1. Using Essential Oils to Enhance Nursing Practice and for Self-Care
By Melissa E. Allard, MA, RN, CCRN, CCAP,
And
Julie Katseres, DNP, RN, APRN, FNP-BC, CCAP

3. Introduction
With the growing popularity of integrative medicine, essentials oils have found their way back into health care. Essential oils provide a simple way to alleviate certain physical symptoms, promote emotional well being, and provide comfort. This article addresses the following:
Common uses of essential oils
Reported benefits,
Potential risks
Contraindications
Current research

4. Holistic Nursing Care
While treating a patient during illness or injury, It is important to maintain awareness of body, mind, and spirit working together. In addition to conventional Western medicine and interventions, nurses can provide comfort through simple, sensory holistic modalities such as essential oil therapy.

5. Use of essential oils in Health Care

6. About Essential Oils Antibacterial Antiviral Antifungal
The use of essential oils is believed to date back 5,000 years.
Today, oils are extracted by steam or hydrodistillation from aromatic plants.
Essential oils contain volatile, complex chemical compounds, which determine its effects.
Today, through tests such as gas chromatography and mass spectrometry, we can better understand the chemical make-up of plant essential oils.
Essential oils are known for the following properties:
Antibacterial
Antiviral
Antifungal
Anti-inflammatory

7. About Essential Oils
Sometimes called “aromatherapy” though some oils do not have a pleasant fragrance.
The therapeutic value of an oil relies on:
Its chemical constituents
Route of administration
Pleasantness or astringency of its scent
Most common routes of administration:
Direct Inhalation – breathing in the scent of the oil from a couple of drops on a cotton ball, tissue, or wick for 5-10 minutes as needed.
Indirect inhalation – breathing the scent dispersed in ambient air, either by electric diffuser or by spray bottle.
Topical application – by massage, light touch, or spray
Oral – mouth washes and gargles.

8. Absorption of Essential Oils
Inhalation
Topical
When oils enter through inhalation, the molecules stimulate olfactory pathways that are closely connected to the brains limbic system, which influences:
Heart rate
Blood pressure
Respiratory rate
Memory
Hormone levels
The limbic system plays a major role in such reactions as fear and anger, and becomes highly active during emotional trauma.
When applied topically, certain oils have been found to make skin more penetrable, which could increase the effectiveness of other topical pharmaceuticals, or of other oils, when used in a blended concoction.

9. Supportive Research
Several research studies were reviewed within this journal article to examine the effectiveness of essential oils. The findings were as follow:
Lavender and rosemary oils affected mood, anxiety levels, and alertness.
Orange and lavender oils [used prior to dental work] helped significantly reduce anxiety.
Lavender and sage oil applied topically helped reduce work-related stress [among 14 STICU nurses]
Lavender and rosemary oils inhaled [by nursing students prior to an exam] helped reduce text-anxiety

10. Methodological Criticism
Much of the research on essentials oils has been criticized for the following reasons:
Failing to incorporate randomization or control groups.
Combining aromatherapy with other complementary modalities, such as massage.
Aromatherapy may be pleasant and enjoyable for patients in stressful situations.
Aromatherapy affects people differently with based on their culture, experience, gender, and personality.
Data did not support legitimate clinical indications.
Efficacy is subjective

11. The Problems Researchers Face
Practitioners may have an impractical means of studying essential oils, as it is impossible to blind study participants to aromas. Also, many professional certified aromatherapy practitioners generally have little training in research methodology.

12. The Problems Researchers Face
While some research faces criticism, the risk of harm has consistently been found to be minimal when essential oils are used with appropriate caution and common sense.

13. Safety Precautions
Essential oils are not FDA regulated in the United States.
It is good to investigate the quality of the oil you purchase. Look for the following:
Location and climate in which the plant source was grown.
Harvest time and technique.
Tests to verify the chemical constituents.
The National Association for Holistic Aromatherapy (NAHA) emphasizes six factors that influence the safety of an essential oil:
Quality
Chemical composition
Method of application
Dosage or dilution
Integrity of skin
Age of client

14. Use of Oils in the Hospital Setting
All oils used in a hospital or clinic setting must have a material safety data (MSD) sheet, which contains the following information:
Oil’s toxicologic properties
Potentially hazardous ingredients
First-aid information

15. 12 Recommended safety Precautions
Keep oils away from children and pets
Avoid sunlight and tanning booths for 24 hours after a photosensitizing oil is used
Avoid prolonged use of the same oil
Research any oil before using it on yourself of your patient
Do not use undiluted oils
Perform a skin patch test with any suspect allergic reaction
Know the safety data on any oil you use
Use caution with oils and pregnancy
Avoid oil contact with the eyes
Keep all oils away from open flames
Ensure adequate ventilation with oils
Do not use oils internally unless properly trained 12
Recommended safety Precautions

16. Essential Oils in Acute Care
Guidelines
considerations
To support safe use of oils in hospitals and other health care settings, a well-developed protocol is required. It is necessary to have the following:
Clear guidelines for training staff
Identifying reputable suppliers
Filing MSD sheets
Determining routes of administration
In clinical settings, oils are not considered FDA regulated and therefore cannot claim to treat disease. The language used when documenting must be monitored. For example:
“minimize discomfort” not “treat pain”
“promote calm and well-being” not “treat anxiety”

17. Essential Oils in Health Care Settings
Hospice
Long-term care
Hospice nurses have long promoted the use of essential oils in the home setting. Common delivery is through:
Steam – float 1-3 drops of oil in a bowel of hot water and inhale the aroma
Therapeutic massage
For elder patients, the use of oils may help reduce polypharmacy. Essential oils that have been found to be safe to use for such at-risk populations and frail elders are:
Lavender
Tea tree
Eucalyptus
Rose

18. FYI: Making an Essential Oil Inhaler Stick
Supplies
Blank inhaler with a wick
Medicine cup
Essential oil(s)
Gloves
label
Apply gloves and then place drops of your choice of essential oil(s) in a medicine cup. (Swirl to combine if using more than one oil). Place the wick into the cup until all the oil is absorbed. Place the wick into the inhaler tube, secure cap, and tightly screw the inhaler cover onto the inhaler tube. Label the tube with the essential oil used.

19. Reference
Allard, M., Katseres, J., (2016). Using Essential Oils to Enhance Nursing Practice and for Self-care: A simple, sensory way to provide comfort and decrease certain symptoms. American Journal of Nursing, 116,