nurses. Results of their study of 21 healthcare professionals suggest that “Reiki shifts the autonomic balance toward parasympathetic predominance”, demonstrated by improved cardiac balance following a single Reiki session. This indicates that healthcare professionals experiencing burnout may benefit from Reiki through the promotion of relaxation and resulting decrease in sympathetic activity. A pilot study by Angela Brathovde (2006), a nurse at Monmouth Medical Center in New Jersey, explored whether First Degree Reiki therapy, taught as part of a self-care practice, would help nurses to “reconnect with the sense of compassionate caring, and…strengthen their own energy reserves, which they might have lost through burnout and compassion fatigue”. Brathovde describes compassion fatigue as “caring for others without caring for oneself”, and discusses how this phenomenon is common to the nursing profession. The framework of her 6 study is based on nursing theorist Jean Watson’s Caring Theory. Watson’s nursing practice involved the philosophy and science of caring, and describes caring as an interpersonal process, with the nurse responsible for helping people to understand the interrelationship between health, illness, and human behavior (Potter & Perry, 2009). Exemplifying Watson’s philosophy of transpersonal caring, Brathovde beautifully states: It is difficult to compassionately care for others if unable to care for oneself. The practice of Reiki allows for the ability of the practitioner to provide compassionate, healing touch to themselves or others, to be fully present in that caring moment, and to participate in establishing a caring, satisfying work setting. (p. 97) Brathovde’s study involved 12 nurses and healthcare providers, who were introduced to Reiki as a self-care practice through a 1 ½ -hour educational presentation. Task: Complementary and Alternative Medicine Discussion

Three months later, surveys and semi-structured interviews were conducted with the participants, from which four themes emerged: spirituality – participants noted feelings of connection, and a reminder that we are not dominant and superior; increased self-care and caring behaviors – making a point of doing little things for themselves, such as watching the sunrise, eating healthier, and being more attentive to their own self-care; healing presence – feeling more mindful when touching, or “touching with intention”; and increased personal awareness – making lifestyle changes, awareness of how learning Reiki has changed their perception of their clinical practice, and a desire to further their holistic education. In her article Reconnecting to Nursing through Reiki, author Glenda Watson Natale talks about how today’s nurses are challenged by the “stressors of a complex and demanding healthcare system that can lead to compassion fatigue and burnout”. Over time, chronic stress and fatigue affect the immune response, promoting alterations between homeostasis and 7 exhaustion. These effects are characterized by increases in blood pressure and cortisol levels, and a decrease in peripheral skin temperature. Natale discusses a 2002 study from the University of Houston (as cited in Engebretson & Wardell, 2002), which collected both qualitative and quantitative information from recipients of a 30-minute Reiki session. The participants reported feelings of safety and calmness, and an increase in mental clarity; and quantitative data demonstrated positive results related to blood pressure, skin temperature, and immunoglobulin levels. Natale also references Provision 5 of the Code of Ethics of the American Nurses Association, which states, “The nurse owes the same duties to self as to others” (as cited in ANA, 2010). She states that Reiki is a valuable tool for integrating a higher level of awareness, empowerment, and acceptance in dealing with the challenges and stressors associated with nursing. Whelan and Wishnia (2003) explored the perceived benefits of nurse/Reiki practitioners, both on their patients and on themselves as providers. This phenomenological study collected information regarding the lived experiences through narrative interviews with eight nurse/Reiki Masters. In addition to perceived benefits of the patient – improved healing process, relaxation and calmness, and pain reduction – there were a couple of themes described by the practitioners that exemplified the beneficial effects of utilizing Reiki in the nursing profession. First, 75% of the participants reported increased satisfaction in their role as nurse/Reiki practitioners compared to their previous nursing work. Specific comments included appreciation of increased time spent with patients; ability to offer “sacred, beneficial, effective, and non-invasive treatment”; decreased stress; increased tuition and insight; and less burnout. Another theme involved the perceived advantage of being a nurse in conjunction with being a Reiki practitioner, with 87.5% of participants answering this question in the affirmative. Responses included knowledge of 8 anatomy and physiology on the part of the nurs e; the caring mindset of the nursing profession; and the increased credibility that comes with being a nurse. Task: Complementary and Alternative Medicine Discussion

Unfortunately, it seems that the opposite may also be true, as demonstrated by the perceived disadvantage of being a nurse/Reiki practitioner. 37.5% of participants reported a perceived credibility issue of Reiki with the nursing profession. Whelan and Wishnia discuss that despite the fact that Reiki has been practiced for centuries, it is still relatively unknown to Western medicine, leading to skepticism on the part of health professionals. However, there is a need for complementary and alternative treatment options in order to address the diverse needs of our population, and Reiki has the ability to work synergistically with conventional medicine to improve patient health and outcomes. In 2007, Raingruber and Robinson studied the effectiveness of a self-care program involving Tai Chi, yoga, meditation, and Reiki healing sessions in promoting health and enhancing the problem solving abilities of registered nurses at the University of California Davis Medical Center in Sacramento, CA. These self-care options were offered to all nurses at the facility, with sessions offered various days and times. Nurses were free to choose the self-care option that fit their interest and their schedule, but were asked to select just one self-care class to attend. In addition to weekly class attendance, nurses were asked to complete self-care journals, reflecting on several questions each week. Thirty-five nurses participated in the study. The intervention lasted for 3 months, at which time nurses were asked to return the anonymous reflection journals. Compliance with the self-care classes was high, with no nurse missing more than one session. Results included noticing sensations of warmth, and a tingly sensation in hands and feet, which the nurses described as being relaxing. The authors note that burnout is associated with a “lack of access to bodily energies, resources and sensations”. The calming 9 effects of the interventions may allow one to cushion them from the exhaustion often associated with burnout. Increased problem solving abilities were reported by the nurses, specifically the ability to recognize solutions to problems more quickly. The nurses attributed this to being calmer and more focused, and generally feeling more grounded. Participants also described a sense of relaxation in their personal lives, allowing them more space to notice subtle cues from their patients. Nurses “consistently described feeling more positive about their work” following their participation in the self-care classes. The authors of the study indicate that self-care programs have beneficial effects in promoting healthy behaviors and attitudes of nurses and improving patient care, and may prove profitable to hospitals and other health-care organizations. Given the nature of our healthcare system, the high acuity of hospitalized patients, and the complexity of current nursing practice today, it is improbable that we will achieve decreases in the nursing workload or stress levels in the near future. Task: Complementary and Alternative Medicine Discussion

What we can do is strengthen the ability of nurses to cope with these demands. While there is no one-size-fits-all program for stress management, it is clear that self-care is a crucial aspect to the health and well-being of our nursing workforce, which in turn benefits a nurse’s ability to care for and heal patients. I believe that Reiki is just one of many complementary and alternative modalities that can be effectively integrated with conventional Western medicine to improve the quality and outcomes of patient care; and Reiki has the added potential to improve the health, vitality, and healing capacity of the nurses administering that care. As a nursing student, I am excited about the possibility of incorporating Reiki into my practice, and plan to pursue Level 1 training. As the current President of the Monmouth Student Nurses Association, I am interested in introducing my fellow nursing cohorts to the practice of Reiki as well. 10 References American Nurses Association. (2010, November 15). Code of ethics for nurses with interpretive statements. American Nurses Association. Retrieved July 23, 2012, from Task: Complementary and Alternative Medicine Discussion http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNur ses/Code-of-Ethics.pdf Barnett, L. (2009). What is Reiki? Reiki Master Libby Barnett, MSW, Reiki Training and Therapy in New Hampshire and New England. Retrieved July 18, 2012, from http://www.reikienergy.com/ Brathovde, A. (2006). A Pilot Study: Reiki for self-care of nurses and healthcare providers. Holistic Nursing Practice, 20(2), 95-101. Díaz-Rodríguez, L., Arroyo-Morales, M., Fernández-de-las-Peñas, C., García-Lafuente, F., García-Royo, C., & Tomás-Rojas, I. (2011). Immediate Effects of Reiki on Heart Rate Variability, Cortisol Levels, and Body Temperature in Health Care Professionals With Burnout. Biological Research for Nursing, 13(4), 376-382. doi:10.1177/1099800410389166 Engebretson, J., & Wardell, D. (2002). Experience of a Reiki session. Alternative Therapies in Health and Medicine, 8(2), 48-53. Natale, G. (2010). Reconnecting to Nursing Through Reiki. Creative Nursing, 16(4), 171-176. doi:10.1891/1078-4535.16.4.171 Potter, P. (2003). What Are the Distinctions Between Reiki and Therapeutic Touch?. Clinical Journal of Oncology Nursing, 7(1), 1-3. Potter, P. A., & Perry, A. G. (2009). Theoretical Foundations of Nursing Practice. In Fundamentals of Nursing (7th ed., pp. 49-51). St. Louis, MO: Mosby Elsevier. 11 Raingruber, B., & Robinson, C. (2007). The effectiveness of Tai Chi, Yoga, meditation, and Reiki healing sessions in promoting health and enhancing problem solving abilities of registered nurses. Issues in Mental Health Nursing, 28(10), 1141-1155. doi:10.1080/01612840701581255 Reiki treatment for mind, body and spirit. (n.d.). Reiki.nu. Retrieved July 18, 2012, from http://www.reiki.nu/ The International Center for Reiki Training. (n.d.). The International Center for Reiki Training. Retrieved July 18, 2012, from http://www.reiki.org/ U.S. National Institutes of Health. (n.d.). ClinicalTrials.gov. ClinicalTrials.gov. Retrieved July 18, 2012, from http://www.clinicaltrials.gov/ Whelan, K. M., & Wishnia, G. S. (2003). Reiki Therapy: The benefits to a nurse/Reiki practitioner. Holistic Nursing Practice, 17(4), 209-217. 12 Sample 2 Complementary and Alternative Medicine: Pregnancy 13 2 For many women, pregnancy is a time of excitement and anticipation in preparation for a new chapter in life. Task: Complementary and Alternative Medicine Discussion

While this may be very exciting, many concerns can arise in the minds of mothers as they become more conscious of what is being put into their bodies. From allergies to insomnia, pregnant women suffer as many ailments as the general population. The main concern to treat these types of conditions is that many medications are unsafe for a pregnant woman and growing fetus. At this point, many pregnant women turn to complementary and alternative medicine (CAM). Women are the largest demographic of CAM users, due to the advice of therapists (especially midwives) and positive experiences with CAM prior to pregnancy (Kalder, 2011). These types of practices have been proven to be very helpful to many pregnant women, are usually easily accessible, come in a variety of treatments, and are generally very safe to practice. CAM t … Task: Complementary and Alternative Medicine Discussion