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Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting

Journal of Holistic Nursing Volume: 35 issue: 1, pages: 97-107 (2017)

Joel G. Anderson, PhD, CHTP, University of Virginia
Mary Ann Friesen, PhD, RN, CPHQ, Inova Health System
Diane Swengros, MSN, RN, BC, Anna Herbst, MSN, RN, Inova Learning Network
Lucrezia Mangione, MA, NCC, LCPC, CMT, CHTP, CHTI, Handcrafted Health

Abstract

Acute care nursing is currently undergoing unprecedented change, with health systems becoming more open to nonpharmacological approaches to patient care. Healing Touch (HT) may be a valuable intervention for acute care patients. Research has shown that HT helps both the patient and the caregiver; however, no study to date has examined the impact that the education of nurses in and their use of HT have on daily care delivery in the acute care setting. The purpose of the current qualitative study was to examine the use of HT by registered nurses in the acute care setting during their delivery of patient care, as well as the impact of education in and use of HT on the nurses themselves. Five themes were identified: (1) use of HT techniques, processes, and sequence; (2) outcomes related to HT; (3) integration of HT into acute care nursing practice; (4) perceptions of HT, from skepticism to openness; and (5) transformation through HT. Education in HT and delivery of this modality by nurses in the acute care setting provide nurses with a transformative tool to improve patient outcomes.

Free full text:
http://journals.sagepub.com/doi/full/10.1177/0898010116644834

Excerpts:

"Acute care nursing is currently undergoing unprecedented change in the method of care delivery. Public report cards and value-based purchasing are driving new, patient-centered processes aimed at improving efficiency, safety, and the patient experience (Long, 2012). Health systems are becoming more open to exploring innovative and creative solutions to fulfill these aims, including nonpharmacological approaches to patient care. Healing Touch (HT), an integrative biofield therapy, may be a valuable nonpharmacological, noninvasive intervention for acute care patients who are particularly vulnerable to adverse reactions and complications. Biofield therapies have the additional benefit of encouraging providers to practice self-care, and nurses who use such mind–body practices report benefits, including improved spiritual well-being, serenity, calmness, compassion, and sleep (Kemper et al., 2011).

"Healing Touch involves a conscious, intentional process of having the practitioner use his or her hands to influence the energy fields and centers of the human energy system to promote self-healing. Janet Mentgen, a registered nurse and founder of the HT curriculum (Eschiti, 2007), blended traditional and contemporary healing practices (Umbreit, 2000) and used intentional presence to balance 'dynamic energy systems' (Thomas, Stephenson, Swanson, Jesse, & Brown, 2013). Students of HT learn processes that cultivate intentional presence, including mindful concepts of centering and grounding (Hover-Kramer, 2002) to achieve a meditative state. Formal HT training began as a nursing continuing education program in the 1980s and has since evolved into a certification program (Wardell & Weymouth, 2004) that is endorsed by the American Holistic Nurses Association. Healing Touch is supported theoretically by Jean Watson’s human caring theory, which describes transpersonal nursing that promotes healing of self and others built on intentionality and caring healing consciousness. Watson (2012) describes a connectedness creating a unique relationship that promotes healing using dynamic energy within both the patient and the nurse. The human spirit is at the center of what Watson describes as authentic, mindful practice.

"Research has shown that HT helps both the patient and the caregiver (Anderson & Taylor, 2011) by significantly decreasing respiratory rate, blood pressure, pain, mood disturbances, and fatigue (Post-White et al., 2003); increasing overall function, emotional role function, and mental health function (Cook, Guerrerio, & Slater, 2004); as well as decreasing mean length of stay and mean anxiety scores (MacIntyre et al., 2008)."

"A major theme identified during the analysis was the use of specific HT techniques and processes, including the basic HT sequence (Hover-Kramer, 2002), by the RNs in their delivery of care, as well as providing HT to coworkers and for self-care. Nurses described the frequency of their use of HT in the acute care setting, with many stating that they 'use it every day' with patients. The techniques used most frequently by the nurses are described in Table 2."

"Table 2. Most Commonly Used Healing Touch Techniques and Indications for Use (Hover-Kramer, 2002)

"Healing Touch Technique - Description - Indications for Use

"Magnetic Passes (including Hands in Motion and Hands Still) - In Hands in Motion, the practitioner moves his or her hands in a sweeping motion through the field to clear imbalances.  In Hands Still, the practitioner places his or her hands on or slightly above
the affected area. - Clears density, promotes energy flow, and balances the biofield

"Magnetic Clearing - The practitioner passes his or her hands slowly across the body from just above the top of the head, down the body, and off the feet. Ten passes each are made down each side of the body and down the midline, for a total of 30 passes. -
Clears congestion, toxicity, and/or emotional debris from the biofield

"Chakra Connection - The practitioner places his or her hands on the minor chakras of the joints and the major chakras along the midline to connect these in sequence from the feet to the head. - Promotes balance of the biofield and major energy centers

"Pain Management Techniques (including Pain Drain, Ultrasound, and Laser) - In Pain Drain, the practitioner places one hand on the affected area and the other hand off the body. In Ultrasound, the practitioner brings together the fingers of one hand and
passes the fingers in continuous, slow movements over the affected area.
In Laser, the practitioner places one or two fingers on or slightly above the
affected area. - Treats acute or chronic pain or inflammation"

"The basic HT sequence is based on standard nursing practice and involves a series of specific steps, including intake, pre-intervention assessment, preparation of the practitioner, providing the HT intervention, post-intervention assessment, and follow-up (Hover-Kramer, 2002)."

"Frequently, the nurses spoke of doing a 'quick assessment' of a patient’s biofield before and after providing HT, using descriptors such as temperature changes (warmth, coolness), disruption of the field (vacant, hole, spike, bulge), and/or movement (wave, tingling, dense, flowing), as in the following example:

"When I did my assessment, I could sense heat around the affected area, I used Laser and Ultrasound [HT techniques] around the affected site and finished with Magnetic Clearing. The patient became immediately relaxed, and his breathing pattern changed. He was asleep at the end of the session and resting comfortably. . . . The heat I sensed around his head was decreased; however, [it was] still present."

"A unique aspect of the exemplars from the nurses in the present study is the modifications (or abbreviating) of HT sequences and techniques. A full HT sequence as outlined in the curriculum and as delivered by a certified practitioner can take up to 1 hour. The modifications made by the nurses evolved as they continued to use HT in the acute care setting. This addressed the time barrier (Anderson et al., 2015), which nurses may fear would prevent them from being able to offer or perform HT during daily patient care delivery. In a previous study, nurses trained in Reiki did not frequently incorporate the therapy into their practice because of time constraints, conflicting responsibilities, and uncertainty over the value of Reiki and their own levels of expertise (Hahn, Reilly, & Buchanan, 2014). Additionally, there is a natural melding of nursing science and biofield therapies given the inherent caring and healing nature of both.

"In the present study, the nurses consciously matched specific techniques to individual patient issues to enhance healing and maximize patient well-being, particularly when other allopathic interventions were exhausted or ineffective. This exemplifies a holistic approach to patient care."

"The participants in the present study reported observing positive outcomes in their patients, such as enhanced pain management, sleep promotion, and decreased agitation and anxiety, which is congruent with the results from several previous studies involving integrative therapies (Kemper, Mo, & Khayat, 2015). The use of HT was perceived to provide a good return on investment as the nurses shared their sense of increased efficiency as their patients’ needs were better met.

"Another outcome repeatedly reported was the establishment of a sense of calm in oneself, which then spread to create a similar environment of calm in the unit. Similar programs involving the use of biofield therapies have been embraced by hospital leadership and recognized as valuable components of the caring and healing environment (Hahn et al., 2014)."

"Education in HT provides a structured way for nurses to use self to bring about positive changes for themselves, their colleagues, and their patients. HT education, by virtue of its holistic approach, supports transformational learning. Nurses on the HT journey are, in a sense, led toward a reflective, mindful process that fosters self-compassion."

"Given that the Affordable Care Act includes restructured reimbursement criteria for delivery of health care services, including complementary and integrative medicine, the trends observed over the past 10 years of hospitals adding and increasing the availability of these services is expected to continue (Vitale, 2014). With growing consumer and health care provider demand for integrative medicine services (Rand, 2011), hospitals that strive to deliver a holistic, caring, and healing environment will be interested in innovative programs. Findings from the current study shed light on methods for the adoption and implementation of HT in nursing education and hold promise for improvement of patient-centered care, evolution of the nursing profession, and advancement of patient-centered health care organizations in incorporating integrative therapies."



Comments: as usual, there is no mention of any controversy about healing touch, and the fact that the medical and scientific communities reject it as pseudoscience.  It is unfortunate that the University of Virginia is involved in this nonsense.