The Benefits of Aromatherapy Presentation by: Susan Kristiniak DHA, MSN, RN, AHN-BC, BC, IAC

Today’s presentation Describe Complementary therapies and use in the United States Describe the integration of aromatherapy, guided imagery and Reiki into nursing care at Abington Memorial Hospital Discuss aromatherapy and use of essential oils by nurses in acute care and home care settings. Identification of self care and the creation of the Healing Room

Complementary and Alternative Therapies Complementary and alternative medicine (CAM) is a group of diverse medical and health systems, practices and products that are not considered to be part of conventional medicine. NCCAM (2008) reports 36% of the population uses complementary therapies adding prayer and vitamin use-62%. Target population: stress and pain management More likely to be used by women than men; people with higher education; people who have been hospitalized in the past year and former smokers as compared to those who smoke or who have never smoked (NCCAM).

Integrative Therapy Categories Natural Products This area of CAM includes use of a variety of herbal medicines (also known as botanicals), vitamins, minerals, and other “natural products.” Many are sold over the counter as dietary supplements. Large amount of consumables in probiotics, and supplements Mind and Body Medicine Mind and body practices focus on the interactions among the brain, mind, body, and behavior, with the intent to use the mind to affect physical functioning and promote health.

Integrative Therapy Categories Manipulative and Body-Based Practices Manipulative and body-based practices focus primarily on the structures and systems of the body, including the bones and joints, soft tissues, and circulatory and lymphatic systems Energy Medicine A therapy in which practitioners seek to transmit a universal energy to a person, either from a distance or by placing their hands on or near that person. The intent is to heal the spirit and thus the body., and healing touch are examples of such practices. Whole Medicine Systems Complete systems of theory and practice that have evolved over time in different cultures and apart from conventional or Western Examples of ancient whole medical systems include Ayurvedic medicine and traditional Chinese medicine.

Integration into Abington Health Department of Integrative Medicine Aromatherapy Reiki Acupuncture Mindfulness Guided Imagery Community Education Heart Health Stress Management

Integrative Council Survey of nurses for interest in integrative care Development of an Integrative Nursing Council in shared governance model Goals Educate nurses Provide complementary experiences for nurses Create a healing room Pilot education program: Integrative Nursing Workshop

Expanding Scope of Nursing Care Pilot (n=22) nurses Weekend program Reiki,Guided imagery and Aromatherapy competency based education program Monitored nurses’ lived experiences of patient care with integrative therapies

Aromatherapy Aromatherapy: “The therapeutic use of pure, unadulterated essential oils, hydrosols and other fragrant plant materials for holistic health treatment.” Gattefosse

Plants Scent acts as attraction and defense Chemical factories Draw energy from light and darkness; sun and earth Synthesize energy into molecules of carbohydrates, proteins and fats Become crude fuels that humans and animals breakdown into adenosine triphosphate which is human energy source

Essential Oils Essential oils are the by-product of water or steam distillation that produces Volatile, non-oily liquid = essential oils Botanically named One pound of any given plant creates one drop of essential oil. Over 350 oils marketed Vary in price Quality=therapeutic value

Chemical: From Gattefosse to Gas Chromatography Terpenes: antiviral: lemon, ginger Sesquiterpenes: anti-inflammatory: pine, cypress Alcohols: energizing: peppermint, neroli Ketones: mucolytic: eucalyptus,camphor Aldehydes: sedative: melissa oil Esters: soothing, balancing: geranium, ylang-ylang Phenols: antibacterial: oregano, clove

How aromatherapy works… 500,000 scents on the earth Average breaths per year: 6.3 million The only sense with direct brain connection Response to smell: 0.5 sec.; to pain: 0.9 sec Sense of smell is 10,000 greater than taste and has more neurons that eyes.

Smell brain connection

Emotional Response Proximity of olfactory bulb to limbic system: the seat of emotion Use essential oils to recreate experiences Elderly: seasonal and cooking scents End of Life: familiar and comforting Trauma: desensitizing House sales: baking bread “Smell is a potent wizard that transports us thousands of miles and all the years we have lived.” Helen Keller

Using essential oils Quality: critical to therapeutic value Identify quality oils/distributors Notes: blending variables Top: bright Middle: lingering Base: grounding Carrier: diluents for application Neat: direct, undiluted application TEA TREE AND LAVENDER ONLY Distillation/hydrosols: the process of oil extraction Steam and Water. Hydrosol: scented water remaining after extraction. Not as powerful Costs: vary with supply/demand.

Application: Inhalation Sprays/spritzers Diffusers Passive solar Electric Cotton ball/handkerchiefs Car diffuser

Diffuse Passive, solar, electric

Massage and compresses Dermal absorption Key areas: palms, Soles of feet, forehead, underarms, wrists.

Soaks and Steams Steams allow for a comfort inhalation that can improve respiratory pathways Soaks are the direct application of essential oil without massage

Lavender Lavendula officinalis, lavendula angustofolia Middle note Low odor intensity Floral scent Do not use: first trimester, extremely low BP All inflammations, hypertension pain from strains, arthritis, anxiety

Aromatherapy and Research Lavender: Calming, reduces stress through a higher alpha brainwave activity, reduces spasms, stimulates the amygdala producing effects similar to diazepam and results in pain relief, alleviates depression (Liu, 2003; Tisserand, 1988; Buckle, 2003; Moss, 2003) Kristiniak & Soniak (2007) Effects of lavender aromatherapy on the dementia patient with agitation in the acute psychiatric setting

Peppermint Mentha Piperita Top note Strong and sharp High odor intensity Do not use during pregnancy or lactation Vasoconstriction, anti- spasmodic, digestive

Blending Blend: combining different oils to achieve a therapeutic effect Carrier oils Dilution percentages: depend on treatment application type Synergies: the end product of mixing oils and carriers

Blending Lavender and Peppermint Dilution Palm blends Spritzers Baths 1%=6 drops/ounce Palm blends Spritzers Baths Cotton Ball/ 2X2

Safety Rules Never consume: dangerous due to potency Always dilute: less is best Keep out of reach of children Use tried and true oils: Avoid mugwort Know cautions and contraindications Photosensitivity, minimal use, dangerous, carcinogenic Use protective gear when handling oils Ventilation Special precautions with children, elderly and pets Use common sense: overuse Recognize botanical names: genus and species. Contraindications: insomnia avoid peppermint, rosemary, basil

Important Points Quality of oil = therapeutic value Less is best Never consume Only lavender and tea tree can be applied ‘neat’ Keep out of reach of children

Use of aromatherapy for nurses Competency based training Use of lavender and peppermint with nursing policies/procedures that define standard of care. Teach hand massage Supply essential oils

Expansion of the program The word got out…. Over 200 nurses are trained Added nurses in the hospice unit Home Care nurses * some adaptions

The demand for self care Council success and increased participation The requests and discussions in the Integrative Workshop classes The stories reported began including staff caring for staff.

The Healing Room

Healing Room Opened September 28, 2010 Within an hour, the room was used To date, 250 staff have received treatments Self-care Provider Research survey Stress level pre and post healing experience Demographics How you got there… Would you come back… Treatments received and comments

© AMH

Any Questions Contact information skristiniak@amh.org

References National Center for Complementary and Alternative Medicine (2011). What is CAM? Retrieved from www.nccam.nih.org Kristiniak, S. (2011) Exploring the experiences of complementary nurses: A qualitative phenomenological study. Research Methodology. Lentz: Las Vegas, NV Watson, J. (2005). Caring science as sacred science. Philadelphia, PA: F. A. Davis.