Holistic Healing

At the height of the pandemic last year, Paras Barnett, BSN, RN, HNB-BC, CMSRN, a nurse at Stanford Health Care in San Jose, Calif., knew her colleagues needed a way to stay calm while treating patients in high-stress clinical settings the likes of which they’d never seen. She distributed about 2,500 care packages that included packets of antifungal, antibacterial and antimicrobial essential oils. "But they’re more than that,” says Ms. Barnett. “I call them ‘health boosts’ because inhaling the oils and engaging in deep breathing allows the staff to use mindfulness in order to be present for their patients.”

She gave the packets to anyone who would take them — pre-op and PACU nurses, emergency department staff, managers, administrators and housekeepers. “Whoever was affected by what we were going through, which was everyone,” says Ms. Barnett. “I said, ‘This is something that could benefit your health and quiet your mind.’”

She instructed the recipients to breathe slowly and deeply and say a positive affirmation in addition to inhaling the calming scents. Several staff members told her they not only had them in their pockets and used aromatherapy throughout the workday, but kept them on their nightstands at home to help them rest and sleep after difficult days at the hospital.

Ms. Barnett is also a certified Caritas Coach who helps healthcare workers instill mind-body practices into a holistic care model. She’s formulating a different combination of essential oils, which she’ll soon distribute to staff. “The first round was to deal with immediate stress in a crisis, and the next will target the anxiety associated with burnout,” she says. “That’s where it starts. Take care of yourself so you’re able to care for patients.”

Even before Andrea Heggem, RN, BSN, CCRN-K, became a certified nurse aromatherapist, she noticed that the anxiety many surgical patients felt manifested in a peculiar way. “I think the prospect of surgery is so scary that their nervousness makes them detach and they start to get the feeling that they’re floating above their body,” she says.

That’s why Ms. Heggem, nurse educator at Stanford Health Care in Mountain View, Calif., thinks mind-body practices combined with the use of essential oils is uniquely and perfectly suited to soothe anxious patients before surgery.

“It grounds them back into feeling the sensations of their body,” says Ms. Heggem. “Aromatherapy, during which patients focus on the scent they’re smelling, and mindful breathing exercise, when they’re focusing on the air going in and out of their lungs, does the trick.”

Aromatherapy certainly has in-the-moment benefits, such as reducing PONV. The oils counteract a patient’s reaction to general anesthesia and provide a simple pleasant distraction to the nausea they’re experiencing. Some combination of peppermint, lavender, ginger or spearmint are effective natural alternatives that can at least assist traditional pharmaceutical PONV treatments. They’re also a wonderful adjunct therapy to mind-body exercises.

When patients are fully present in their bodies, actual physiological changes take place. Blood pressure drops, anxiety is reduced and nausea is relieved, all of which contribute to faster recoveries and better outcomes. Ms. Heggem says holistic therapies are simple and inexpensive to implement and add significant value to surgical care.

These types of practices can include energy therapy such as reiki, guided imagery or physical activities such as yoga, massage therapy, tai chi and qigong. Ms. Heggem focuses on a combination of mindfulness, meditation and breathwork when teaching fellow nurses how to calm surgical patients preoperatively.

Patients can attain a state of calm in minutes by following a simple process, she says. First, have them focus their attention on the area of their heart and breathe in a rhythm that’s comfortable for them, deeper and slower than usual. Ask them to envision their breath going in and out of their chest. If patients need help getting comfortable with the exercise, suggest they inhale for five seconds, then exhale for five seconds for a total of about six full breaths each minute. This alone can have a powerful soothing effect on the entire body and make the prospect of a stressful event such as an upcoming surgery easier to accept and handle.

Next, add a gratitude-based thought or pleasant memory — such as a loved one, or their favorite place or activity — into the exercise. Then encourage them to re-experience the feelings they have when they’re with that person, in that place or doing that thing. For Ms. Heggem, it’s walking along her favorite hiking trail. “These thoughts produce regenerative, joyful feelings,” she says. “The original experiences produced endorphins when they happened, and the memories will do the same as patients are approaching and recovering from surgery.”

These techniques can be especially helpful for people who have PTSD, which sometimes originates from arduous medical histories. “Patients at VA hospitals or those who have had multiple repeat surgeries are often extremely afraid of returning to the operating room, so getting them reconnected to their body on a regular basis before they come back for another procedure is very helpful,” says Ms. Heggem.

One of the best parts about what Ms. Heggem teaches is that even a little bit of holistic care before procedures is enough to help patients in recovery. Meditating for just five to 10 minutes a day for two weeks leading up to surgery will instill the muscle memory they need to use the practice in pre-op and in early recovery. On the day of surgery, patients are often pleasantly surprised to feel like they’ve been meditating for an hour even when it’s only been a few minutes.

Rather than asking patients to set aside a certain time to practice mindfulness, which comes across as an additional unneeded task to their already busy lives, Ms. Heggem believes it’s better to get them to attach it to daily activities. Suggest five minutes of breathing before or after they brush their teeth in the morning, and to practice shorter periods when they’re waiting at a red light. That alone will get them more grounded to their body and they’ll see positive changes in just a couple weeks, according to Ms. Heggem. “If you combine breathing techniques and meditation with aromatherapy and memory or gratitude work, the results are amazing,” she says. OSM

Note: This three-part article series is supported by Soothing Scents.