CAM (Contemporary and alternative medication) has been used by many of the healthcare professionals since a long time but still its significant use is limited in healthcare practice. From the ancient time, people are using acupuncture therapy for managing pain and hospitals require clear policies and guidelines for the application of CAM. In the case study, nurse use the non-invasive approach for pain management, however the use of alternative medication is not clearly stated in the clinical guidelines of the hospital, and the hospital organizations need clear guidelines for the practical application of CAM. A clear relation of contemporary and alternative intervention and National Safety and Quality Health Service Standards (NSQHS) is clearly detailed in the case study. In the given case, the patient’s chronic back sore can increase pain and discomfort and may increase the existing illness, however, using complementary and alternative medication for back pain management has shown positive results by reducing pain with less side-effects (Mehta et al., 2017). Moreover, National Health and Medical Research Council (NHMRC) have also defined the effectiveness of alternative medication for pain management based on the beneficial use of homeopathic measures for managing pain. However, guidelines should also focus on the introduction of non-invasive approaches like topical ointments and exercise for managing pain (Beattie et al., 2016). It has been observed that 1 in 5 Australians suffers from chronic pain and the incidence is increasing every day and around 67%–72% people have visited osteopathic therapy for lower back pain or neck pain. This evidence will create space for evident based policies for guiding the population to use CAM (Beattie et al., 2016).
These approaches can be included in the 2 and 3 standard of the NSHQS guidelines for improving patient health, based on evident based practices (Australian Commission of Safety and Quality in Health Care (ACSQHC). This non-invasive approach has been addressed by the National Health Priority Areas (NHPA) to strengthen hospital care guidelines to minimize risk associated with the medications. However, there should be a standardized guideline to support nurses for the effective application of CAM as an alternative method. However, the evidences mentioned suggests that the increasing use of non-invasive procedures will minimize the side effects from medication and NSQHS Standard safe use of mediation, highlights a system that focuses on the safe and appropriate prescribing and monitoring for effective care and safety(NMBA, 2020). The guidelines must introduce the policies of CAM as an alternative approach for pain management. Research areas for safe use of CAM need to improve moreover, multiple uses of therapies for pain management can be detailed. The government should focus on non-invasive strategies for enhancing and improving the arranged care disciples altogether.
The four principles in nursing practice includes autonomy, beneficence, non-maleficence, and justice (Bakewell et al., 2020). In the care system, the guidelines does not include the use of contemporary and alternative medications for pain management, however the alternative medicine has been in process and used by few hospital organizations. The policies for complementary practices is not defined in the standard Australian guidelines and therefore conflicts with the ethical principle of justice by unsuccessful attempts to create space that guarantees equity in care. The idea of beneficence ethic is observed to entail the idea of doing well considering patient benefit. The argument tries to evaluate the right of patient to receive arranged care for improved patient outcome (Kemparaj et al., 2020). The ethics of beneficence focuses to provide no harm to the patient by taking potential decisions for patient safety. In the healthcare systems, nurse provides contemporary pain management medications to minimize pain without their consent which otherwise can result in potential harm in terms of various side-effects and therefore contradicting the beneficence bioethics (Kemparaj et al., 2020).
When considering non-maleficence, it could be argued that alternative method for pain management can outline the potential side-effects from pain relievers like shallow breathing or dermal allergies and therefore adding pain to patients. For example, aspirin has been widely used to pain inflammatory pain however, many can cause allergic reactions in some patients like itchy rashes and asthma (ASCIA, 2020). Therefore, the idea of non-maleficence or doing no harm is not justified (Bakewell et al.,2020). In contrast, providing pain killers can increase the associated risk with illness and therefore providing contemporary aid supported the patient and manages pain. Also, the incidences in the hospital settings have positive results of contemporary pain management, acting in the best interests of the patient by improving quality care and therefore, the healthcare organizations should engage the healthcare workers for effective application of CAM (Beattie et al., 2016).The prime principle of medical ethic aim to allow the patient to take decisions regarding their medical care. Also, it enables the health professionals to make decisions in best interest of the patients and protects their rights to safe and quality care During therauptic process nurses must first explain the treatment procedure by keeping the final call on the patient (Bakewell et al.,2020). In the healthcare systems, most of the nurse did not inform patient before going for contemporary and alternative medication to treat pain which disagree with the bio-ethic autonomy (Beattie et al., 2016). In contrast, health care workers must involve patients in the advanced care planning and use of contemporary medications to achieve autonomy bio-ethic.
So the healthcare systems should involve patients in advanced planning by providing the multiple treatment choices including contemporary and alternative to meet their bio-ethical rights.
The complementary and alternative medication is not implemented in every health care channels. After researching and evaluating a wide range of evidences regarding their practical application, the lack of education and clinical leadership skills was found the prime reason creating gap in the CAM intervention (Steel et al., 2018). Moreover, lack of formal training for providing CAM is also considered in the deficit. Also, lack of effective communication to guide patients about use of CAM is a reason for failed CAM interventions. These three sustaining issues will hamper the practical application of contemporary and medical interventions in the healthcare systems (Reid et al.,2017). However, imparting knowledge among the health care nurses regarding the importance of non-invasive medications and alternative interventions for pain management will support the CAM progression. The most essential aspect in CAM implication is knowledge about the illness along with proper knowledge about the taxonomy and pharmacokinetics of the CAM interventions. It has been observed around 46% of the healthcare know about the safety of non-invasive medication in the hospital settings and evidences have stated the future policies regarding the safe use of CAM is beneficial (Blaicha et al.,2018). CAM will be favored by educating the nurses to use CAM as an alternative option for pain management. Implication of clinical governance and clinical decision making skills supported the alternative medication intervention during safe and effective therapeutic practice. Academic Medical Centers for Integrative Medicine is a consortium which aims to implement CAM activities in integrative medicine for minimizing pain associated with chronic illness.
The lack of formal training among nurse prevent the use of alternative medication for pain management in the healthcare systems. Evidences emphasize that the inability to accurately identify the disease and apply guidelines into clinical practice within the CAM are barriers to timely care and support. Firstly, the introduction of clinical criteria to assist with the identification of patient illness (Blaicha et al.,2018). Moreover, the introduction of these clinical and medical interventions in the guidelines will provide documental support during its practical implication. Effective communication bridges gap in therapeutic relationship leading to quality care and improved patient outcomes. Proficient nurses will effectively communicate and share the information regarding alternative medication for managing pain while keeping the last decisions on them (Blaicha et al.,2018). This means the effective use of contemporary medication is only possible, by asking the patients for treatment options. The application of alternative and non-invasive treatment option is useful to minimize the pain associated with end-of-life phase which is supported also by the family members. Moreover, non-invasive treatment options will minimize the side-effects linked with the pharmaceutical meications.
ASCIA.(2020). Allergic reactions to aspirin and other pain killers. Retrieved from https://www.allergy.org.au/patients/drug-allergy/allergic-reactions-to-aspirin-and-other-pain-killers
Blaicha, A..Steelbc, D..Clarka, J.. Adams, B. (2018). Challenges and opportunities for Australian osteopathy: A qualitative study of the perceptions of registered osteopaths. International Journal of Osteopathic Medicine, 30,18-24.
Bakewell, F., Pauls, M. A., &Migneault, D. (2020).Ethical Considerations of the Duty to Care and Physician Safety in the COVID-19 Pandemic.Canadian Journal of Emergency Medicine, 22(4),1–6.
Beattie, P.F., Silfies, S.P., & Jordon, M. (2016). The evolving role of physical therapists in the long-term management of chronic low back pain: Longitudinal care using assisted self-management strategies Brazilian Journal of Physical Therapy, 4(2), 1-10.
Kemparaj.,Kadalur,V., &Umashankar. (2018). Understanding the principles of ethics in health care: a systematic analysis of qualitative information. International Journal of Community Medicine and Public Health, 5(3),82-825.
Mehta, P., Dhapteb, V., Kadamc, S., Dhapte, V.(2017). Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments. Journal of Traditional and Complementary Medicine, 7(2), 251-263.
NMBA.(2020). Regulating Australia's nurses and midwives.Retrieved from https://www.nursingmidwiferyboard.gov.au/.
Reid, R., Steel, A., Wardle, J. (2017). Complementary medicine use by the Australian population: A critical mixed studies systematic review of utilisation, perceptions and factors associated with use. BMC Complement Altern Med, 16(176), 1-17.
Steel, A., Mclntyre, E., &Frawley, J. (2018).Complementary medicine use in the Australian population: Results of a nationally-representative cross-sectional survey. Scientific Reports, 8(17325), 1-12.
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