Complementary and Alternative Medicine and Holistic Nursing Care: The Necessity for Curriculum Revision

CAM therapies are not limited to medical treatments, but they regulate fundamental caring principles [3] and are considered as integral part of care management [4]. The philosophy of CAM is consistent with the philosophy and concept of healing and holistic nursing care [5]. The nursing profession has a long history of caring for clients in a holistic manner and integrating the healing arts with conventional treatments. Florence Nightingale recognized the importance of caring for the whole person and encouraged interventions that enhance each individual’s abilities to draw upon their own healing powers [6]. Many CAM treatments such as massage, therapeutic touch, use of relaxation methods, cold and heat therapies, imagery, music intervention, and creating an optimal healing environment are among the traditional nursing activities [7]. Integrating CAM therapies in nursing not only enables nurses to provide comprehensive and holistic care [8], but also would improve nurse-patient relationship and increases patient satisfaction [4]. Therefore, nearly half of the US state nursing boards have formally been accepted that CAM therapies are compatible with nursing activities [5].


Introduction
The increasing use of complementary and alternative medicine (CAM) reflects an increase in patients' requests for this therapeutic approach [1]. CAM is playing a major role in health care in the 21st century. It is predicted that this increasing use will make CAM therapies an integral part of all the healthcare systems [2].

CAM and Holistic Nursing Care
CAM therapies are not limited to medical treatments, but they regulate fundamental caring principles [3] and are considered as integral part of care management [4]. The philosophy of CAM is consistent with the philosophy and concept of healing and holistic nursing care [5]. The nursing profession has a long history of caring for clients in a holistic manner and integrating the healing arts with conventional treatments. Florence Nightingale recognized the importance of caring for the whole person and encouraged interventions that enhance each individual's abilities to draw upon their own healing powers [6]. Many CAM treatments such as massage, therapeutic touch, use of relaxation methods, cold and heat therapies, imagery, music intervention, and creating an optimal healing environment are among the traditional nursing activities [7]. Integrating CAM therapies in nursing not only enables nurses to provide comprehensive and holistic care [8], but also would improve nurse-patient relationship and increases patient satisfaction [4]. Therefore, nearly half of the US state nursing boards have formally been accepted that CAM therapies are compatible with nursing activities [5].

A Gap in Nursing Practice
Despite the long history of nurses in holistic care and using interventions that are parts of CAM, in the last few decades most nurses have mostly been engaged in modern procedural activities and distanced from the holistic paradigm of their profession [9]. A recent study showed that patients often consult with nurses about CAM therapies, however, only 5% of nurses were able to respond their questions in this regard [10]. Nonetheless, as the largest body of the health care workforce, nurses have the highest number of professional contact hours with patients, making it critical to have sufficient knowledge and information concerning safe and effective use of CAM to be able to communicate and assist patients to make informed choices about appropriate forms of CAM for various conditions [11].

The Necessity for Curriculum Revision
Nurses can be the missing link between the conventional medicine and CAM [3]. The nursing community should develop its role in CAM and be a reliable source for patients who use CAM or are willing to use it [4]. Nursing curricula have constantly been evolved to improve patient care and keep pace with the everchanging health care system. The integration of CAM therapies in the nursing curriculum is no exception. Nurses should play an active role in the development of evidence-based performance in the field of CAM through research. By introducing CAM in nursing curriculum, nurses can educate and change attitudes and practices, and provide comprehensive and effective care and treatment for patients.
In addition to the increasing use of CAM therapy by the public, safety issues with the combining of conventional and alternative modalities, the need to provide patient-centered care; and increasing evidence of the positive impact of CAM on health care outcomes [12], have made the National Council Licensure Examination to expect nurses to have a knowledge base in CAM therapies for entry-level registered nurses since 2004 [13]. Such