Letters Letter to the Editor are encouraged and welcomed. II letter mu t be typed double-spaced, and hould bent on di k r via E-mail to: khalm@ena.org

'Twas the night ... "

'Twas the night before Christmas, when all through the ED

The nurses were waiting for what was to be. IVs were hung by the bedsides with care For the traumas and MIs that soon would be there. The charts were nestled all snug in their slots While med students practiced with sutures and knots. And the staff in their scrubs with nary a cap, Thought how nice it would be to just take a nap When out on the drive there arose such a clatter, We sprang from the desk to see what was the matter. Away to the doors we flew like a flash, We watched intently, it felt sort of like M* A *S*H. The voice on the console of the radio below Gave us more info than we needed to know. When what to my wondering eyes should appear But an ambulance loaded with Santa and reindeer. The EMT driver, so lively and quick, Had been summoned on 9-1-1 by St Nick. The response had been rapid, the medics they came As Santa had listed each reindeer by name. Dasher had mono, Dancer had flu, Prancer was limp­

ing and Vixen was too. Comet had migraines, Cupid felt punk, Donder was

listless and Blitzen was drunk. From the front door at triage to the treatment room

walls Was heard the call, "Treat them fast! Cure them all!" As the nurses who work in the ED all know, Reindeers oft think that the service is slow. So up to the patients the nurses all flew With IVs and meds and compassion too. And then in a twinkling I heard on the roof The whirring of a chopper, not reindeer hoofs. As I drew in my head, and was turning around, Through the metal detector St Nicholas came with a

bound.

J Emerg Nurs 1998;24:482-8. Copyright © 1998 by the Emergency Nurses Association. 0099-1767/98/$5.00 + 0 18/64/94174

482 Volume 24, Number 6

He was dressed all in fur from his head to his foot, And his clothes were all tarnished with ashes and soot. The questions on insurance had him confused. Which PCP had the reindeer all used? His eyes how they twinkled! His dimples how merry' Everyone noticed, though they were all in a hurry. His droll little mouth was drawn up like a bow, As he worried about toys and the kids and the snow. The stump of the pipe he held tight in this teeth, Couldn't provide smoke to encircle his head like a

wreath. He'd been told several times that he couldn't smoke, So he settled for microwave popcorn and Coke. The reindeer were better, feeling stronger and well. Boy, would they have a story to tell. The winks of their eyes and twists of their heads Soon gave Santa to know he had nothing to dread. The staff spoke not a word, but went straight to their

work, Completing the charts, then turned with a jerk And giving each reindeer instructions on care, Reminded them all that "We're always there!" The deer sprang to their sleigh, St Claus gave a whistle, And away they all flew like the down of a thistle. But we heard him exclaim, ere he drove out of sight, "You are Angels of Christmas! Have a good night!" -Linda Snyder, RN, MSN, CRNp, CEN, Nurse Practi­tioner, Emergency Department, University of Pitts­burgh Medical Center, Presbyterian-University Hospi­tal, Pittsburgh, Pa

Complementary therapies are used in one emergency department

Dear Editor: What place does the holistic approach to nursing

have in the emergency department? Who has time to meditate when you are busy saving a life? What is it that you do that could add value in the stressful envi­ronment of an emergency department? These pro­vocative questions challenge us to take a closer look at the role of the holistic practitioner in the emer­gency department.

The concepts of holistic nursing are not new. In our clinical practice, we incorporate naturally such in­terventions as caring therapeutic touch, healing sug­gestions using imagery, relaxing breath, spirituality, and prayer. We are advocates of preventive medicine. We pay attention to our intuitive perceptions. The use of intuitive diagnosis goes back as far as Hip­pocrates.! We learn to develop awareness and listen to those "gut feelings" that gnaw at us when we know that a patient is critical even when his or her vital signs or laboratory values seem normal. From the minute we encounter a patient, many of us routinely act on "strong hunches."

The holistic approach to healing serves as an ad­junct to traditional nursing, complementing allopath­ic medicine/nursing-not replacing it. The holistic approach will indeed change nursing as professionals gain an understanding of its effectiveness. The rich resources that are available for the holistic practition­er engage the nurse and the client at a higher level. It is a powerful, noninvasive, and cost-effective connec­tion with the unlimited capabilities of the body-mind­spirit. Patients come to know themselves in a new way when they experience self-awareness, self-ac­ceptance, self-love, and self-worth.2

Holistic nursing invites us to open the door for dynamic change in consciousness as we awaken our own inner healer. 3 One of the major survival skills in the emergency department is the ability to focus on the client and tune out all other ED chaos, including our own emotional responses that can be triggered by the trauma we observe. Before we can develop skills to help clients "center" themselves, focus, balance en­ergy flow, and relax, we must start by learning to cre­ate these healing responses in our own lives. It is our responsibility to work on our own personal perspec­tive of body-mind-spirit and to practice health as we endeavor to promote healing awareness in the lives of others.

I have been a holistic practitioner in hospitals throughout California and Arizona. Many misconcep­tions and myths about this approach to healing exist. I now work in a medical center in which the director of nurses, Cindi Mortimer Kies, RN, BSN, has become an informed advocate of these concepts and has in­corporated holistic policies into our nursing care. The approval, support, and educational opportunities of­fered by the hospital administration provides credibil­ity for the holistic practitioner to become an accepted and respected part of the health care team. I highly recommend involving your hospital administration and other professionals in holistic health. They can offer invaluable resources, design guidelines for the hospital policies and procedures, and further the edu-

JOURNAL OF EMERGENCY NURSING

cation of the staff on the ever-growing topic of holis­tic healing.

The goal for holistic nursing is to provide an opti­mal environment for healing and well-being. Our hos­pital is located in the White Mountains of Arizona, where we have the unique opportunity to blend our traditional medicine with that of the Apache and Navajo Native American cultures. We set appropriate goals with a focus on meeting educational needs, pro­viding care in a timely manner, documenting inter­ventions, supporting the client's participation, and evaluating the client's responses in the medical record. 4-Kathleen Kelly, RN, Staff RN, Emergency Department, Navapache Regional Medical Center, ShowLow, Ariz

References

1. Shealy CN, Myss CM. The creation of health: the emotional, psychological, and spiritual responses that promote health and healing. Walpole (NH): Stillpoint Publishing; 1988. p. 63. 2. Dossey BM, Keegan L, Guzzetta C, Gooding Kolkrneier L. Instructor's manual for holistic nursing: a handbook for prac­tice. Gaithersburg (MD): Aspen Publishers; 1995. p. 610. 3. Dossey BM. Core curriculum for holistic nursing. Gaithers­burg (MD): Aspen Publishers; 1997. p. 207. 4. American Holistic Nurses' Association. Description of holistic nursing. Flagstaff (AZ): The Association: 1994.

Integration of complementary therapies into ED practice encouraged Dear Editor:

I commend the Journal of Emergency Nursing for its endeavor to explore the integration of allopathic and complementary modalities in the emergency de­partment. I appreciate the opportunity for emergency nurses to share experiences and information.

In our emergency department, some of the staff have individually expanded their scope of knowledge to include healing touch, reiki, massage, reflexology, nutrition, and numerous relaxation techniques such as visualization, muscle relaxation, and breath aware­ness. These complementary modalities are noninva­sive and simple to use. We commonly use them as a "bridge to care" in the ambulance while en route to the emergency department, while awaiting assess­ments and procedures, and prior to medication ad­ministration and effect.

Reiki and healing touch, for example, can be used following a bone or joint realignment, after suturing, over burns, during anxiety attacks, with psychiatric patients, with patients in shock, and during preoper­ative and postoperative periods. The rationale is that these modalities may enhance healing, diminish pain and anxiety, and provide a sense of reassurance and

December 1998 483