"Beginnings" Newsletter of the American Holistic Nurses Association. April/ March issue 2000

byToni Gilbert

Herbal medicine is rapidly gaining mainstream acceptance to the degree that some major insurance companies now cover the cost of herbs recommended by licensed health practitioners. Many holistic nurses have private practices in complementary modalities such as energy work, imagery, and aromatherapy. Because nurses are generally associated with allopathic medicine, clients often assume that they know about using herbal medicinal products as an alternative to prescription "drugs."

First, assure the client that their inquiry is indeed valid and important. Then explain about the medicinal use of plant substances by telling clients that herbal medicine really is an effective and gentler form of medicine. This is because these organic substances are in their natural state rather than being chemically derived and therefore are more easily integrated into the body's own chemistry, resulting in fewer side effects than pharmaceutically manufactured substances. Mention how plants are the basis of about 75 percent of all traditional, physician prescribed, drugs. Some examples that can be given are aspirin (from the bark of the willow tree) and the heart medication digoxin (derived from the fox glove plant).

Help clients understand that, in essence, there is little difference between an herb and a chemically derived drug other than the concentration of the therapeutic component. The herbal product is usually weaker and, though this may sound paradoxical, may be more suited to an ailment. Dr. Andrew Weil, a Harvard educated physician and botanist, bears this out. He maintains that a pharmaceutical preparation may be likened to hitting a walnut with a sledgehammer while the naturally derived and less potent herbal preparation may, depending upon the medical diagnosis, be the better remedy.

Some herbal remedies common to nursing can be recommended without a prescription. They are usually in the ream of comfort measures and are relatively free of side effects. For instance: Peppermint and Chamomile teas are popular remedies used for the treatment of indigestion because they are an antispasmodic. Chamomile, unlike peppermint, also produces a pronounced anti-inflammatory activity on the gastrointestinal tract and is a natural antibiotic. Externally chamomile is used for skin and mucus membrane inflammations to promote healing. For example it can be used as a gargle for pulpitis, gingivitis, and in poultice form for ano-genital inflammation. Another herbal remedy that research has shown to be effective is ginger. This herb can be used in the treatment of some kinds of nausea including motion sickness, and is generally taken in the form of hard gelatin capsules containing the powdered rhizome.

As with all drugs, one should read the most recent research and be familiar with any precautions, side effects, dosages, and application before administration. Take care not to recommend taking herbal medicines that replace prescription drugs and do not claim to know more about pharmaceutical preparations than the primary care provider. However, one can respectfully discuss options with the client.

If a nurse's education does not include pharmaceutical privileges care should be taken to make sure clients understand that he or she can only discuss and make recommendations. Beyond the usual comfort measure herbs common to nursing; encourage clients to seek out a licensed health practitioner who specializes in herbal remedies. Keep information in a file to help them with professional referrals. Always remind clients to talk to their primary care provider before making any changes in their medication regimen.

It is up to all health care providers, whether or not they can prescribe, to educate their clients whenever they can. For the benefit of my own clients, I wrote an informational handout to use as a teaching tool which states that there is a growing body of research, much of it done in Europe, that demonstrates both the long history of medicinal botanical use and the healthful potential of these plants. The U.S. and British medical journals contain a multitude of scientific studies supporting the effectiveness of some herbal products.

My handout goes on to state that under the FDA and congressional legislation, herbs are classified as "dietary supplements." This means that manufacturers can make general statements on their labels about an herb's effect on the body's structure and function (e.g. "good for energy boost" or for "healthy looking skin") but they can't make the more specific health claims (e.g. "prevents atherosclerosis") which are allowed to pharmaceutical drug manufacturers. The consumer is left to guess exactly what condition the herb could be used for. At the same time, the government has done little to regulate the quality of herbal products. Herb manufacturers, unlike drug companies, are not required to conduct controlled studies to prove the safety and effectiveness of their products. The result, unfortunately, is a great deal of promotion of herbal products that is unfounded and misleading.

Recent research on alternative treatments has indicated the client will not always talk to their primary provider about their choice to take an herbal medicine. For this reason I include some education about taking herbs in my handout. It states that if the client chooses to take an herbal formula, it is good to keep in mind that such preparations are dilute formulas of natural drugs so the client needs to use common sense. They should buy herbal formulas from large companies whose reputation is well established and who can provide written materials explaining the safe use of their product. My handout recommends that the client take herbal medicines only when needed. To give one's body time to work with the herb, clients are encouraged to start the dose slowly and not to exceed the recommended dosage. If negative side effects are noticed, clients are instructed to stop taking the preparation.

Many people are confounded because of all the sometimes-exaggerated hype that surrounds an herbal supplement. Included in my handout is information about the American Botanical Council, a non-profit research and education organization, which clients can reach by phone at (512) 331-8868 or on the Internet at www.herbalgram.org. As competent health care providers, the educating we do goes a long way in helping clients make important decisions about their health and healing.

References

Weil, A (1997, February). A Consumer's Guide to Herbal Medicines. Self-Healing: Creating Natural Health for Your Body and Mind. P. 1 & 4.

PDR for Herbal Medicines (1998). Montvale, NJ, Medical Economics Co. P. 961, 976, & 1229.

Preparing Medicinal Tea

Prepare chamomile tea by pouring about 2/3 cup of boiling water over a heaping tablespoonful of the freshly dried heads (about 3 g). To prepare peppermint tea pour the same amount of boiling water over one tablespoonful (1.5 g) of freshly dried leaves and flowering tops. Allow 10 to 15 minutes for steeping. One cup of freshly prepared tea (used individually or in combination) is drunk between meals 3 to 4 times daily for stomach or intestinal disturbances.

Because the steeping time is longer than the average steeping time of 3 minutes, for pleasure drinking, the medicinal teas will be quite strong. To make them more palatable one might add a dollop of honey and or small amount of cream to taste.

Tyler, V.E. Ph.D. (1994) Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, Pharmaceutical Products Press.