Alternative Systems of Medicine

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Alternative Systems of Medicine

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Content

Index
Sr.No.

Content

Pg.No.

Nursing Practice
1

Framework of nursing practice







2





3







4

Introduction
Definition
Characteristics
Development
Implementation
Evaluation and research

5
5
5
5
6
7
7

Scope in nursing practice

8

Introduction
Background
Scope of nursing practice
Nursing practice act
Nursing Practice in Different Settings

8
8
8
8
9

Trends in nursing practice

13

Introduction
Broadening Focus
Scientific basis
Technology
Changing Trends in Nursing
Modern Trends in Nursing Practice
Role of Professional Nurse

13
14
14
14
15
16
16

Complimentary and alternative systems of medicine

19

 Introduction
 Terminologies
 Definition of complementary & alternative therapy

19
20
20

1

5

 Basic concepts
 Type of complementary and alternative medicine

20
20

A.
B.
C.
D.
E.
F.

21
26
27
31
33
35

Alternative medical system.
Biological based treatment
Ming body techniques.
Manipulative & body based methods and
Energy therapies.
Other therapies.
Extended and Expanded role of nurses

Introduction
Nursing Roles
Extended care facilities
Extended Roles of the Nurse
Expanded Role of Nurses

41
41
41
46
47
56

6

MCQs

66

7

Answer key

67

8

References

67

2

General objective
 At the end of the seminar the group will be able to gain
in depth knowledge about the Complementary and
Alternative systems of medicine & Extended and
Expanded role of nurses and they can utilize their
knowledge at clinical setting, theory portion as well as
at examination.

3

Specific objectives
 At the end of seminar the group will be able to;
 Know about nursing practice.
 Gain knowledge about framework of nursing practice.
 Identify the scope of nursing practice.
 Know about the changing and modern trends in nursing
practice.
 Define the Complimentary and alternative systems of
medicine.
 List out the types of Complimentary and alternative
systems of medicine.
 Describe and list out the Extended and Expanded role of
nurses.

4

NURSING PRACTICE

Framework in nursing practice
Introduction
 Society and its health care needs are always evolving. As a result, health care
faces many challenges, including rising costs, shortage of professional, and an
aging population. The introduction of new technologies and difficulties with
access to care is also challenges. The demand for collaborative, innovative
clinical practitioners to act as leaders in healthcare has never been stronger.
Nurses in advanced nursing practice are well positioned to respond to the
evolution of health care. In particular advanced nursing plays a key role in
meeting the health needs by building the nursing knowledge, advancing the
nursing profession and contributing to a sustained and effective health- care
system.
Definition of nursing practice
 Advanced nursing practice is an umbrella term describing an advanced level of
clinical nursing practice that maximize the use of graduate educational
preparation, in depth nursing knowledge & expertise in meeting the health
needs of the individuals, families, group, communities & populations.
It involves,
 Analyzing & synthesizing knowledge.
 Understanding, interpreting & applying nursing theory & research.
 Developing & advancing nursing knowledge & the profession as the whole.
Characteristics of nursing practice
 Provision of effective and efficient care, delivered with a high degree of
autonomy.
 Demonstration of leadership and initiation of change to improve client,
organization and system outcome.
5

 Deliberate, purposeful and integrated use of in-depth nursing knowledge,
research and clinical expertise.
 Depth and breadth of knowledge that draws on a wide range of strategies to
meet the needs of client and to improve access to and quality of care.
 Ability to explain & apply the theoretical, empirical, ethical and experiential
foundations of nursing practice.
 Understanding, development and dissemination of evidence based nursing
knowledge.
 Ability to initiate or participate in planning, coordinating, implementing and
evaluating programmes to meet client needs and support nursing practice.
 Demonstration of advanced judgment and decision making skills.
 Critical analysis of and influence on health policy.

Development of the Framework
 One of the first priorities of the vice president and CNO (Chief Nursing Officer)
of the Calgary Health Region was to develop a vision for nursing in the region.
Through the development of this vision, it became apparent that a mission for
nursing was also essential. As this work progressed, an evident need emerged to
establish a definition of professional practice and a guideline or framework that
nurses could utilize on a daily basis to achieve the vision and mission of nursing
in the region.
Approval of the Framework
 After several months of consultations with nurses across the Region, discussion
at Regional Nursing Council and numerous revisions, the final draft of the
professional Practice Framework was approved by nursing council and
distributes during Nurses Week 2003.
The Art of Nursing
 Nurses demonstrate ethical. Insightful, caring practice by focusing on the health
and well-being of individuals, families and communities is health and during
episodes of illness and transition.
Attributes of Practice
6

 Autonomous professional practice in nursing requires taking personal
responsibility for excellence in practice and effective collaboration with
multidisciplinary team members in meeting the health needs of the population.
Competence
 Nurse's competence is grounded upon nursing theory, scientific knowledge and
experience, and is reflected in everyday practice. It is enhanced through
continuous learning.
Personal Commitment
 Nurses demonstrate commitment to the profession by valuing nurses and
nursing, contributing to the advancement of the procession and continually
striving for excellence in patient care.
Implementation of the Framework
 Numerous sessions were held to familiarize nursing staff with the framework
when it was first launched.
 Introduction to the framework is now routinely incorporated into the orientation
of all new nurses who join the Region.
 The frame-work also gives the development of preceptors and change nurses.
 The major elements of the framework have been linked to the expected RN,
LPN and RPN competencies articulated in job descriptions, and application of
the framework in practice is not incorporated into nurse's ongoing professional
development and continuing education plans.
 Further elaboration of frame work will be ongoing. For example use of the
framework has exposed the need to clarify some of its terms; such has.
Insightful practice.
Evaluation and Research
 Now that the Professional Practice Framework has been articulated, it will be
important to determine the effectiveness with which it is being implemented
across the many sites and settings in this large regional health authority and
measure its impact on practice and patient outcomes. Over the course of the
next several years, specific implementation initiatives will be targeted for
7

evaluation and research. An over changing framework will be developed to
guide the evaluation of specific initiatives.

Scope in nursing practice
Introduction
 Nursing is responsible for articulating and disseminating clear definitions of the
roles nurses engage in, and the profession's scope of practice.
 The scope of practice is not limited to specific tasks, functions or
responsibilities but includes direct care giving and evaluation of its impact,
advocating for patients and for health, supervising and delegating to others,
leading, managing, teaching, undertaking research and developing health policy
for health care system.
Background
 The scope of practice is defined within a legislative regulatory framework, and
communicates to others the roles, competencies (knowledge, skills and
attitudes) and the professional accountability of the nurse.
 Nursing's authority comes from evidence-based knowledge related to its sphere
of practice.
 The complexity of the health care delivery system today is such that the role and
responsibility of the nurse within this system can change.
 Each registered nurse is responsible and accountable for making decisions and
practicing in accordance with his or her educational background and experience
in nursing within the statutory parameters of the Nurse Practice Act.
The Scope of Nursing Practice
 Nursing, like other professions, is accountable for ensuring that its members act
in the public interest and provide the unique service that has been designated to
them by society. This process is called professional regulation.
 The legal boundaries of the scope of practice are determined by the definition of
nursing found in the Nurse Practice Act (NPA) and provide the basis for
interpreting the practice of the individual registered nurse.
Nurse Practice Act
8

 The Nurse Practice Act was enacted by the legislature to regulate the practice of
nursing and to define the parameters of nursing practice for the purpose of
protect the public.
 The act does not address specific nursing duties that health care for local
residents who preferred to receive are proper to be performed by nurses, or
hospital staffing patterns, labor practices or employment criteria
 The Nurse Practice Act is designed to protect the public from incompetent
nursing practice, not to protect nurses from discriminatory or questionable
employment practices.
 Each nurse is responsible and accountable for making decisions and practicing
in accordance with that individual's educational background and experience in
nursing.
Nursing Practice in Different Settings
Individual RNs Responsibility,
 The registered nurse is responsible and accountable, professionally and legally,
for determining his/her professional scope of nursing practice.
 Since the role and responsibilities of nurses, and consequently the scope of
nursing practice, is ever changing and increasing in complexity, it is important
that the nurse makes decisions regarding his/her on scope of practice.
The Nurse Manager & Nurse Executive's Responsibility
 As a registered nurse, the nurse manager is responsible and accountable,
professionally and for determining his/her professional scope of practice.
 The nurse manger makes decisions regarding the roles and responsibilities for
nurses within the institution or agency in order to provide quality care.
Mobile Nursing Practice
 In 1984 a need was seen to offer more extensive home health care for local
residents who preferred to receive needed care in their own homes.
 This enabled many to reduce costs and remain in their homes, at least for a
longer period of time.
Mobile nursing services
9

These services provide home teaching and care for patients with varied needs and
health problems.












Patients discharged early from hospitals.
Patients suffering from chronic and acute medical problems.
Surgical Patients.
Patients requiring IV therapy.
The elderly.
Respiratory patients.
The seriously
Patients in need of medication management (including pain control)
Hospice Concept.
Ventilator Dependent.
Assistance with Bathing, Dressing, Meals, Transportation, Light, Housekeeping.

Services may be covered by Medicare, Medicaid, private insurance, private payment,
VA or other third party payers.

Military Nursing Services
First World War
 The Military Nursing Service has its origin from the Army Nursing Service
formed in 1881 part of Royal Army. The Army nurses served in Flanders, the
Mediterranean, the Balkans, the Middle East and onboard hospital ships. After,
the war on 1st October1926, the Nursing Services was granted permanent status
in Indian Army
Second World War
 During the middle of the war in 1943, the Indian arm of the Nursing Services
was separated through Indian Military Nursing Service Ordinance, 1943 and re
designated it, there by constituting the Military Nursing Service (MNS) in its
present form.
 The Officers of the Military Nursing Service are governed by Indian Military
Nursing Service Ordinance 1943 and Military Nursing Service Rules, 1944.
 The Nursing Service Officers are also subject to Army Act 1950, Army Rules
1954, Defense Service Regulations and various Government Orders, Army
Instructions, Army Orders, issued from time to time.
10

Tele- nursing
 Refers to the use of telecommunication and information technology for
providing nursing service in health care whenever a large physical distance exist
between patient and nurse, or between any numbers of nurses.
 As a field it is a part of Tele-health, and has many points of contracts with other
medical and non medical applications, such as Tele-diagnosis, Teleconsultation, and Tele-monitoring etc.
The nursing robot
 Development of a nursing robot system “included the development of a mobile
robot system (the nursing robot) to help physically handicapped people.
 Complete in 1986, the nursing robot was one of the first fully functioning
mobile robots equipped with a manipulator arm. Also integrated were seven
different sensor systems.
Nursing in occupational health
Occupational health nursing (OHN)
 OHN are registered nurses who independently observe and access the worker’s
health status with respect to job task and hazards. Using their specialization
experienced and education, these registered nurses recognize and prevent health
effect from hazardous exposure and treat workers’ injuries/illnesses.
Scope
 Educationally prepared to recognize adverse health effect of occupational
exposure and address methods for hazard abatement and control, OHNs bring
their nursing expertise to all industries such as meat packing manufacturing,
construction as well as the health care industry. OHNs:
 Have special knowledge of work place hazards and the relationship to the
employee health status.
 Understand industrial hygiene principles of engineering control, administrative
control, and personal protective equipment.
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 Have knowledge of toxicology and epidemiology as related to the employee and
the work site.
OHN activities
 Observation and assessment of both the workers and the work environment.
 Interpretation and evaluation of the worker’s medical and occupational history,
subjective complaints, and physical examination, along with any laboratory
values or other diagnostic screening tests, industrial hygiene and personal
exposure monitoring values.
 Interpretation of medical diagnosis to workers and their employers.
 Appraisal of the work environment for potential exposures.
 Identification of abnormalities.
 Description of the worker’s response to the exposures.
 Management of occupational & non occupational illness and injury.
 Documentation of the injury or illness.
Academic preparation
 OHNs with varying degrees of academic preparation from entry level to phD
work in capacities commensurate with their experience and academic
preparation: clinical nurse, clinical nurse manager, nurse manager, corporate
nurse, nurse researcher, nurse educator & nurse consultant.
School health nurses
 School nurses are primary care nurses for school children. They work with
individual children, young people and families, schools and communities to
improve health and tackle inequality. In addition they are recognized as
contributing to raising education standards.
 A school nurse is a qualified, experienced professional and the only trained
nurse working across health and education boundaries. They also provide the
link between school, home and the community.
School health nurses responsibility
School nurses have special responsibility for,
 Promoting healthy lifestyles and schools.
 Child and adolescent mental health.
12

 Chronic and complex health care needs in children and young people.
 Vulnerable children and young people.
Activities of school health nurses
The school nurses work includes,






Health assessments for children at entrance to school as required.
Individual health interviews offered to young people aged 13-14 years.
Immunization programmes.
Child protection.
Health education.

Space Nursing Society (SNS)
 Is an international space advocacy organization devoted to space nursing and
the contribution to space exploration by Registered Nurses. SNS is an affiliated,
non-profit special interest group associated with the National Space Society.
 The SNS provides a forum for the discussion and exploration of issues related
to nursing in space and its impact upon the understanding of earthbound nursing
through conference participation and its newsletter expanding horizons.
 The information being learned in the microgravity environment of space has
tremendous applications for the bed-bound patient on earth.

Legal Regulation
 Nursing practice in Connecticut is regulated by Connecticut statues. The
professional nurse is responsible and accountable for making decisions that are
based upon the individual’s educational preparation and experience in nursing.

Trends in nursing practice
Introduction
 Trends in nursing are closely tied to what is happening to health care in general.
Trends are fascinating phenomena, but they do not exist in vacuums. Most are
interrelated, one trends often spawns another. Although trends are more than
fads, they are far from money-back guarantees. We watch to anticipate the
13

direction that a particular trend will take us, to remove the element of surprise.
When we look back on trends, however, some will have heralded permanent
changes, but others might have been no more than blips on the radar screen.
Broadening Focus
 The focus of nursing has broadened from the care of the ill person to the care of
the people in illness and from care of only the patient to care of the client, the
family, and in some instance the community.
 In the past, nursing, like medicine was oriented towards disease and illness.
 Today, there is increasing recognition of peoples need for health care as distinct
from illness care and of the nurses' independent functions in this area.
Scientific basis
 In the past nursing largely was either intuitive or relied on experience or
observation rather than on research. Through trial and error the individual
nurses discovered with measures that would assist the client and many nurses
became highly skilled in providing care through experience.
Technology
 Technology or mechanization is being applied in the health field extensively.
Certain areas of a hospital are more technologic than others. Nurses find
themselves in the midst of this rapidly changing, increasingly technologic
environment in hospital and in client's homes.
Indicators of Increasing Technology
a) The proliferation of technologic equipment used in case of clients in hospitals
and homes.
b) The increasing home and self care equipment.
c) Use of computers in many areas of health care.
Renewed focus in caring
 The increasing use of technology in hospital and homes has created an
increasing need to humanize. Nursing has traditionally been a caring and
humanizing profession.
14

Indicators of this trend
a) The increasing number of professionals, articles and books about balancing of
caring and technical skills.
b) Many studies regarding caring as an aspect of nursing.
c) Increasing recognition in nursing of needs of clients in technology and
environment.
Expansion of employment opportunities
 Nursing practice trends include a growing variety of employment setting in
which nurses have greater independence, autonomy, and respect as member of
the health care team.
Nursing's public perception
 Any member of society who has been ill, hospitalized or visited an emergency
department has experienced nursing campaign noted .everybody needs a nurse.
Changing Trends in Nursing
 Nursing has originated from the word = nurturing', which means nourishing,
helping in growth and development of a human being. In the past, nursing was
family-based work.
 Modern nursing began in the 19th century under the leadership of Florence
Nightingale.
 The aim of nursing was only to promote the recovery of patients. Even now, the
central concern of nursing is nurturing the human beings.
 The present day nurse provides care for the people in health and illness.
 Nursing is one of the health services, which contributes to well-being of an
individual, family and community. Therefore, nursing is defined as a humanistic
science dedicated to maintain and promote health, preventing illness, care for
and rehabilitation the sick and disabled persons.
 Nursing process includes doing, thinking and interaction component. It is
mainly and basically a problem solving approach of nursing cares. The nursing
consists of five steps- Assessment nursing diagnosis, Planning, implementation
and & Evaluation. Each step of a nursing process leads to the next one. This
makes it a continuing cyclic process.
15

Modern Trends in Nursing Practice
 The public perception of alternative, Complimentary treatment method has been
changing over the past few decades. In the late 1960’s and early 1970's, Natural
New Age Self Help Movements “begin to attract followers, first among
consumers and later among health care practitioners. During that time provides,
there was a growing trend towards refection of traditional medicine because it
was perceived invasive, painful, cost and ineffectiveness.
 In 1993 a landmark survey found that 1/3 of the US population had used some
non-traditional alternative methods of treatments in addition to the standard
medical treatment.
 In 1992 the US Government established an Office of Alternative Medicines
(OAM) at the National Institute of Health. One of the reasons for the OAM's
creation was the federal Governments recognition that US citizens are pursuing
alternative methods of health care with unpredicted enthusiasm. In 1992, the
OAM was allocated 2 million to investigate the use of non-traditional treatment
methods. Congress increased the (OAM) budget to 20 million for the year 1998.
The few therapies investigated By the OAM 1995







Biofeedback to control pain.
Acupuncture to relieve depression.
Imagery to control asthma
Ayurvedic medicine to treat Parkinson’s disease.
Music therapy to treat brain injury clients and
Shark cartilage to treat cancer.

Role of Professional Nurse
 Each role is described as a separate entity for the state of clarity. However the
role is not in actuality exclusive of one another. In practices several roles often
coincide.
1) Care provider
 The goal of nurse in this role is to convey understanding about what is
important and to provide care.
 The nurse supports the client by attitude and actions that show concern
for the client welfare and acceptance of the client as a person, not merely
a mechanical being.
16

2) Communicator/Helper
 Communications shapes the relationships between nurse & clients, nurses
and support persons, and nurses and colleagues.
 Communications facilitates all nursing actions.
3) Teacher
 It is an interactive process between a teacher and one or more learners in
which specific learning objectives or desired behavior changes are
achieved.
4) Counselor
 It is the process of helping the client to recognize and cope with stressful
psychological or social problem to develop improved interpersonal
relationship, and to promote personal growth.
5) Client Advocate
 Advocacy involves concern for and defined actions in behalf of another
person or organizing to bring about a change.
 A client advocate is an advocate of client' right.
 It involves promoting what is best for the client, ensuring that the client'
needs are met, and protecting the clients right.
6) Change agent
 Is a person or group who initiates change or who assists others in making
modifications in themselves or in the system.
7) Leader
 Nursing leadership is defined as a mutual process of interpersonal
influence through nurse helps client make decision in establishing and
achieving goals to improve the client's wellbeing.
 To improve the health status and potential of individuals or families
 Increasing the effectiveness and level of satisfaction among the
professional colleagues providing care.
8) Manager
 Management is planning, giving direction, developing staff, monitoring
operations, giving rewards fairly and representing both staff members and
administrations as needed.
 The nurse manages the nursing care of individuals, groups, families, and
communities.
 The manager delegates nursing activities to ancillary workers and other
nurses and supervises and evaluates their performance.
9) Researcher
17

 Nurse who will engage in research, there is a growing expectation that all
nurses will be able to critically appraise research reports and will utilize
the scientific studies as a basis for making decisions in their work.
10) Expanded nursing roles
 An expanded role is one that a nurse assumes by virtue of education and
experience. The nurse who assumes an expanded role has increased
responsibility and, usually greater autonomy. Nurses are assuming
expanded roles in both hospitals and community settings.
11) Nurse Generalist
 The ANA conducts nurse generalists certification programs that issue
certificates in eleven areas: General nursing practice, medical surgical
nursing, gerontology nursing, pediatric nursing, perinatal nursing, college
health nursing, school nursing, community health nursing, psychiatric &
mental health nursing, nursing continuing education & stall development
& home health nursing .
12) Nurse Clinician
 The Clinician's provide bed side or direct care in a specialty area. They
may or
may not have advanced educational preparation.
13) Nurse Practitioner
 The role of nurse practitioner is an extension of the nurse’s basic care
giving role. It prepares nurses for an expanded role in the provision of
primary care. The nurse practitioner may be generalists. (Eg : Family
nurse practitioners) or specialists.( eg : Geriatric Nurse Practitioners )
 Nurse practitioner in a community employed in health maintenance
organizations, health centers, schools & physicians office.
 They are usually skilled at making nursing assessment, performing
physical assessments, counseling, teaching & treating minor, self limiting
illnesses, long term illnesses.
14) Nurse specialist
 The nurse specialist has advanced knowledge & skill in a particular area
of nursing.
18

 This nurses practice in hospitals or communities. In hospitals such nurses
give direct client care, advice other nurses & co-ordinate nursing given by
others.
 The clinical nurse specialists are a role model & are expected to keep
abreast of new development in the field.

Complimentary and alternative systems of medicine

Introduction
 Complementary and alternative medicine (CAM) includes various healing
approaches and therapies that originate from around the world and that are not
based on conventional Western medicine. These therapies are called alternative
medicine when they are used alone and complementary medicine when they are
used with conventional medicine.
 Alternative medicine includes therapies and health care practices not widely
taught in most medical schools; however, many such practices are popular, and
some are used in hospital.
Terminologies
Holism:
 The idea that the whole of the sick person, including their body, mind and way
of life, should be considered when treating them, and not just toe symptom of
the disease.
19

Humanism:
 A system of thought that considers the solving of human problems with the help
of religious beliefs. It emphasizes the fact that the basic nature of humans is
good.
Balance:
 A situation in which different things exist in equal, correct or good amount.
Energy:
 The ability to put effort and enthusiasm into an activity, work etc.
Healing:
 The process of returning to normal function after a period of injury.
Definition of complementary & alternative therapy
 Complementary and alternative medicine is a group of diverse medical and
health care systems, practices, and products that are not generally considered
part of conventional medicine.
Basic concepts
 Several concepts are common to most alternative practices. These are holism,
humanism, balance, spirituality, energy & healing environments.
Type of complementary and alternative medicine
A.
B.
C.
D.
E.
F.

Alternative medical system.
Biological based treatment
Ming body techniques.
Manipulative & body based methods
Energy therapies.
Other therapies.

Healing modalities
A. Alternative medical systems
20

1. Ayurveda

 Ayurveda is a system of healing based on homeopathy and natural therapthy,
with an extensive use of herbs.
 Ayurveda is a system of traditional medicine native to the Indian subcontinent,
originated > 5000 year ago and practiced in other part of the world as a form of
alternative medicine. In Sanskrit, the word ayurveda consists of the word ayus,
meaning life and veda, meaning related to knowledge or science. Evolving
throughout its history, ayurveda remains an influential system of medicine in
South Asia. The earliest literature of ayurveda appeared during the vedic period
in India.
 The Sushruta Samhita and the Charaka Samhita were influential works on
traditional medicine during this era..Ayurvedic practitioners also identified a
number of medicinal preparations and surgical procedures for curing various
ailments and diseases.
 As par Indian heritage and science, “Ayurveda” is an Upaveda or annexure to
the four main vedas (knowledge system). The famous treaties of Ayurveda are
charaka samhita by sage charaka, which details the prevention and treatment of
disease, and sushruta samhita of sage sushruta, which deals with Ayurvedic
surgical procedures. In the ayurvedic system, the prevention of all type of
disease has a prominent place in treatment, including restructuring a patient's
lifestyle to align with the course of nature and the four seasons to guarantee
complete wellness.
 The aim is to remove the cause, of disorders, present illness and harmonize
body, mind and consciousness. Ayurveda aids in maintaining good health,
increasing longevity and overall quality of life.
 Alternative Ayurvedic treatment and self help regimens include, nutrition,
herbal remedies, aromatherapy, lifestyle recommendation, massage treatments,
color/ sound therapy, meditation, panchakarma (detoxification), Yoga,
meditation and rejuvenation therapies. Ayurveda empower the individual to take
control of their own health and well-being.
21

1.Terminalia arjuna is Useful in alleviating the pain of angina pectoris and in treating
heart failure and coronary artery disease. Terminaha in ay also be useful in treating
hyperchelesterolemia.
2. Black pepper and long pepper are combined with ginger to form the traditional
trikatu mixture in Ayurveda. This mixture increases appetite, promotes the secretion of
digestive juices, and cures certain gastric disorders particularly Achlorhydria and
Hypochlorhydria.

2. Siddha
 The Siddha medicine is a form of south Indian Tamil traditional medicine and
part of the trio Indian medicines - ayurveda, siddha and unani. However Lord
Sri Akshunna, a master of northern siddha tradition, says there is use of siddha
medicine in the north Indian part or rather in Himalayan region as Thar phuk
and siddha buti (medicine) tantra. This system of medicine was popular in
ancient India,due to the antiquity of this medical system ,the siddha system of
medicine is believed to be the &Jest medical system in the known universe.
 The system is believed to be developed by the 9 natli and 84 siddhas in the
north and 18 siddhas in the south called siddhar. They are the ancient
supernatural spiritual saints of India and the Siddha system is believed to be
handed over to the Smear by the Hindu God - Lord Shiva and Goddess Parvathi.
Su are the siddhars, the followers of Lord Shiva (saivam). Siddhar's total
numbers which are eighteen in which thernagathiyar is the first siddhar.
 Siddharas were of the concept that a healthy soul can only be developed through
a healthy body. So they developed methods and medication, that are believed to
strengthen their physical body and thereby their souls. Men and women who
dedicated their lives into developing the system were called Siddharas7They
practiced intense yogic practices, including years or fasting and meditation and
believed to have achieved super natural powers and gained the supreme wisdom
and overall immortality. rjtis assumed that when the normal equilibrium of three
humors (vatha, pitha and kapha) is disturbed, disease is caused. The factors,
which assumed to affect this equilibrium, are environment, climatic conditions,
diet, physical activities, and stress. According to the siddha medicine system,
diet and life style play a major role not only in health but also in curing
diseases.
 The treatment in siddha medicine is aimed at keeping the three humors in
equilibrium and maintenance of seven elements. So proper diet, medicine and a
22

disciplined regimen of life of are advised for a healthy Eying and to restore
equilibrium of humors in diseased condition. Saint Thiruvalluvar explains four
requisites of successful treatment. Treatment is classified into three categories
ie. Devamaruthuvum (Divine method), manuda maruthuvum ( rational method)
and asura maruthuvum (surgical method).
 According to therapies the treatments or siddha medicines could be further
categorized into following categories, such as purgative therapy, emetic therapy,
fasting therapy, steam therapy, oleation therapy, physical therapy, solar therapy
and bloodletting therapy, yoga therapy, etc.
3. Unani & Tibbi
 As an alternative form of medicine, Unana has found favour in Asia, especially
India. In India these Unani practitioner can practice as qualified doctors, as the
Indian government approves their practice. Unani medicine is very close to
ayurveda. Both are based on therapy of the presence of the elements (in Unani,
they are considered to be fire, water, earth and air) in the human body. (The
elements, attributed to the philosopher Empedocles, determined the way of
thinking in Medieval Europe.) According to followers of Unani medicine, these
elements are present in different fluids and their balance leads to health and
their imbalance leads to illness.
 All these elaborations were built on the basic Hippocratic theory of the Four
Humours. The theory postulates the presence in the human body of blood,
phlegm, yellow bile and black bile. Each person's unique mixture of these
substances determines his temperament: a predominance of blood gives a
sanguine temperament; a predominance of phlegm makes one phlegmatic;
yellow bile, bilious (or choleric); and black bile, melancholic. As long as these
humours are in balance, the human system is healthy; its imbalance can result in
disease.
4. Homeopathy
 The treatment is based on the principle, “Like cures like”. Homeopathic
medicine are taking original substance from plants, animals and minerals and
highly diluting them. It is believed that body’s own healing ability is stimulated
by these medicines. They are sold over the counter without prescription. They
are so light that they are considered to have very less side effects.
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History of Homeopathy:

Dr. Samuel Hahnemann is the Founder of Homeopathy
 Homeopathy's roots emerge from the findings, teachings and writings of Dr.
Samuel Hahnemann (1755-1843). Hahnemann graduated from medical school
in 1779 and started his own medical practice. He soon began his first
homeopathic experiments in 1790, as a result of his disillusionment with such
common medical practices of the day as purging, bloodletting, and the use of
toxic chemicals.
 During his practice, he began his quest for a better way of providing healthcare
using the principles of "Similars." While working on this project, he became
fascinated with a species of South American tree-bark (cinchona) which was
being used to treat malaria-induced fever. Hahnemann ingested the bark and
discovered that it caused symptoms similar to malaria. He continued his
research into "cures" and the idea of "similar suffering," and began compiling
his findings. Similia similibus curentur, the Latin phrase meaning "let likes be
cured by likes," is the primary principle of homeopathy. A homeopath searches
for a substance that produces in a healthy person those same symptoms a patient
experiences.
 It is a system of therapy based on the concept that disease can be treated with
drugs (in minute doses) which are capable of producing the same symptoms in
healthy people as the disease itself.
 Homeopathy: Developed in Germany in the late 1700s, homeopathy is based on
the principle that like cures like. A substance that, when given in large doses,
causes a set of symptoms is believed to cure the same symptoms when it is
given in minute doses.
 Remedies used in homeopathy are derived from naturally occurring substances,
such as plant extracts and minerals. Extremely low concentrations are prepared
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in a specific way. The more dilute the homeopathic medicine, the stronger it is
considered to be.
5. Naturopathy
 It is a system of therapy based on preventive care, and on the use of heat, water,
light, air, and massage as primary therapies for disease.
 This therapy began as a formal health care system in the US during the early
1900s. Founded on the healing power of nature, naturopathy emphasizes
prevention and treatment of disease through a healthy lifestyle, treatment of the
whole patient, and use of the body's natural healing abilities. This system also
focuses on finding the cause of a disease rather than merely treating symptoms.
Some of This system's principles are not that different from those of modern
Western medicine.
 The following therapies are considered to be of primary importance in the
naturopathic treatment of disease.
a. Nutrition and Dietetic
 This includes the prescription of a balanced wholesome, natural diet, based on
the principles advocated by naturopathic practitioners.
b. Fasting
 The controlled abstinence from food has been used therapeutically for over
2,000 years. It was advocated by Hippocrates as a treatment for many diseases.
 Because it allowed the body to concentrate its resources on dealing with the
disease rather than the processes of digestion, although largely ridiculed by
orthodoxy for many years, fasting has recently begun to gain a reputation as an
excellent and safe treatment for conditions such as obesity, high blood pressure,
arthritis and rheumatism, various allergies and some psychiatric disorders.
c. Structural Adjustment
 By such methods as osteopathy, chiropractic, neuromuscular technique, postural
re-education and remedial exercises, the naturopathic practitioner seeks to
balance and integrate the spine, muscles, ligaments and pints of the whole body.
d. Hydrotherapy

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 This is the use of water, both internally and externally in the form of baths,
packs, compresses, sprays and douches. Hydrotherapy is of value in most
conditions and rightly applied can give remarkable results in the treatment of
both acute and km-standing conditions.
e. Healthy Lifestyle
 This includes the general care of one's body, the use of moderate physical
exercise, the cultivation of a positive approach to life and health, relaxation
techniques, etc.
f. Education
 In naturopathic philosophy it is just as important, if not more so, to explain to
the patient why disease occurs and what the patient can do for him or herself to
maintain the new, improved level of health given to them by naturopathic
treatment. In this way the patient is given responsibility for his or her health.

B. Biologically Based Treatments

1. Herbal Medicine
Herbal medicine has always attracted some scientific interest and many well known
drugs are plant derived, for example digoxin from foxgloves and morphine from
poppies. The following are some of the herbs commonly thought to be effective.
 St John's Wort (Hypericum perforatum) is a safe and effective treatment
(if taken as the only treatment) for mild to moderate depression. It may
also help fatigue possibly because fatigue is a common aspect of
depression.
 Ginkgo Biloba may be effective in relieving the symptoms of dementia
and it may also support memory in as older people.
 Ginger is an effective remedy for nausea and vomiting.
 Horse chestnut seed extract can alleviate the symptoms of varicose veins.
 Tea tree oil may be effective against fungal infections such as athlete's
foot.

26

 Vegetables from the Mum family (onions and garlic) may protect against
certain cancers if eaten regularly, especially cancers of the digestive tract,
though further studies need to be done.
Remember, some herbal medicines and prescribed drugs do not mix, consult your
doctor if you are taking conventional drugs.

2. Nutritional Therapy
 Nutritional therapy is a system of healing based on the belief that food, as
nature intended, provides the medicine we need to obtain and maintain a state
of health: our food is our medicine and our medicine is our food. Although
some health problems require specific medication, many conditions can be
relieved effectively with nutritional therapy. These include disorders ranging
from chronic fatigue, energy loss. Insomnia and depression, to backache, skin
complaints, asthma, and headaches.
 Nutritional therapy will also benefit you if you have no specific illness, but want
to maintain a state of optimum health. It is safe for babies and children as well
as adults, and the change of eating patterns that is typically prescribed usually
has far fewer side effects than synthetic medicine.

C. Mind-Body Techniques

 Mind-body techniques are based on the theory that mental and emotional factor
can influence physical health. Behavioral, Psychological, Social and spiritual
methods are used to prevent or cure disease.
 Because of the abundance of scientific evidence backing the benefit of mindbody techniques, many of the approach are now considered mainstream.
Methods include the following,







Meditation
Hypnotherapy (hypnosis)
Biofeedback
Qigong & Tai Chi
Relaxation techniques
Guided imagery
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 Ming body techniques can be used to treat anxiety mid panic disorders, chronic
pain, coronary artery disease, depression, headaches, difficulty sleeping
(insomnia), and loss of urinary control (incontinence). Mind-body methods also
are used as an aid in childbirth, in coping with the disease-related and treatmentrelated symptoms of cancer, and in preparing people before surgery.

1) Meditation

 In meditation, people regulate their attention or systematically focus on
particular aspects of inner or outer experience. Meditation usually involves
sitting or resting quietly, often with the eyes closed. Sometimes it involves the
repetitive sounding of a phrase (a mantra) meant to help the person focus.
 The most highly studied forms of meditation are transcendental meditation and
mindfulness meditation. Meditation has been shown to have favorable effects on
heart and blood vessel (cardiovascular) function, immunity, and brain activity,
such as increasing activity in parts of the brain associated with mental clarity.
Meditation often induces physical relaxation, mental calmness, and favorable
emotional states such as loving-kindness and even-temperedness. Most
meditation practices were developed within a religious or spiritual context and
held as their ultimate goal some type of spiritual growth, personal
transformation, or transcendental experience. As a health care intervention,
however, meditation may be effective regardless of people's cultural or religious
background.
2) Relaxation Techniques
 Relaxation techniques are practices specifically designed to relieve tension and
strain. The specific technique may be aimed at reducing activity of the nerves
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that control the stress response (sympathetic nervous system), lowering blood
pressure, easing muscle tension, slowing metabolic processes, or altering brain
wave activity. Relaxation techniques may be used in combination with other
techniques, such as meditation, guided imagery, or hypnotherapy.
3) Guided imagery
 Guided imagery involves the use of mental images to promote relaxation
wellness, reduce pair, or facilitate healing of a particular ailment, such as cancer
or psychological trauma. The images can involve any of the senses and may be
self-directed or guided by a practitioner, sometimes in a group setting.
 For example, a person with cancer might be told to imagine an army of white
blood cells fighting against the cancer cells. Guided imagery has not been
thoroughly scientifically studied, but many people claim to have had success
with it.
4) Hypnotherapy
 This alternative therapy is derived from Western practice. In hypnotherapy
(hypnosis), people are guided into an advanced state of relaxation and
heightened attention. Hypnotize people become absorbed in the images
suggested by the hypnotherapist and are able to suspend disbelief. Because their
attention is more focused and they are more open to suggestion, hypnotherapy
can be used to help people change their behavior and thus improve their health.
Hypnotherapy can be used to treat or help treat purely psychological symptoms.
Hypnotherapy also may be helpful in treating many conditions and symptoms in
which psychological factors can influence physical symptoms:
 Phobias
 Certain in syndromes
 Smoking cessation
 Conversion disorders (in which apparent physical illness actually is caused
mainly by psychological stress and conflict)
 Irritable bowel syndrome
 Headaches
 Asthma
 Some skin disorders (such as warts and psoriasis)
 High blood pressure

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 Nausea and vomiting caused by chemotherapy, particularly the nausea some
people get before chemotherapy (anticipatory nausea)
 Anxiety and diminished quality of life in people who have cancer.
Hypnotherapy has been used with some success to help people stop smoking and
lose weight. Some people are able to learn to hypnotize themselves. The
mechanism of hypnotherapy is poorly understood from a scientific standpoint.

5) Biofeedback
 Biofeedback is a method of bringing unconscious biologic processes under
conscious control. Biofeedback involves the use of electronic devices to
measure and report back to the conscious mind information such as heart rate,
blood pressure, muscle tension, and brain surface electrical activity. With the
help of a therapist or with training, people then can understand why these
functions change and can learn how to regulate them. Biofeedback typically is
used to treat pain including headache and chronic abdominal pain, stress,
insomnia, focal or urinary incontinence attention deficit disorder and mild
cognitive impairment, and tinnitus.
 Biofeedback has been shown to be clinically effective in treating certain
problems (for example, headaches, incontinence. and attention deficit disorder),

D. Manipulative and Body-Based Methods

1) Yoga
 The fundamental idea behind the practice of Yoga is to unite the
individual self (Jiva) with the supreme or pure consciousness (Brahma).
The factual connotation of Yoga is unification. Merging in this static
realism liberates the spirit from all sense of separation. It liberates the
mind from the ignorance of tome, space & causation. However, as yogic
philosophy says, the human body and mind are part of the deceptive
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world of matter, matter with a limited period, whereas the spirit is endless
and passes onto a new world when this body dies. Therefore, fundamental
to yogic philosophy are the concept of karma cause and effect
relationship.

 In the present view, Yoga is one of the most helpful and healthy form of
experience to manage the influence of thinking by turning psychological and
physical force into spiritual energy. Yoga therapy eases oneself from the
cramped tension. Concentration is enhanced by yoga. Yoga therapy cures all
disease and controls the aging process. Its daily practice is often seen as a way
of gaining control over your health.
 Yoga therapy consists of three basic parts of your body which work together.
Physical posture
 It helps to stretch and strengthen your muscle. It also improves your mobility,
flexibility and balance. The proper posture enhances your body’s natural
function of circulation, elimination, respiration, and digestion.
Breathing technique
 It mainly focuses on awareness of breath and helps promote calm, focus the
mind and relieve stress and fatigue.
Relaxation technique
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 It mainly helps you to recharge and ease tension.
Benefit of yoga therapy
 Yoga therapy shows positive result in treating depression.
 Deep breathing associated with yoga is beneficial in controlling premature
ventricular complexes.
 Yoga therapy is beneficial in post treating strategy, breast cancer & other
survivors.
 Yoga therapy shows significant benefit that includes emotional function, fitness
variation and psychological benefits. In also shows variation in tension, mood
disturbances, cognitive function and gastrointestinal disturbances.
 Practice of regular yoga exercise increases your body’s ability of using
antioxidants. This is beneficial in prevention of cancer.
 If you are a diabetic patient then yoga therapy improves nerve function and
lower blood sugar.
 If you are suffering from rheumatoid arthritis, the practice of yoga increases
your hand grip strength.
 Yoga helps in treating some problems like asthma, respiration problems, back
pain, etc. it help in weight reduction.
2) Chiropractice
 In chiropractice, the relationship between the structure of the spine and function
of the nervous system is thought to be the key in maintaining or restoring
health. The main method for achieving balance is spinal manipulation.
 Chiropractic is often useful in treating low back pain, headaches, and nerve
impingement syndromes. Generally, however, the effect of manipulation on
conditions not directly related to the musculoskeletal system has not been
established. Serious complications resulting from spinal manipulation (eg, low
back pain, damage to cervical nerves, damage to arteries in the neck) are rare.
3) Tai Chi & Qigong
 It has recently been considered as an alternative method for lowering the blood
pressure levels. This discovery has big implication for patients who are
suffering from chronic hypertension. Knowing this makes it possible for such
people to avoid negative effects of continuous intake of prescribed anti32

hypertension drugs. Let's take a closer look at some issues surrounding such
therapy with regard to blood pressure monitoring.
 The potential of Tai Chi therapy to lower the high blood pressure is growing, as
we are continuing to live in high stress conditions., When we experience stress,
our body elicits a certain response to the stressful situation. The prolonged
periods of stress lead to chronic blood pressure fluctuations and create physical
changes in your body organs. All of these in their turn intensify hypertensive
conditions, When we are stressed, our pituitary gland releases a hormone called
ACTH (adrenocorticotropic hormone) which is triggering other glands,
including adrenal glands, to produce enormous amounts of adrenaline.
 Meditation including Tai Chi therapy, leads to a relaxation response. This can
result in loosening the walls of the arteries that carrying the blood to the brain.
This way the blood supply to the brain is increasing. Apart from reducing the
high blood pressure, repetitive activities (i.e., Tai Chi, Yoga, and others) can
positively affect m-iSbolic rate, heart and breathing rate, and other life
supporting processes.
E. Energy therapies
1) Massage Therapy
 Body tissues are manipulated to promote wellness and reduce pain and stress.
The therapeutic value of massage for many musculoskeletal symptoms and
stress is widely accepted. Massage has been shown to help relieve muscle
soreness, pain due to back injuries, and fibromyalgia and to help relieve anxiety
in cancer patients. Massage therapy is also effective in treating low birth weight
infants, preventing injury to the mother's genitals during childbirth, relieving
chronic constipation, and controlling asthma.

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2) Acupuncture
 A therapy within traditional Chinese medicine, is one the most widely accepted
alternative therapies in the Western world. Specific points on the body are
stimulated, usually by inserting thin needles into the skin and underlying
tissues. Sometimes additional stimulation is added by using a very low voltage
electrical current, by twisting the needle, or by warming the needle. Stimulating
these specific points is believed to unblock the flow of qi along energy
pathways (meridians) and thus restore balance between yin and yang. The
procedure is not painful but may cause a tingling sensation.
 A variation of acupuncture, called acupressure, uses localized massage instead
of needles to stimulate acupuncture points. Acupuncturists are licensed to
practice after receiving 3000 hours of training and passing a state board
examination, some medical doctors, often Pain specialists, perform acupuncture
after about 300 hours of training.

3) Reflexology
 A variant of massage therapy relies on manual pressure applied to specific areas
of the foot these areas are beloved to correspond to different organs or body
systems via meridians. Simulation of these areas is believed to eliminate the
blockage of energy responsible for pain or disease in the corresponding bogy
part.

4) Hand Mediated Bio-field Therapies
 Therapeutic touch (TT) is a mostly secular variant at healing, started by Dolores
Krieger in the early 1970s. The TT practitioner moves his hands over the
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patient's body, specifically the affected area, without actually touching the
patient. TT adherents claim that this directs the flow of chi so that the patient
can heal. The practice is based on the belief that living beings have an energy
field or aura which extends beyond the surface of the body that can be
manipulated by the therapist. No evidence of effectiveness has been found.

F. Other therapies

1. Traditional Chinese Medicine
 Traditional Chinese medicine: Originating > 2000 years ago, traditional Chinese
medicine is based on the theory that disease results from improper flow of the
life force (qi). Qi is restored by balancing the opposing forces of yin and yang,
which manifest in the body as heat and cold, external and internal, and
deficiency and excess. Various practices (eg, acupuncture, herbal remedies,
massage, meditation) are used to preserve and restore health.
2. Curanderismo
 It is a cultural healing tradition found in latin America and among many latinos
in the United States. Although it is a traditional healing system, it utilizes
western biomedical belief , treatment and practices. Three levels of care are
practiced among curanderos (man) and curanderas (women) the material level,
the spiritual level and the mental level. Healers have the gift for working at only
one of this level. The majority of a. healer Nock at the material level and most
combine spiritual healing, herbal medicine and first aid techniques.
3. Aroma Therapy
 Aromatherapy is based on the healing power of plant oils which may be
massaged into the skin, inhaled or used in the bath. Anecdotally it is said to
induce a feeling of well-being.
 Aromatherapy massage relieves tension and improves circulation and can
reduce anxiety in short-term settings such as intensive care. A trial of ‘melissa’
(lemon balm) aromatherapy shows highly significant effects in reducing
agitation and increasing social interaction in dementia patients.
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4. Spiritual Therapy
 Spiritual therapy is a regimen designed to heal ones spirit and psyche as well as
the body. In many traditions it is believed if one's spirit is ailing one's whole
being suffers. This is where spiritual therapy comes in. It treats the whole being,
especially the spirit to promote a healthy whole person.
a. Faith and prayer
 Faith is the confident belief or trust in the truth or trustworthiness of a person,
idea, or thing. The word 'faith* can refer to a religion itself or to religion in
general. As with "trust", faith involves a concept of future events or outcomes,
and is used conversely for a belief "not resting on logical proof or material
evidence. Informal usage of the word "faith" can be quite broad, and may be
used in place of "trust' or "belief."
b. Baha'i Faith
 In the Baha'i Faith is ultimately the acceptance of the divine authority of the
Manifestations of God. In the religion's view, faith and knowledge are both
required for spiritual growth. Faith involves more than outward obedience to
this authority, but also must be based on a deep personal understanding of
religious teachings.
c. Prayer
 Prayer is the act of addressing a god or spirit for the purpose of worship or
petition. Specific forms of this may include praise, requesting guidance or
assistance, confessing sins, as an act of reparation or an expression of one's
thoughts and emotions. The words used in prayer may take the form of
36

intercession, a hymn, incantation, words of gratitude, or a spontaneous utterance
in the person's praying words. Praying can be done in public, as a group, or in
private.
5. Music therapy
 It is an interpersonal process iii which a trained music therapist uses music and
all of its facets physical, emotional, mental, social, aesthetic, and spiritual to
help clients to improve or maintain their health. In some instances, the client's
needs are addressed directly through music; in others they are addressed
through the relationships that develop between the client and therapist. Music
therapy is used with individuals of all ages and with a variety of conditions,
including: psychiatric disorders, medical problems, physical handicaps, sensory
impairments, developmental disabilities, substance abuse, communication
disorders, interpersonal problems, and aging. It is also used to: improve
learning, build self-esteem, reduce stress, support physical exercises, and
facilitate a host of other health-related activities.
 It is considered one of the expressive therapies.
6. Humor and Laughter
 Laughing is found to lower blood pressure, reduce stress hormones, increase
muscle flexion, and boost immune function by raising levels of infectionfighting T-cells, disease-fighting proteins called Gamma-interferon and B-cells,
which produce disease-destroying antibodies. Laughter also triggers the release
of endorphins, the body's natural painkillers, and produces a general sense of
well-being. Laughter is infectious. Hospitals around the country are
incorporating formal and informal laughter therapy programs into their
therapeutic regimens. In countries such as India, laughing clubs in which
participants gather in the early morning for the sole purpose of laughing are
becoming as popular as Rotary Clubs in the United States.

Benefits of laughter,
 Laughter Activates the immune System
 Laughter Decreases "Stress" Hormones
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 Laughter brings in positive emotions that can enhance well being but cannot
replace conventional treatments. Hence it is another tool available to help
fight the disease.
Humour
 Humour or humor,is the tendency of particular cognitive experiences to provoke
laughter and provide amusement. Many theories exist about what humour is and
what social function it serves. People of all ages and cultures respond to
humour. The majority of people are able to be amused, to laugh or snUe at
something funny and thus they are considered to have a "sense of humour.
7. Bioelectromagnetic Therapy
 Binelectromagnetic therapy (BT) is the application of electromagnetic fields to
treat and prevent disease and promote health and longevity. Electromagnetisin is
a powerful clinical tool, simple to apply yet complex in its biological effects.

8. Photo Energy Therapy
 Photo energy therapy devices emit near infrared light (NIR Therapy) typically at
a wavelength of 880nm. This wavelength is believed to stimulate the release of
nitric oxide, an endothelium derived relaxing factor into the blood stream, thus
vasodilating the capilaries and venuoles so the microcirculatory system. This
increase in circulation has been shown effective in various clinical studies to
decrease pain in diabetic and non diabetic patients. Photo Energy Therapy
devices seem to address the underlying problem of neuropathies, poor
microcirculation, which lead to pain and numbness in the extremities.
9. Detoxification therapy
 Detoxification therapy involves the removal of toxic substance. Our body
naturally eliminates or neutralizes toxins. But due to industrial revolution the
accumulation of toxin (food additives, chemicals, anesthetics and residue of
pharma drugs, pesticides and heavy metals) surpasses its elimination.
Detoxification therapy treatment
 There are number of method of detoxification.
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 Firstly a brief physical checkup is made, X-Ray is taken, urine & blood sample
are sent for analysis, sometimes sweat and hair may be analyzed.
 Colonic irrigation, fasting, special diets, hyperthermia, other hydrotherapy
treatments, lymphatic stimulation and nutritional supplements are some
methods of detoxification.
 Nutritional Supplements - Intake of massive quantities of Vitamin C are
recommended for people undergoing detoxification treatment. Vitamin A,
Vitamin B and Vitamin E and minerals like Magnesium, Potassium, Selenium
and Zinc are also suggested. Herbs such as cayenne, Echinacea and garlic are
also included.
10. Animal Assisted Therapy
 (AAT) a type of therapy that involves an animal with specific characteristics
becoming a fundamental part of a person's treatment. Animal-assisted therapy is
designed to improve the physical, social, emotional, and/or cognitive
functioning of the patient, as well as provide educational & motivational
effectiveness for participants. AAT can be provided on an individual or group
basis. During AAT, therapists documents records and evaluate the participants’
progress.

Benefits
 People who have pets benefit in various ways, for example, the comfort of
physical contact with animals, reducing Icneliness, and increased opportunities
for meeting others, via the pets. In addition, caring for pets encourages
nurturance, responsibility, and adherence to a daily schedule.
Physical
 Improve fine motor skills.
 Improve wheelchair skills.
 Improve standing equilibrioception (balance). May lower blood pressure. Risk
for stroke or heart attack, and decrease depression.
Mental
39







Increase attention skills
Develop leisure/recreation skills.
Increase self-esteem.
Reduce anxiety.
Reduce loneliness.

Criticism
 The practice of capturing dolphins can leave more injured or even dead.
11. Horticultural therapy
 It is the practice of horticulture as therapy to improve human well-being.
“According to the American horticultural Therapy Association” is defined as "a
process utilizing plants and horticultural activities to improve social, educational,
psychological and physical adjustment of persons thus improving their body, mind,
and spirit."

Extended and expanded role of nurses
Introduction
 During the past five decades the nursing profession made significant progress
towards developing a body of scientific knowledge and establishing the
credibility of nursing science Nursing practice changes in response to consumer
demands and accessibility and involvement in decision making, new technology
changes in health care delivery systems and policy.
Nursing Roles
 Role is a set of expected behaviors associated with a poison's status or position
and it includes behavior, rights and responsibility.
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 Predominant Nursing Roles Nurses assume a number of roes when they provide
care to the client. Contemporary nursing requires that the nurse possess
knowledge and skits in a variety of areas. In the past the principle role of a
nurse was to provide care and comfort. But changes in nursing nave expanded
the role to include increased emphasis on health promotion and illness
prevention as well as a holistic approach.
The roles are
1. Health promoter and care giver.
2. Counselor.
3. Learner and teacher.
4. Protector and client advocate
5. Resource person.
6. Communicator.
7. Leader and manager.
8. Case manager.
9. Resource consumer.
10.Rehabilitator.
11.Clinical decision maker.
12. Political advocate.
13.Colleague and collaborator.

1.) Health Promoter and Care Giver

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 Health promotion is an important aspect of nursing practice. It is a way of
thinking that revolves around philosophy of wholeness, wellness and well
being. Many people are aware of the life style and illness and are developing
health promoting habits. The role of the nurse in health promotion is to work
these people for the process of assessing and evaluating health. Care giver role
includes those activities that assist the client physically and psychologically
while preserving client's dignity. Nurse's actions may involve full or partial care
for the client and supportive educative care to assist clients in attaining highest
possible levels of health and wellness specific activities of the care giver include
feeding bathing and administering medical care.
2.) Counselor

 When acting as a counselor the nurse assists the clients with problem
identification and resolution. Counseling is done to help clients increase their
coping skills. Effective counseling is holistic in that it addresses individual's
emotional, cognitive, spiritual dimensions.
3.) Learner and Teacher

42

 Nurse’s nave both learning and teaching responsibilities. We must continue to
team so that we can maintain our knowledge and skills amidst the many
changes in health care. Teaching is an intrinsic part of nursing. The nurse views
each interaction as an opportunity for education. As a teacher the nurse helps the
client ream about their health and the health care procedures they need to
perform to restore or to maintain the health. Nurses also teach unlicensed
assertive personal to whom they delegate care and they share their expertise
with other nurses and health professional.
4.) Protector and Client Advocate
 As a protector the nurse helps to maintain a safe environment for the client and
takes steps to prevent injury and protect the client from possible adverse effects
of diagnostics and treatment measures. A client advocate is a person, who
speaks up for or acts on behalf of the client. In the role of client advocate, the
nurse protects the client's human and legal rights and provides assistance in
asserting those rights if need arise. The nurse may also defend client's rights in a
general way by speaking out against policies or actions that endanger clients
well being or conflict with their rights.

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5.) Change Agent
 Nurse acts as clients to make modifications in their own behavior. Nurses also
act to make changes in a system such as clinical care if not helping client return
to health. Technological changes, changes of the population, and medication are
few of the change that nurse deals with daily.
6.) Communicator
 Communication is integral to all nursing roles. Nurses communicate with the
client, support person, other health professional and people in the community. In
the role of communicator nurses identify the patient problems and then
communicate these verbally or in writing to the other member of the health
team. The nurse must be able to communicate clearly and accurately in order for
clients health care needs to be met.
7.) Leader and manager
 Today’s professional nurses assume leadership and management responsibilities
regardless of the activity in which they are involved. A leader influences others
to work together to accomplish a specific goal. The leader role can be involved
in different level as individual, client, family, and group of clients, colleagues or
the community. As a manager the nurse manages the nursing care of the
individual’s families and community. The nurse manager also delegate nursing
activities to auxiliary workers and other nurse’s supervisors and evaluate their
performance.
44

8.) Case manager
 Nurse case manager works with the multidisciplinary health care team to ensure
the effectiveness of the case management plan and to monitor outcomes. Each
agency unit specifies the role of the nurse case manager. Regardless of setting
case manager help ensure that care is oriented to the client, while controlling
costs.
9.) Research consumer
 Nurse often use research to improve client care in nursing. According to ANA
position statement on education for participating in nurse’s research (1994) all
nurses share a commitment to the advancement of nursing science. Nurses in
clinical practice identify the need for investigation and collaborate with nurse
researcher who designs studies to address the problem and analyze data and
clinician will determine appropriate application of those findings to practice.
10.) Rehabilitator
 Rehabilitation is the process by which the individual returns to maximum
functioning after illness, accident or disabling events. Rehabilitative and
restorative activities range from teaching client to with crutches to helping
client cope with lifestyle changes associated with chronic illness.

11.) Clinical decision maker
45

 To provide effective critical care the nurses use critical thinking skills
throughout the nursing process. Before understanding any nursing actions the
nurse plans the action by deciding the best approach for the client. The nurse
makes this decision alone or in collaborative with family and in consultation
with other health care professionals.
12.) Political Advocate
 Nurses are actively participating in political process to promote change within
the profession and to influence policy making regarding nursing and other
health care policy issues.
13.) Colleague and collaborator

 Changing models of health care have created n need for modification of
traditional roles.
 Collaborating among health care professional professionals involves recognition
of expertise of others within and outside ones profession and referral to those
provide when appropriate.
 Collaborating also involves some shared functioning and common focus on the
same overall mission.
Extended care facilities
 Extended care facilities formerly called nursing homes are more often
multilevel campuses that include independent living quarters for seniors and
assisted living facilities skilled nursing facilities and extended care facilities that
provide care to clients of all ages who require rehabilitation or custodial care.
An extended care facility is an institution providing intermediate and long term
46

medical, nursing or custodial care for clients recovering from acute illness or
clients with chronic illness or disabilities. Extended care facilities are becoming
the more popular means for managing the health care needs of clients who
require additional care but do not meet the criteria for remaining in hospital
nurses in extended care facilities assist clients with their daily activities, provide
care when necessary and coordinate rehabilitation services.
Extended Roles of the Nurse
 Nurses in extended care facilities assist clients with their daily activities provide
care when necessary and coordinate rehabilitation activities. These nurses has
increased responsibilities and autonomy and they are supposed to provide car in
variety of settings such as hospital, community etc.
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
21)
22)
23)
24)
25)

Care Giver.
Manager.
Advocate.
Counselor.
Educator.
Consultant
Researcher
Collaborator
School Health Nurse.
Occupational Health Nurse.
Parish Nurse.
Public Health Nurse.
Private Health Nurse.
Home Care Nurse.
Hospice Nurse.
Rehabilitation Nurse.
Office Nurse.
Nurse Epidemiologist.
Military Nurse.
Aerospace Nurse.
Tele nurse.
Disaster Nursing.
Forensic Nurse.
Prison Nurse.
Peace Corps Nurse.

47

1.) Care Giver

 Care giving role is a primary role of the nurse. The provision of care to clients
combines both the arts & science of nursing which helps clients regain health
through healing process. Healing is more than just curing a specific disease,
although treatment skills that promote physical health are important to
caregivers. The nurse adds the holistic health care needs of the client, including
measures to restore emotional, spiritual & social well being. The caregiver helps
the client & families set goals & meet those goals with a minimal cost of time &
energy.
2.) Manager
 As a manager, the nurse coordinates the activities of other members of the
health care team, such as nutrionists & physical therapists, when managing care
for a group of clients. Nurses must also manage their own time & resources of
the practice setting when providing care to several clients. As a clinical decision
maker, the nurse uses critical thinking skills throughout the nursing process to
provide effective care. Before giving care, the nurse should plan the action by
deciding the best approach for each client. The nurse makes these decisions
alone or in collaboration and consultation with other health care professionals.
3.) Protector and Advocate
 As protector, the nurse helps to maintain a safe environment for the client and
takes steps to prevent injury and protect client from possible adverse effects of
diagnostic or treatment measures confirming that a client does not have an
allergy to a medication and providing immunization.
 As advocate, nurse protects the client human and legal rips and provides
assistance in asserting those rights if the need arises. The task of an advocate is
48

to be a supporter and source of information for the patient and the patients
significant others.
 Eg: Nurse may provide additional information for a client who is trying to
decide whether or not to accept a treatment or the nurse may assist with
communication within the family.
4.) Counselor
 In the role of a counselor, nurse helps to explore feelings and attitudes about
wellness & illness with patients and their families. It involves providing
emotional, intellectual arid psychological support. In contrast to a
psychotherapist, the nurse counsels primarily healthy individuals with normal
adjustment difficulties. The nurse encourages the client to look at alternative
behaviors, recognize the choices and develop a sense of control, Counseling can
be provided on a one — to — one basis or in groups. Counseling requires
therapeutic communication skills. She should be a skilled leader able to
analyses a situation, synthesize information & experiences & evaluate the
progress & productivity of the individual or group. The nurse must also be
willing to model & teach desired behaviors, to be sincere when dealing with
people.
5.) Nurse Educator
 The nurse educators are employed in nursing programs at educational
institutions and in hospital staff development department of health care agencies
and client education departments. A nurse educator usually has a baccalaureate
degree or more advanced preparation. Faculty members in a school prepares
student's to function as a nurse and are responsible for teaching current nursing
practices theory and necessary skills in laboratories and clinical settings.
 Nurse educators in staff development department provide educational programs
for nurses within their institute. As a nurse educator in client education
department she/he teaches ill or disabled client and families to provide care in
home.
6.) Communicator
 The role of communicator is central to all nursing roles and activities. Nursing
involves communication with clients, families, other nurses and health care
professionals, resource persons and the community. With any clear
49

communication, it is impossible to give care effectively, make decision with
clients and families, and protect clients from threats' to well being, coordinate
and manage client care, assist the client in rehabilitation, offer comfort or teach.
Quality of communication is a critical factor in meeting the needs of
individuals, families and communities. Communication facilitates all nursing
actions. The nurse communicates to other health care personnel's the nursing
interventions planned and implemented for each client and should document
them on client record. This type of communication needs to be concise, clear
and relevant.
7.) Rehabilitator
 Rehabilitation is the process by which individuals return to maximum levels of
functioning after illness, accidents or other disability events. Usually, client
experiences physical or emotional impairment that changes their lives and the
nurse helps them to adapt as fully as possible by using her knowledge and skills
of many concepts when she learned. Rehabilitation activities range from
teaching client to walk with crutches to helping clients to cope with life style
changes often associated with chronic illness.
8.) Collaborator
 Many professions make up the team involved in the care of each client. Besides
nurse, there also can be physical therapists, occupational therapists, medical
social workers, home health aids, recreational therapists, volunteers and
nutritionist. The nurse collaborates with other team members when providing
care to a client. Quality care is given when nurse and team members work
together in planning for the patient's care management. A nurse can be a good
collaborator when she is knowledgeable, a good planner when providing patient
care, and a good communicator of each patient's assessment and need to work
well with patients, families and health care members.

9.) School Heath Nurse
 School nursing is a specialized practice of professional nursing that facilitates
the well being, academic success and lifelong achievements of students. School
heath services have the goal of supporting educational
50

 Success by enhancing health. Effective school health services are
comprehensive programmes that Integrate health promotion principles
throughout school's curriculum. A school nurse develops programmes that foster
children's growth, positive life skills for successful coping and acquisition of
knowledge and skills for self care and thereby reinforce positive health
attitudes.
10.) Occupational Health Services

 Occupational and environmental health nursing is the specialty practice that
provides for and delivers health and safety programmes and services to workers.
Worker populations and community groups. The practice focuses on promotion
and restoration of health, prevention of illness and injury and protection from
work related and environmental hazards.
11.) Parish Nurse
 Parish nurse is the most commonly used term for the professional advanced
nurse practice role for the gathering in churches, cathedrals, temples, or
mosques and acknowledge common faith traditions. Parish nurse in church has
been referred to as congregational health minister, an emergency church nurse, a
faith community nurse or a health minister's nurse. Parish nurse respond to
health and wellness needs within the context of populations of faith
communities and are partners with the church in fulfilling the mission of health
ministry.
51

12.) Public Health Nurse
 Public Health Nurse (PHN)
community health. The PHN
area & help the client & the
lifestyle issues. PHN should
immunity.

is a registered nurse with special training in
works special training in a specific geographic
family with health concerns and parenting and
be knowledgeable about the resources in her

13.) Private Duty Nurse



Private duty nurse is a registered nurse or a licensed practical nurse that provide
nursing services to patients at home or any other setting in accordance with
physician orders. Patients may receive continuous nursing services beyond the
scope of care available from Certified Home Health care Agencies (CHHAS).
Patients, may need only intermittent nursing services which are normally
provided with CHHAS which are unavailable at the time the patients needs
them.

14.) Home Care Nurse

52

 Home care nurse is a nurse who provides periodic care to patients with in their
home environment as ordered by the physician. It includes health maintenance,
education, illness prevention, diagnosis and treatment of disease, balliation and
rehabilitation. It is component of a continuum of comprehensive health care
where by health services are provided to individuals and families in their home
to promote, maintain or restore health, or to maximize the level of independence
while minimizing the effects of disability and illness. Home care can be
restorative care or acute care depending upon the client condition. Home care
nurse acts as referral agent for clients who are discharged from acute care
settings such as hospitals or mental health facilities for continued care & follow
up. In community have care nurse, conducts home visits where nurse can view
clients in perspective and thus can understand them better, capitalize on their
resources and tailor health services to meet their needs.
15.) Hospice Nurse
 Hospice nurse is one who provides a family centered care and allows clients to
live and remain at home with comfort, independence and dignity, while
alleviating the strains caused by terminal phase. The nurse provides care and
support for the client and family during the terminal phase or at the time of
death. Hospice care can be given to patients to hospital, nursing home or private
hospice facility
16.) Rehabilitation Nurse
 Rehabilitation nurse is a nurse who specializes in assisting persons with
disabilities and chronic illness to attain optimal function, health and adapt to an
altered life style. Rehabilitation nurse can practice in hospitals, inpatient
53

rehabilitation center, outpatient rehabilitation centers, long term care facilities,
community and home health settings, insurance companies, private practice.
17.) Office Nurse
 Office nurse is also called as clinic nurse. Office nurse provides patient care
along with physician in settings such as, physician offices, surgi centers and
medical office buildings. The main focus is on diagnosis and treatment of
specific illness rather than health promotion. But now the patient enrole to have
regular physical examination.
18.) Nurse Epidemiologist
 Nurse epidemiologist searches for new diseases and its reporting and taking part
in health programmes.
19.) Critical Care Nurse
 Critical care has progressed from a "do the test you can” approach into a
specialty based on a solid body of scientific knowledge and intricate skills. The
critical care nurse uses primary nursing delivery system which allows a certain
degree of independence and also serves as a fully fledged team member in
patient management. Qualification of critical care nurses are basic B.Sc. degree
or diploma in nursing and advanced preparation in critical care nursing.
20.) Nurse Administrator
 The nurse administrator manages client care, including delivery of nursing
service. The functions of nursing administrator include budgeting, staffing and
planning programs. The educational preparation for the nurse administrator is at
least a baccalaureate degree in nursing and frequently a masters or doctoral
degree.
21.) Nurse Practitioner
 Nurse practitioners are currently recognized as a critical component of health
care reform. They are employed in health care agencies or community based
settings. They usually deal with non emergency, acute or chronic illness and
provide primary ambulatory care.
54

22.) Nurse Midwife
 An RN who has completed a course in midwifery and is certified by the
corresponding national council can be a nurse midwife. The nurse midwife
gives perinatal care for the mothers. They also conduct routine pap smear,
family planning and routine breast examinations.
23.) Community Health Nurse
 Community health nurse functions within the communal framework and serves
the health needs of the portion of public assigned and delivers care to the
community as a whole. The goal of the community health nurse is to improve
health of the community as a whole.
24.) Occupational Health Nurse
 It is a branch of public health nursing. The occupational health nurse work in
traditional manufacturing, industry service, construction sites and government
settings. The roles include: worker/ workplace assessment and surveillance,
primary care, case management, counseling, health promoting and protection,
research, administration and management, community orientation, legal and
ethical monitoring.
25.) Psychiatric Nurse
 It is a branch of nursing that deals with mentally challenged and mentally
disturbed clients and their needs, in daily life as well as in the social life. The
role includes educator, surrogate, counseling, psychotherapist, and advocate.
26.) Medical Surgical Nurse
 It is a branch of medicine that deals with the overall medical and surgical needs
of the client and the functions include assessment of the problem help in
diagnosis, treatment, administration of medication, assistance in ADL.
(Activities of daily living) and so on.

Expanded Role of Nurses

55

 Because of increasing educational opportunities for nurses, the growth of
nursing as a profession and a greater concern for lob enrichment, the nursing
profession offers expanded role and different kinds of career opportunities.
The expanded roles include the following,
1. Advanced Nurse Practitioner.
2. Clinical nurse specialist.
3. Nurse anesthetist.
4. Nurse researcher.
5. Nurse educator.
6. Nene entrepreneur.
7. Acute care nurse practitioner.
8. Operating home nurse.
9. Professional nurse care manager.
10. Rehabilitation nurse.
11. Nurse analyst.
12. Travel nurse.
13. Nurse oncologist.
14. Sport nursing.
15. Nurse as authors.
16. Nurse liaison,
17. Space nursing.
18. Hospice nurse.
19. School health nurse.
20. Tele nursing.
21. Cruise ship/ resort nurse
56

22. Attorney.
23. Disaster/ bioterrorism nurse.
24. Epidemiology nurse.
25. Ethicist.

1.) Advanced Nurse Practitioner
 Nurses who has an advanced education and is a graduate of a nurse practitioner
program is employed in health care agencies or in community settings and deals
with non emergency acute or chronic illness and provide primary ambulatory
care.
The major nurse practitioner categories are:
 Adult nurse practitioners are those who provide primary ambulatory care to
adults with a non emergency, acute or chronic illness and some setting tertiary
care.
 Family nurse practitioners provide primary ambulatory care for families usually
in collaboration with family care physician.
 Pediatric nurse practitioner provides care to infants and children.
 An obstetrics and gynecology nurse practitioner provides care to women
seeking obstetrical and gynecological health care and conducts delivery
independently.
 Geriatric nurse practitioner provides ambulatory or in patient care to older
adults. Their activities include interventions for health maintenance, illness
prevention or health restoration
2.) Nurse Clinician/ Clinical Nurse Specialist
 The clinical nurse specialist has a master's degree in nursing and expertise in a
specialized area of practice. The CNS may work in primary care, acute care,
restorative care and community based settings. The CNS function as client care
provider, educator, and consultant, and researcher, manager, to plan and
improve the quality of care provided to the client and family.
3.) Nurse Anesthetist
57

 A nurse anesthetist is an RN who received advanced training in an accelerated
program of anesthesiology.
Functions
 Carries preoperative visits and assessments.
 Administration of general anesthetic agent for surgery under supervision of
anesthetist.
 Assessment of post operative status of client.
4.) Nurse Researcher
 Minimum educational qualification is a doctorate, with at least a masters degree
in nursing. The nurse researcher investigates problems to improve nursing care
and to further define and expand the scope of nursing. They may be employed
in an academic setting, hospital or independent professional or community
service agencies.
5.) Advanced Nurse Educator
 The nurse educator is usually holder a baccalaureate degree holder or more
advanced and frequently an expert in a particular area of practice.
6.) Acute Care Nurse Practitioner
 An acute care nurse practitioner functions in settings where critically ill patients
reside, this type of nurses provide special expertise. The certification includes
physiology, advanced assessment, advanced pathphysiology, pharmacology and
advanced therapeutics.
7.) Nurse Entrepreneur
 An entrepreneur is an individual who organize operates and assumes the risk for
business ventures. Such business includes independent nursing practice,
consultant services etc. The nurse may be involved in education consultation
research etc.

8.) Operating Room Nurse
58

 When patients are admitted before and after surgery, the operating room nurse
monitors the patient’s progress from the time he/she enters the operating room
until he/she is dismissed to the attending staff nurse. She also performs
preoperative assessment, prepares the patient for surgery, set up for surgery,
assists the surgeon during the procedure and manages patent recovery.
9.) Professional Nurse Case Manager
 The nurse case manager assesses the patient and develops care according to
expected out comes in terms of cost and quality.
10.) Rehabilitation Nurse
 The most important role of rehabilitation nurse is education. She teaches the
client to perform self assessment, make decisions about beginning continuing
self care measures. Perform every day activities and evaluate the progress and
recovery.
11.) Travel Nursing
 Travel nursing and the Travel Nursing industry developed in response to the
nursing shortage in which nurses are relocated for short-term nursing positions.
Most nurses enjoy travel nursing for 3 reasons,
 Visiting many different locations.
 Free benefits.
 Higher salary with bonuses.
12.) Nurse Oncologist
 Advance oncology nursing practice is defined as the practice of expert
competency and leadership in the provisional care to individuals with an actual
or potential diagnosis to cancer.
13.) Nurse Informatics/Nursing Analyst
 The nursing analyst works within the management team to ensure high quality
of performance, compliance and technical support to both the management and
the nursing staff. The nursing analyst is involved in data analysis and
interpretation with regards to effectiveness and efficiency of data collection,
entry and use within the various areas of the hospital or healthcare facility.
59

14.) Sport Nursing
 Helping humans stay healthy and prevent disease is one of the main thrusts
behind an emerging trend that combines nursing with some aspect of fitness or
sports. Although the nursing profession has yet to officially develop a specialty
in 'fitness nursing' or 'sports nursing' on either the professional or academic
level, a growing number of nurses are becoming involved in these areas. The
connection between physical fitness, wellness and disease prevention is well
documented. As a result, hospitals and HMOs around the country have begun
opening fitness centers and offering wellness programs with information on
nutrition, stress management and exercise.
 Some nurses are involved in sports medicine on a full-time basis while others
work on a part-time, contract basis for sports teams For example, some nurses
work for professional football teams each slimmer, evaluating the health and
fitness of players who are either preparing for another season or trying to make
the team for the first time. Other nurses work professional baseball games,
either sitting in the dugout to help injured players or treating injured fans at the
first-aid stations.
15.) Hospice Nurse/ Palliative Nurse

 The focus of hospice care is a comprehensive physical, psychosocial, emotional,
and spiritual care to terminally ill persons and their families. Hospice providers
promote quality of life by protecting patients from burdensome interventions
and providing care at home, whenever possibly, instead of the hospital. The care
that both hospice and palliative care nurses provide is essentially the same as
demonstrated by the Hospice and Palliative Nurses Role Delineation Study.
However, hospice and palliative care nurses differ in their preparation and
practice settings.
60

16.) Nurse liaison
 The Nurse Liaison's role is multifaceted. They are the vital link between the
potential patient and the rehabilitation facility. In this capacity, the transition
between an acute hospitalization and rehabilitation is made as smooth as
possible for the patient. The Nurse Liaison explains to the potential patient and
his/her family members what to expect during the rehabilitation stay. This
explanation is usually given during the assessment of the potential patient. The
Nurse Liaison performs the assessment at the request of the attending physician.
This information, once obtained, is then submitted to the physician and the
admissions staff for review. The major role in liaison nursing is enhancement of
delivery of psychological nursing care and effective management. Also serves
as a catalyst in negotiations with stet and clients The Nurse Liaison is an
RN/LPN currently licensed in the state of Tennessee He/she has three or more
years of diverse clinical experience, sound clinical judgment, and excellent
assessment skills.
17.) Space Nursing
 Space nurses provide a on the ground monitoring and a full range of health
services to astronauts, who are screened to determine if they meet the NASA
health requirements and in some cases, military stipulations It is very crucial for
mission safety and service eligibility A dispensary stalled by nurses is included
in NASA's long term plans, which call for larger space stations and a permanent
lunar base Flight medicine nurses also coordinate dietary and fitness services,
clinic nurse staff a sick call service for astronauts to use before and after flight.
Space nurse society members now meet yearly at conferences to exchange ideas
share research findings, and discuss application of research findings, and
application of nursing methods used on earth in space settings. The members are
with a basic nursing degree and a doctorate or masters in any discipline of
nursing. The skills needed are excellent communication interest and knowledge
of aerospace industry and challenges, mental health skills, innovation and
creativity, knowledge of physics and engineering.

61

18.) Tele Nursing

 This refers to the use of telecommunications and information technology for
providing nursing services in health care whenever a large physical distance
exists between patient and nurse, or between any numbers of nurses. As a field
it is part of telehealth, and has many points of contacts with other medical and
non-medical applications, such as tele-diagnosis, tele-consultation, telemonitoring, etc. Telenursing is achieving a large rate of growth in many
countries, due to several factors: the preoccupation in driving down the costs of
health care, an increase in the number of aging and chronically ill population,
and the increase in coverage of health care to distant, rural, small or sparsely
populated regions. Among its many benefits, telenursing may help solve
increasing shortages of nurses; to reduce distances and save travel time, and to
keep patients out of hospital. A greater degree of job satisfaction has been
registered among telenurses.
19.) School Health Nurse
 The role of the nurse is to support the educational process by helping students
keep healthy and by teaching students and teacher's preventive practices. The
responsibilities include first aid, screening follow up, control of communicable
diseases. Immunization, teaching health classes, transmitting knowledge
regarding healthy behaviors, conducting health related studies, referral services.
62

20.) Cruise Ship/ Resort Nurse
 These nurses work on ships or resorts to provide emergency and general care to
passengers/ vacationers, should it be required. These nurses also serve as part of
the occupational health team of the crew who live in the ship for 6 to 8 months
of time, or the staff at resorts. Responsibilities include providing patient care in
the health centre and dealing with onsite emergencies. The requirements are A
registration with a minimum of 2 years of experience in recent hospital
required. Experience with cardiac care, trauma, and internal medicine is
desirable. They must possess excellent interpersonal skills, enjoy travelling and
be very flexible with time, strong health assessment skills, possess a valid
passport and able to tackle minor illnesses
21.) Attorney
 Nurse attorneys engage in a range of legal activities including the following,
providing legal consult, prosecute, defend cases; may represent individuals,
patients, hospitals health professionals or institutions, provide depositions and
court testimony, engage in legal research , define standards of care, serve as
quality-of-care experts for hospitals and other health care institutions, review'
cases, define applicable standards of care, organize records, research the
literature, provide behind the screen or up front consultations, interview clients
and witnesses, prepare exhibits, prepare questions for depositions and court. A
register nurse with a law degree fulfills the criteria.
63

22.) Disaster/ Bioterrorism Nurse

 These nurses' works in disaster areas that are the result of bioterrorist attack on
in situations caused by natural disaster, war or poverty, Red Cross nurses are
often part of this wing of nurses. A basic degree in nursing is needed and
should be the member of a society like Red Cross. The skills include emergency
room and critical care experience, experience with local disaster action teams,
management skills, ability to meet the needs of the people in high crisis
situations. Knowledge of disaster preparedness and basic first aid.
23.) Nurse as Authors
 An RN who works in any area of writing, this written material may be used in
research education, training, sales and marketing, and other mediums and
communication forums. Nursing knowledge must be disseminated as widely as
possible to nursing practice and keep pace with the health needs of the
community. The quality of journals which publish, materials concerning nursing
issues depends on quality of material submitted. It's the responsibility of nurses
to attempt to publish any new knowledge they gain.
24.) Epidemiology Nurse
 A nurse epidemiologist investigates trends in groups or aggregates and studies
the occurrence of diseases and injuries. The information is gathered from census
data and statistics and reportable disease records. They identify population at
64

risk monitor the progress of disease, specify areas of health care need,
determine priorities and size and scope of programs and evaluate their impact.
They don't provide direct nursing care, but they do research and publish the
latest trends in health care. Masters degree in community health or PhD
preferred.
25.) Ethicist
 A nurse knows about legal/morale/ethical issues and provides services for
patients & families are called nurse ethicist. The nurse may work with an
ethicist team to develop a detailed investigation plan to answer question raised
by an ethics violation allegation or resolve clinical dilemmas. The criteria are
the master’s degree in bioethics or related field along with a registered nurse
certificate.

65

MCQs

1) What is NPA?
a. Nurse planning association
b. Nurse practice act
c. Nurse preparation act
d. Nurse providing act
2) When the Military Nursing Service has origin?
a. 1881
b. 1820
c. 1888
d. 1920
3) What do you mean by “nurturing”?
a. Health
b. Illness
c. Nourishing
d. Diseases
4) Which one of the below therapy is one type of Biologically Based Treatments?
a. Herbal Medicine
b. Naturopathy
c. Ayurveda
d. Meditation
5) Which one of the below is the expanded role of nurse?
a. Advocate
b. Military Nurse
c. Occupational Health Nurse
d. Sport nursing

Answer key
1)

b
66

2)

a

3)

c

4)

a

5)

d

References
Website
1. www.Who.int/health-system- performance/www.cms.hhs.gov/
2. http://www.ask.com/web?
q=ayurveda+as+alternative+system+of+medicine&qsrc=19&o=14087&l=dis
3. http://www.springerlink.com/content/m41312558q8440p4/
4. http://journals.lww.com/hnpjournal/Abstract/2009/07000/An_Ayurvedic_Approach
_to_Postpartum_Depression.2.aspx
5. http://www.answers.com/topic/alternative-medicine
6. http://en.wikipedia.org/wiki/Yoga_as_exercise_or_alternative_medicine
7. http://en.wikipedia.org/wiki/Power_yoga
8. http://en.wikipedia.org/wiki/Wikipedia:About.
9. www.wikipedia.com
10.www.roleofnurse.in
11.www.googleimages.in
12.www.expandedroleofnurse.in
13.www.extendedroleofnurse.in

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published by EMMESS Publishers, P. 648 – 655.
67

 Barker Anne M. “A text book of Advanced nursing practice”, 2009
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 Dr.Sundar lal, Adarsh, Pankaj: Text book of community medicine. 1st
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EVIDENCE BASED STUDY ON
USE OF COMPLEMENTARY MEDICAL THERAPIES BY ISRAELI
PATIENTS UNDERGOING IN VITRO FERTILIZATION
68

Abstract
OBJECTIVE:
To evaluate the prevalence and characteristics of complementary medical therapy (CMT) use among
Israeli couples undergoing in vitro fertilization (IVF).
METHODS:
In a cross-sectional study, men and women undergoing treatment at four IVF units in Israel were
invited to complete an anonymous questionnaire between May 2010 and December 2011. Patients
were considered users of CMT if they reported that either partner used at least one type of CMT for
treating infertility. Stepwise backward logistic regression was used to assess the independent effects
of variables on CMT utilization.
RESULTS:
Of 511 patients approached, 400 (78.1%) completed the survey and 159 (39.8%) indicated that CMT
for infertility was used by one or both partners. Higher CMT use was significantly associated with
the treating hospital, post high-school education, more than three previous IVF trials, being
employed, and using psychosocial support (all P<0.05). Most users (75/129; 58.1%) did not notify
the IVF clinic medical staff about concurrent use of CMT.
CONCLUSION:
Use of CMTs was widely reported by Israeli patients undergoing IVF, particularly those with higher
education, and those undergoing repeated IVF trials and receiving psychosocial support. IVF staff
ought to be aware of the widespread utilization of CMTs because the impact of these therapies on
IVF outcomes is inconclusive.

Population

Intervention

Comparison

Outcome

(P)

(I)

(C)

(O)

To evaluate the prevalence
and characteristics

Patients were considered
users of CMT if they

No comparison

Of 511 patients
approached, 400

69

of complementary medica
l therapy (CMT) use
among Israeli couples
undergoing in vitro
fertilization.

reported that either partner
used at least one type of
CMT for treating infertility.
Stepwise backward logistic
regression was used to
assess the independent
effects of variables on
CMT utilization.

70

(78.1%) completed
the survey and 159
(39.8%) indicated
that CMT for
infertility was used
by one or both
partners. Higher
CMT use was
significantly
associated with the
treating hospital,
post high-school
education, more
than three previous
IVF trials, being
employed, and using
psychosocial
support (all P<0.05).
Most users (75/129;
58.1%) did not
notify the IVF clinic
medical staff about
concurrent use of
CMT.

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