Seeking an alternative way or providing health care: for 20 years a nurse nurtured a dream of offering people a different style of care than that available in our present health system. Finally she is realising that dream.

MY FIRST ever experience with herbal medicine seemed like a life saver at the time! I was a student nurse at Green Lane Hospital and was on the latest high-protein fad diet. On about day five of the diet, my digestive system went on strike and after self-administering some local treatments (which did nothing to alleviate my discomfort) I crawled home from work, barely able to walk. My flatmate took one look at me and made me a nice cup of herbal tea. Relief followed fairly quickly. I hastily returned to eating normally, except I couldn't bear to touch or smell meat again for two years!

That experience highlighted something that had been growing during my nursing training--that a lot of what affected health was being overlooked. As I developed a new awareness of the possibilities, I realised I wanted to be involved in a broader scope of health care than what was, for the most part, a regime primarily involved in symptom removal. While during our training, lip-service was paid to the importance of seeing the patient as a whole, as a spiritual and emotional/psychological being, as well as a physical body presenting with problems, the reality of the job was--and still is--that one rarely has much time for anything other than attending to those physical needs. Convinced that health was a lot more than that which presented physically, I had a new goal--finding non-chemical and non-surgical ways of helping people.

As soon as I graduated in 1980, I considered training to be a naturopath, but the prospect of international work and travel seemed somewhat more attractive than a further three years of financial hardship and study. As a nurse, I found the closest I would ever come to my niche, in intensive care work. I consider it no paradox that I should find my place as a nurse in the high-tech environment of intensive care nursing, while strongly believing in the healing powers of complementary therapies. Intensive care is an essential service and the greatest gift modern medicine and technology offers humanity.

But my interest and belief in complementary therapies never diminished. My personal health care practitioners of choice have included homoeopaths, naturopaths, osteopaths and alternative-minded GPs. Twenty years after graduating from the Auckland School of Nursing, Green Lane Hospital, I enrolled in a naturopathic course. I'd had a varied and interesting life in the interim, adding office management, nursery production, landscape design and development, medical practice management, teaching English as a second language and three children to my list of accomplishments.

I chose Wellpark College of Natural Therapies in Auckland because I could select subjects that interested me and could put together a schedule to fit around my busy life. (My children ranged from 15 to one year old when I enrolled.) My intention was to complete a naturopathic diploma over five years part-time, instead of the usual three years of full-time study.

In my first year I discovered aromatherapy and have cursed the term ever since. Aromatherapy is much much more than expecting to get well from smelling nice smells, as the term suggests, and as, unfortunately, many people think. There is no doubt fragrances can have very intense psychological effects. However, essential oils are highly concentrated plant extracts which a practitioner is trained to deliver in a variety of ways for different applications, the most common being massage and inhalation.

I decided to focus initially on aromatherapy and massage. My objective was to acquire new skills I could use to generate enough income to replace what I earnt through part-time nursing, in that first year of study I found some of what I had been looking for throughout my nursing career--a truly holistic approach to the care of a person, a therapy that really supported a person's emotional experience, as well as their physical body.

I have now completed a diploma of aromatherapy and a certificate in massage. I work part-time as an aromatherapist, fitting clients around my study schedule. I am still nursing, working a few shifts a month as an agency nurse, which can take me anywhere, although I am generally in the cardiology day stay unit at Green Lane Hospital.

I love working as an aromatherapist. Most of my clients, many of whom are nurses, make appointments because of physical strain or stress reasons. While it is gratifying to get the immediate "I feel great" feedback, it is rewarding, encouraging and sometimes surprising to learn of the other way clients have benefitted from treatment. Examples include coping better with stress, feeling lessanxious or agitated, being able to concentrate for longer, having better quality sleep and one client who was able to deal effectively with stage fright. Just as a complementary health care practitioner sees the client as a whole person, who is more than isolated complaints, so too are herbs and essential oils whole extracts of plants and, as such, are more than the sum of their "active ingredients". In time, I'm sure the general public will see aromatherapy as more than "smell therapy" and will realise how powerful this therapy can be.

I'm now back on track with my naturopathic diploma. The second-year schedule includes nutrition, pathology, diagnosis, iridology, herbal studies and herbal manufacturing. I think having a nursing background enhances the general public's respect and earns the whole field of complementary medicine greater respect. It creates a bridge, as it were, between the conventional and the alternative.

Nurses are generally very interested in complementary health care and I am often approached for advice about different therapies. Perhaps there are many who are at the same place as I was 20 years ago, knowing there is something more they could be offering people. Nurses are often in situations where their patients ask for advice on lifestyle choices to help them get and stay well, yet few nurses would have the confidence to say: "I think it might help if you saw a naturopath/aromatherapist/osteopath/acupuncturist etc".

Complementary therapies have an important place in conventional nursing. Many, if not most, midwives use acupuncture, Bach Flowers, homoeopathy and the occasional "old wives' remedy" eg cabbage-leaf poultices on early mastiffs (including on myself with fantastic results!)

I have seen a patient's blood pressure reduce by 10mmHg simply by getting his wife to give him a ten-minute foot massage using plain sweet almond oil.

A six-month trial involving more than 200 people at the renal unit in Westmead Hospital, Sydney, showed how an aromatherapy massage, using oils specifically selected for each patient, reduced pain, physical discomfort, mental/emotional discomfort and fatigue and increased patients' sense of wellbeing. (1)

The use of twice-weekly foot massages in the intensive care unit of Royal Sussex County Hospital in a trial in 1992 showed consistent decreases in blood pressure, heart rate, pain, respiratory rate and wakefulness. Another study using vapourisers in a coronary care unit and post-coronary care ward showed reduction in anxiety levels. (2)

Wound care is another area in which aromatherapy is achieving remarkable results, particularly with persistent deep venous ulcers. (2)

As well as these physical and psychological benefits, another advantage is that the use of something simple such as a vapouriser in the hospital environment can soften the clinical atmosphere.

As an aromatherapist, I am always drawing on my nursing knowledge and skills. My nursing background also gives me more understanding and empathy with the journey many people have taken before arriving at the door of a complementary health practitioner. Many people turn to alternative therapies feeling that mainstream medicine has nothing more to offer them. I know what they have endured in our health system to get to that point.

Unfortunately many nurses and the public in general are not sufficiently aware of safety issues in the use of complementary therapies. You can do harm with these remedies. If nurses want to include aromatherapy or massage in their conventional practice, they must undertake a reputable course. There are an increasing number of doctors who are learning more about alternative treatments and I am starting to hear of more and more GP referrals to naturopaths and GPs who work with naturopaths.

Better controls

I fully support current moves to register complementary health care practitioners. Promises of better controls on the sale of herbs, oils and other supplementary products (which I believe are too readily available for self-prescription and are sold by people who often know very little, if anything, about them) will raise the level of safety. Ensuring adequate training standards are maintained will enable the public to distinguish between the bona-fide practitioners and the "weekend-course" ones. These moves can only benefit the public, as well as raising the profile of genuine complementary health practitioners.

Unfortunately, in mainstream society health care is still just illness treatment and this is exacerbated in times of severe staff shortages and increasing patient acuity. Maintaining wellness is the field to which I am increasingly drawn. I want to be part of a health system that truly nurtures and supports health--mental, physical and spiritual. I want to be part of a system that shares knowledge, empowering people to be fully in control of the choices they make for their life and their health. And they feel so much better for it!

REFERENCES

(1) Casey, M. and Kerr, J. (2003) An aromatherapy clinic in a public hospital ward. Aromatherapy Today; 26: 6, 18-20.

(2) Price, S. and Price, L. (1999) Aromatherapy for Health Professionals. Edinburgh and New York: Churchill Livingstone.

--Sharon Erdrich, RGON, Dip Aromatherapy, Cert Relaxation Massage, works part-time as an aromatherapist and as an agency nurse, usually in the cardiology day stay unit at Green Lane Hospital.