Complementary and Integrative Therapies
When integrating complementary and integrative therapies into the school setting, the nurse steps beyond allopathic (conventional) treatments into therapies that may not be accepted as traditional. It is the position of the National Association of School Nurses (NASN) that the registered, professional school nurse (hereafter referred to as school nurse) advocates for evidence-based strategies that promote positive outcomes. It is important that when doing so, nurses familiarize themselves with the treatment requested and potential practice implications in light of federal and state regulations, district policy, and their state nurse practice act.
BACKGROUND AND RATIONALE
The use of complementary, integrative, and alternative approaches to health and healing is growing across the United States. Complementary and integrative medicine is an unconventional modality that is used in addition to standard Western medical treatments, while alternative medicine is used in place of standard medical treatments and is not usually evidence-based (McClafferty, 2017; Centers for Disease Control and Prevention, 2020; National Center for Complementary and Integrative Health (NCCIH), 2021). Use of complementary therapies is most often associated with adults; however, more parents and guardians are using integrative approaches as treatment modalities for their children (Beltz, 2018; NCCIH, 2021). Approximately 12% of children in the United States use complementary, integrative, and alternative medicine (Esparham, 2018; NCCIH, 2021).
The nursing profession has a long history of viewing and caring for individuals in a holistic manner. School nurses recognize cultural, psychosocial, and spiritual needs that can impact parents’ decisions about health care practices, as well as choices and preferences for traditional, complementary, or integrative treatments, or non-intervention for their child. School nurses interface with parents and guardians to understand and support their child in school, including the use of non-traditional complementary or integrative therapies (Nathenson, 2021; NCCIH, 2021).
When deciding whether or not to incorporate the use of non-FDA approved therapies or dietary supplements into school nurse practice, it is important that the school nurse first determine what is known about the product, such as ingredients, precautions, recommended dose, and any potential adverse effects. Secondly, determine whether administration is allowable under federal and state law, including applicable state nurse practice acts, and district policy. Additionally, complementary and integrative therapies in the school setting should not disrupt the educational process.
School nurses should familiarize themselves with complementary and integrative therapies that may be used to treat the students under their care, whether at home or in school. NASN supports the use of evidence-based complementary and integrative therapies in the school setting when the school nurse follows their state nurse practice act and the School Nursing: Scope and Standards of Practice, and when requested treatments are allowed under federal and state regulations and district policy.
Beltz, C. (2018). Complementary and integrative health approaches – insights and implications for practice and research. Journal of Pediatric Nursing. https://doi.org/10.1016/j.pedn.2018.01.002
Centers for Disease Control and Prevention. (2020). Complementary and alternative medicine. https://www.cdc.gov/cancer/survivors/patients/complementary-alternative-medicine.htm
Esparham, A., Msra, S., Sibinga, E. et al. (2018). Pediatric integrative medicine: Vision for the future. Children, 4(11). doi:10.3390/children5080111
McClafferty H., Vohra S., Bailey M. et al. (2017). Pediatric integrative medicine. Pediatrics, 140(3), e2017-1961.
Nathenson, P., & Nathenson, S. (2021). Nonpharmacologic approaches to pain management. Nursing 2021. http://www.qgdigitalpublishing.com/publication/?m=62587&i=721643&p=64&ver=html5
National Center for Complementary and Integrative Health. (2021, August). Skin conditions and complementary health approaches: What the science says. https://www.nccih.nih.gov/health/providers/digest/skin-conditions-and-complementary-health-approaches-science
National Center for Complementary and Integrative Health. (2021, April). Complementary, alternative, or integrative health: What’s in a name? https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name
Acknowledgement of Authors:
Julia Lechtenberg, MSN, RN, NCSN
Joshua Landry, MSN, RN, NCSN
Karen S. Elliott, ADN, RN
Char Kizior, BSN, RN, NCSN
Sharon Morris, MSN, RN
Adopted: June 2022
Suggested citation: National Association of School Nurses. (2022). Complementary and integrative therapies [Position Statement]. Author.
“To optimize student health, safety and learning, it is the position of the National Association of School Nurses that a professional registered school nurse is present in every school all day, every day.”
All position statements from the National Association of School Nurses will automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time.