Potentials and challenges of an integrative medicine protocol in intensive care: the perspective of intensive care nurses.

backgroundPatients admitted to intensive care (IC) settings are exposed to a set of inevitable environmental stressors, such as high noise levels, inadequate lighting conditions, long-term immobilization, and prolonged administration of psychopharmaceuticals, the combination of which is known to be associated with clinical challenges, including poor sleep quality, dysregulation of circadian rhythms, agitation, anxiety, disorientation, or delirium. Due to the great complexity of the IC setting, these conditions are difficult to address with conventional means. The goal of the current study was to assess from the perspective of IC nurses the implementation of an integrative medicine approach based on topically applied herbal medicine substances to attend to some of these challenges. External applications of for instance Rosmarinus officinalis, Oxalis acetosella, and other herbal substances can have beneficial effects on peripheral circulation, sleep cycles, and digestion; they are considered safe with little drug interactions, hence presenting a valid candidate for the IC context.

methodsEmploying a qualitative research approach, we used a series of focus groups with a sample of N = 49 specialized IC nurses working at the IC department of the University Hospital Bern, Switzerland. The qualitative data was analyzed using computer-assisted thematic analysis.

resultsFour main theme clusters, each consisting of various sub-clusters, emerged from the analysis. Overall, participants considered the integrative medicine methods a valuable expansion to their therapeutic toolkit, as they offer additional, readily available, non-invasive, and low risk care options they could apply at their own discretion for their often greatly challenged patients. They described favorable experiences, but also reported barriers, like time constraints, or ineffective operational procedures and offered concrete suggestions on how to improve these.

conclusionsTaken together, while not assessing clinical effects, this work suggests tailored topical herbal medicines were perceived by IC nurses as feasible and acceptable complementary care options in selected situations. CLINICAL TRIAL NUMBER: Not applicable.