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Role of CAM in nursing/midwifery practice

Table of Contents

Introduction. 3

Scope of practice. 4

Education. 5

Regulation. 7

Communication and collaboration. 11

Conclusion. 13

References. 13



Practice in nursing and midwifery discipline involves following the therapeutic approach and several interventions adopted by the people practicing in the “medical field.” Australian society is commonly known for the usage of a wide range of complementary therapies and alternative medicines (CAM) and in Australian society these needs to be valued by the people till time not making harm to society (Whorton, 2012). It means that CAM practice are different from traditional medical practice but proves beneficial for the society at large. Complementary and alternative medicines in the context of Australian health system are defined as the medical practices which are not a part of the Australian tradition for medical practice and not even integrated into the health care system maintained in Australia. But these medical practices are being followed looking into the benefits generated by complementary and alternative medicines. Alternate name given to CAM is natural medicine or holistic medicine as termed by World health organization.

Complementary therapy can be further explored as the intervention made through traditional methods complementing the care made by nurses. Complementary therapy used by nurses may also include massage, therapeutic touch, meditation, relaxation, yoga and aromatherapy but complementary therapy is not limited up to all these practices used by nurses. In the present context usage of CAM for practice of nursing and midwifery professionals would be explored in order to understand the overall scope of practice for the CAM, education regarding usage of CAM, regulations which are framed in Australian society for the usage of CAM and communication & collaboration required for the usage of CAM in medical field (Hilsden & Verhoef, 2010).

Scope of practice

It is important to understand the scope of practice for complementary and alternative medicine usage in Australian society as this would define application of CAM in different situations for medical practitioners. Nurses, midwifery and other health practioners having adequate level of professional knowledge and required certifications would be allowed to carry out CAM therapy for the treatment of patients. It has been identified that usage of the therapeutic methods such as orthodox as well as, traditional would increase overall health for human beings. Individuals in Australian society are said to possess the right to avail health services of their choice (Jordan&Delunas, 2011). It is important that nurses and midwifery practicing CAM should remain in touch with new developments in area of CAM so that any changes made in this area is in their knowledge as this would help them to make better implementation of CAM while making treatment. It is under the scope of practice for the licensed practical nurses (LPN) and registered nurses (RN) to implement complementary and alternative medical practices. Below are the set of conditions which needs to be fulfilled in order to practice CAM:

  • Nurses should practice the code of CAM as per the regulations set for the category of nurse i.e. whether LPN or RN.
  • A nursing assessment needs to be performed by nurses i.e. Registered nurses may perform the comprehensive or focused assessment while licensed practical nurses may perform the focused assessment, based on the diagnosis assessment diagnostic statement would be framed and a nursing plan suitable to the diagnostic statement would be adopted by nurses for the patient treatment. LPN may select the diagnostic plan through available resources and care plan may be developed for LPN. Both LPN and RN would be responsible in order to develop suitable documentation while applying CAM (Cassileth, 2009).
  • CAM can be practiced with consumer consent and it is to be make sure by nurses that patient is well informed about CAM
  • Nurses need to obtain necessary certification if needed for practicing CAM so that they posses all required technical skills


Education in the field of Complementary and alternative medicine demands adoption of written policies and protocols which needs to be maintained by the medical practitioners so that high level of standardization can be maintained in education for the nurses and midwives towards CAM. It is the prime duty of nurses and mid wives to obtain written consent of the patient undergoing alternative therapies, further patient should be imparted information regarding his health status and impact which alternative therapy can have on his health (Zollman& Vickers, 2013). It should be known by the nurses and midwives that CAM therapy in separate or mixture with the traditional technique can have a severe impact over the health of a person, and this contains high risk for the patient for which CAM has been applied. In order to apply CAM therapy for patient nurses or midwives in Australia should be having proper knowledge of Australian Nursing &Midwifery Council- code of professional conduct for nurses in 2003 and code of ethics for nurses in Australia 2002. This guideline needs to be followed by nurses in totality so as to ensure that there is no risk to the patient health due to unawareness among nurses and due to violence of standard code of practice for the patient treatment (Fitch et al, 2009,). Nurses and midwives are expected to initiate research in field of alternative therapy so that improvements can be made into alternative therapy field, and outcome based research can result into advanced level of findings for the medical practitioners in the alternative therapy discipline (Zollman & Vickers, 2013).

The major objective behind imparting CAM education among nurses and midwives is not to create experts in the area of CAM, and this is even outside the scope of the internal medicine field. The major objective behind imparting education related with CAM for nurses is to develop knowledge level among the medical practitioners so that effective communication can be established with the patients to develop suitable knowledge base among patients regarding CAM literacy (Cassileth& Chapman, 2010). Knowledge imparted by nurses to patient regarding CAM would help the patients to makeaninformed decision before their treatment. Fundamental goals of the CAM education would be to focus on the safety, benefits and potential risk which might bother patient health by implementation of alternative therapy (Cassileth & Chapman, 2010).

One of the major dilemmas faced by the medical practitioners is to decide whether or not to add alternative therapy to the curriculum of medical practice (Gray et al, 2008). In addition to this it is really difficult to add such vast amount of information to the field of medical curriculum. Further education in field of CAM is limited by the current sources of development and with the increasing interest of practitioners in field of CAM would enhance overall findings on the techniques and skill set required for the development of alternative therapy. Medical practitioner would make utilization of the current development in order to enhance their knowledge base and skill level (Hilsden & Verhoef, 2010)

Some of the basic educational strategies for CAM in nurses and midwives include adoption of conference with small group of people, providing field experience with the experienced CAM and didactic lectures (Gray et al, 2008). Along with this selected reading in the field of CAM would help the practitioner to gain more information and knowledge to enhance their skillset.


Regulations are the detailed policy which is adopted by the nurses and midwives for the usage of CAM in Australian society which can be given as under:

  • Documentation of policy: A written protocol should be available with the nurses and midwives while practicing the alternative therapy on patient. Documented policy for the implementation of CAM would result into much lower level of error for the midwives and nurses.
  • Prior patient consent: Midwives and nurses should ensure that application of alternative therapy should be done with the written consent of the patient and complete information should be provided to the patient so that informed decision making can be done by patients for the usage of alternative therapy.
  • Integrated patient care: Usage of the alternative therapies should be included in such a way that it becomes the part of total care for the patient (Fitch et al., 2009)
  • Documentation of medical procedure: Only having documentation for the usage of alternative therapy would not serve the purpose for implementation of suitable policy but it is also important that documentation of the medical procedure used while following the alternative therapy so that continuous improvement can be made in the procedure followed by nurses and midwives for the implementation of alternative therapy.
  • Focus on positive results: Medical practitioner in field of CAM should focus more on results for the therapy into positive direction. Midwives and nurses into medical practice should take care that practice which may result into adverse impact on the patient should be not being adopted frequently. For example alternative therapy such as Coffee enemas should not be used as this may have significant adverse impact on patients.
  • Adequate level of knowledge and skill: It is the responsibility of midwives and nurses to ensure that they have adequate level of education and knowledge in order to make use of the alternative therapy. With appropriate skill level with the nurses and midwives usage of alternative therapy in accordance with the framed guideline can be done.
  • Appropriate qualification: Midwives and nurses practicing in complementary and alternative therapy should accomplish qualification which is required in order to get well versed with the therapies. Further in case of any adverse situation while practicing alternative therapy midwives and nurses should refer the patient to the competent medical practitioner in case they does not possess the appropriate level of education and skill set (Streubert& Carpenter, 2011).

Patients making use of the alternative and complementary therapy should be able to accomplish certain guidelines so that it can be ensured that CAM does not make harmful impact on the patient health. In order to adopt the complementary and alternative therapy for the patient it is important to carry out the assessment for patient with three aspects i.e. culture, medical diagnosis and clinical setting. Culture and spiritual environment surrounding the patient needs to be assessed to find out whether or not CAM needs to be implemented on a particular patient. Patient’s medical or nursing diagnosis would help in order to assess the patient need for the diagnosis while clinical setting for the patient would provide detail of history regarding medical treatment given to the patient. Patient making decision to adopt CAM needs to be properly aware of the benefits, limitations and cost involved in the process of complementary and alternative medicine (Michaud, 2010). Based on the facts explained to patient informed decision making should be done for the patient which would allow patient to take responsibility of the chosen decision by themselves. Patient should know the difference while deciding between conventional medicine and CAM. Hence accordingly decision for the conventional or non conventional medicine should be adopted for the patients. Patient should be aware of the qualification received by medical practitioner such as nurses and midwives before adopting CAM

Regulations for midwives and nurses practicing CAM forms a vital part of the overall medical practice. Nurses and midwives should have required post registration specialized qualification which is essential in order to undertake CAM for the patients. The qualification obtained by the nurses and midwives should be approved and authorized by the professional body dealing with the related issues in this domain. Professional body should regulate all practitioners in CAM field so that there is high degree of standardization maintained between the medical practitioners (Coss et al, 2008). The usage of alternative therapy for the patient need to be evidence based and patient should be aware of the degree up to which remedies and test have been adopted in order to utilize CAM. Further degree of predictability and suitability for the adopted therapy towards safety and efficacy of the patient health needs to be informed to patient in advance. This would ensure that informed risk is taken by the nurses & midwives and even patient undergoing such treatment are aware of the risk. Usage of alternative therapy for nurses and midwives needs to be well supported by the policies and protocols as framed by the authority in related field. Protocols in field of CAM need to clearly mention several aspects so as to avoid future confusion.

Some of the major elements to be described in protocols and policy include qustion statement in order to clarfiy various aspects of CAM. Who can practice the alternative therapy in terms of the qualification, experience, training, skill level and competencies for the nurses and midwives? What are the criteria to apply CAM on different type of patients, situations and assessment made in order to define suitability for the application of alternative therapy? What are the different types of therapies used by medical practitioners and limitations which these therapies are related with? What is the requirement for medical environment in order to perform the particular therapy? What are the reporting requirement and documentation needed in order to perform alternative therapy? What are the policy requirements in order to seek patient consent before application of the suitable alternative therapy in order to treat the patient? What are the specific consumer guidelines for the CAM application so that adequate information can be imparted to the patients in order to start treatment for CAM? Nurses and midwives need to provide adequate amount of documentation while carrying out the alternative therapy for treating patients. This documentation would be audited by the competent medical authority on local level so as to ensure that medical practitioners such as nurses and midwives are adopting framed guidelines and protocol in order to implement alternative therapy for the patients (Michaud, 2010).

Communication and collaboration

Nurses and midwives dealing with patients in order to implement alternative therapy need to have appropriate level of communication skill and team collaboration which would prove of mutual benefits to the nurses as well as for the patient. Nurses and midwives should be provided adequate training in order to develop effective communication with the patient which would avoid any possible risk for the patients (Wyatt et al, 2013). In case nurses and midwives are not communicating information to the patient there would be inherent risk to the patient safety. Lack of communication between patient and nurses can evolve problems in several forms such as lack of vital information to be passed to patient, threat of misinterpretation by patients and fear which would be going in patient mind regarding medical processes & procedure followed during treatment through alternative medicine practice by nurses (Hilsden & Verhoef, 2010).

Lack of communication between patient and nurses can have such high significance that it might also result into danger to health or even can become cause of death in severe situations. It has been revealed through medical research that in Australia if top ten list of major cause of deaths to be prepared then medical error resulted due to lack of communication would stand at number five which would be ahead of the number of deaths caused by diabetes, accidents, AIDS and Alzheimer (Zollman & Vickers, 2013).Nurses and midwives needs to be properly educated through the communication program so that they can educate customer with appropriate level of knowledge regarding medical procedure followed. Nurses should create belief with the patient while establishing communication and a friendly behaviour needs to be extended towards patient. This would help in developing understanding between patient and nurses and this understanding would be of mutual benefit. Further nurses need to be equipped with different languages and non verbal language so that patients’ problems can be understood and continuous communication can be established with the patient (Hilsden & Verhoef, 2010).

Team collaboration in health care domain can be understood as the activity where in all professional assume complementary roles & responsibilities so as to develop extensive plan for the patient care. Team collaboration and co-operation between the nurses, physicians and other medical practitioners would enhance level of awareness and understanding for the medical practitioner which would enhance their knowledge level as mutual knowledge sharing would happen in such environment. With increasing knowledge between the various stakeholders in medical practice it would be easy for the medical practitioners to utilize the information and make sound decisions benefiting patient health & safety. Team collaboration is characterized by the mutual trust, respect and help for each other. While adopting alternative therapy which is non-traditional in nature a supportive environment should be established where in all stakeholders would contribute to ensure best possible care can be extended for the patients.


Complementary and alternative medicine therapy is playing vital role in the medical field in present time where in demand for the adoption of CAM is increasing with passage of time in Australian society. Nurses and midwives are playing a crucial role in implementation of the CAM for patients and they have highest degree of responsibility in order to implement CAM for the patients. Nurses and midwives needs to understand scope of practice under which they should practice CAM and posses relevant skill set before making use of the CAM therapy on patient. Further it is the prime duty of medical authorities to impart adequate level of education for the nurses so that lack of knowledge does not become a barrier in practicing CAM therapy. Regulations in CAM therapy would play a vital role and documented policies should be available in order to educate nurses and midwives regarding policies & procedure which needs to be adopted for the CAM practice. Communication and team collaboration among the nurses and midwives is of high importance as active communication would help the nurses to avoid any medical error and ensure high degree of safety for the patient. Team collaboration is required to develop mutual sharing of knowledge to adequately implement CAM.

Total word count: 2873


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