As noted earlier, Nightingale suggested the use of complementary therapies in the care of patients. Early fundamental nursing texts include therapies such as back rubs (a form of massage), heat and cold, and nutrition. Thus, complementary therapies have a long history in nursing. However, as nurses began to be employed primarily in hospitals that largely supported the Western biomedical approach to care, more of the nurses’ time was allocated to collaborative activities associated with the medical plan of care including the monitoring of the patient’s status. Time demands provided nurses with less opportunity to administer those aspects of nursing that included complementary therapies.

In the late 1950s, the nursing process was introduced. This four part problem-solving approach to nursing included assessing, planning, intervening, and evaluating. Eventually a fifth element, diagnosis, was added. In addition to the honing of assessment skills, the process also drew attention to interventions. Distinction was often made between dependent or collaborative actions and independent actions or interventions. The latter was often relegated to more advanced courses. As graduate education of nurses for clinical practice increased, interest in and use of independent nursing interventions grew. Complementary therapies provide opportunities for nurses to function autonomously.

Within nursing, the term intervention has often included therapies that are now classified as complementary therapies. A number of the interventions included in the first two texts on independent nursing interventions (Independent Nursing Interventions [Snyder, 1985 ] & Nursing Interventions: Treatments for Nursing Diagnoses [Bulechek & McCloskey, 1985 ]) included complementary therapies such as music, imagery, progressive muscle relaxation, journaling, reminiscence, and massage. The subsequent development of the identification and classification of nursing interventions in the International Council of Nurses Project (ICNP) and the National Intervention Classification Project (NIC) has broadened the scope of the term intervention to encompass all nursing activities (International Council of Nurses, 1997; McCloskey & Bulechek, 1996 ). Thus, the term intervention as it is conceptualized in nursing does not distinguish complementary therapies from other activities nurses perform such as monitoring the status of a patient or coordinating care. To distinguish complementary therapies from the broader domain of interventions, the authors titled their third edition on independent nursing interventions, Complementary/Alternative Therapies in Nursing (Snyder & Lindquist, 1998).

Nurses have and do use numerous complementary therapies to help patients achieve positive health outcomes. Table 2 lists complementary therapies commonly used by nurses. A subsequent article in this journal discusses the educational preparation of nurses to administer complementary therapies and which therapies should be included in the various curricula. Many nurses have pursued courses to prepare them to administer other therapies such as acupuncture, hypnosis, spiritual direction, and Reiki.

Are there any complementary therapies that are not within the purview of nursing?

...where possible, therapies that have a research base should be selected.

These authors believe that competence in performing a therapy and its use to achieve an outcome that is within the scope of nursing are the guiding principles to use to determine if a therapy can be administered by a nurse. The Royal College of Nurses (RCN) has formulated 11 beliefs to guide the use of complementary therapies (Buckle, 1997 ). One of the beliefs is that the nurse works in partnership with the patient to determine the suitability of a therapy. Another belief notes that, where possible, therapies that have a research base should be selected. What is paramount, according to the RCN, is that the nurse must have the necessary preparation to administer the therapy and that she/he follows the established practice protocols and standards of care and practices within the local legal requirements.

In recent years, exposure to other cultures has increased the scope of therapies classified as being complementary therapies. It is incumbent on nurses to increase their knowledge about various complementary therapies. This does not necessitate a nurse becoming prepared to administer a multitude of therapies but rather to have a broad knowledge so as to understand therapies patients may be using or considering to use. It is also important that health histories obtain information about a patient’s use of complementary therapies.

It is also important that health histories obtain information about a patient’s use of complementary therapies.

Patients are sometimes reluctant to convey this information as they may feel that the health professional is not accepting of these practices. Obtaining this information requires an openness on the part of the nurse, and it may require the nurse to re-state the question or use probes. Seeking this information is important as interactions between some herbal preparations and prescribed medications and the impact that other complementary therapies may have on a biomedical treatment requires that health professionals be aware of all therapies a patient is using so that the plan of care is coordinated and safe.

The increasing public interest in complementary therapies provides an opportunity for nursing to share with the public and colleagues in other disciplines how these therapies have been a part of nursing for centuries. Also, nursing needs to convey that a holistic, caring philosophy has been and is an integral part of nursing. Additionally, nurses have conducted a considerable amount of research on complementary therapies such as imagery, music, therapeutic touch, massage, humor, reminiscence, animal-assisted therapy, and prayer. With the knowledge gained from these studies nurses are in a prime position to take the lead on interdisciplinary complementary therapy research teams.

Use of complementary therapies is a part of nursing’s heritage. Administration of complementary therapies provides an opportunity for nurses to act autonomously in the delivery of care. Also, inclusion of complementary therapies in the plan of care allows nurses to demonstrate caring in a holistic fashion, which is a key characteristic of nursing.