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Canyon College

online reflexology for nurses course at Canyon College

Module IV

Method, accessory techniques(magnets,tape seeds), and summary Method



Course Title:
Department:
Instructor: 		NUR470 - Reflexology for Nurses
Nursing
Heather Johnstone, Ph.D., R.N., A.P.N., C.S.,N.P. Email | Vita


General preparation

Overall, this modality does not require much preparation. The short preparation time is one reason this modality is appropriate for nurses in any setting. I have a subsequent comment for the hospital or extended/long-term care nurse. The reflexology treatment is a type of massage. Since massage is part of nursing care(Donahue,1985;Henderson & Nite,1978), you do not need any specific orders,etc to perform reflexology for the client in the hospital or extended/long-term care facility. An important area of preparation by the provider is ensuring intact finger integument. So if you have any cuts or breaks in the skin, you will need to wear gloves to provide this treatment. It is easier to perform the reflexology, if your nails are trimmed short. If you prefer having long nails, you can work with your thumb tip. The angle of the thumb will allow you to deliver direct, firm fingertip pressure without having your nail in the way, as would occur with the index finger. The preparation for the client is minimal. Decide what area/s you are going to work with for the client. Reflexology can be done on the ears, scalp, feet, or hands. Any of these areas is appropriate to work with for any client for any condition, as all the areas provide gentle but effective stimulation to the any or all of the body's parts or energy balance. If you have not already done so, describe the session to the client(see handout below for client information). Tell the client that the reflexology session is designed to relax the client. It also will work to improve the client's overall wellbeing. The client may notice improvements with one treatment. However, it may take several treatments for results to manifest and to be maintained. The schedule for reflexology could be similar to that of physical therapy, such as two to three times per week for several weeks. Many clients have reflexology treatments once a month or so to maintain good health or to prevent health problems. Tell the client that the session itself may be slightly uncomfortable. This is more applicable for the hand or foot treatments. The pressure of the ear and scalp reflexology should be lighter, so sessions for these areas are usually very comfortable and immediately relaxing. Let the client know that with this bodywork, as with any form of bodywork, the client's symptoms may get worse rather than better for the next 48 hours. Use of the accessory techniques and pushing fluids can minimize this apparently negative response. Reinforce to the client that a worsening of symptoms is a good response, because it indicates that toxins are being eliminated and that the vital energy is being re-balanced. Then assess the area(hands, feet, ears, scalp) to be treated for breaks in the integument. If there are obvious breaks, you should glove up. If the skin appears intact, you may provide the stimulation without gloves. For the hands or feet, if you have time and the resources, a soak is a nice introduction to the session. I recommend a tea tree product to be added to the soak solution as it has low allergenicity and high surface anti-infective properties. The tea tree product can be an essential oil(3-4 drops per soak basin), lotion, or even shampoo(Hair Therapy is one low cost, high tea tree concentration shampoo). So with this short preparation you are ready to start the session.

Method

The session itself can be brief, as little as five minutes, or extended, up to an hour. If you are going to provide a short treatment, you should usually work with one area. For the longer treatments, you may want to include several of the areas. The feet or hands can tolerate a full hour session with thirty minutes on each foot or hand. The pressure is delivered dry without any oils. So having completed the aspects listed above in general preparation, you are ready to start. The client may be seated or lying down. Make sure that you are able to reach your areas of treatment while maintaining good body mechanics for yourself, as well as maintaining a comfortable position for the client.
Technique for the hands and feet

In working with these areas, you want to provide a very firm, direct, fingertip pressure. You can support the hand or foot with your non-dominant hand. Then use your thumb or index fingertip of the dominant hand to deliver the pressure. In order to minimize strain on the thumb or finger, you want to bend the thumb or finger slightly at all the joints. In this way the pressure from contacting the area of the client is absorbed by the angles of the joints,thereby reducing strain on your hands. Apply the pressure in a clockwise fashion turning the thumb or finger from the elbow to avoid stressing your fingers or wrist. Apply pressure systematically to the entire foot or hand. Please see the reflexology maps for the graphic definitions of these areas. You may spend extra pressure time on the areas that correspond to the client's complaints. However, it is not necessary. Interestingly, as you work the hands or feet of clients you will begin to sense the areas that correspond to the affected areas for the clients. In this way, you will be able to determine the clients' problems as well as manage the clients' problems, providing helpful feedback about their health status(Carter,1981;Kunz & Kunz,1982).
Technique for the ears and scalp

In working with these areas, you want to provide a slightly firm, direct fingertip pressure.As with the hands and feet, the pressure should be in a clockwise fashion turning the thumb or finger from the elbow to avoid stressing your fingers or wrist. Apply pressure systematically to the entire area of the ears or scalp. Please see the reflexology maps for the graphic definitions of these areas. As with the hands and feet, you will be able to sense the affected areas by understanding changes in the corresponding areas of the ears and scalps. And so, again, you will be able to provide feedback about the health status of your clients.
Accessory techniques

In working with reflexology, I have found that the use of accessory techniques can help the effects of the session last longer and help the client's symptoms resolve more quickly. The accessory techniques of magnets and tape seeds that I incorporate into my reflexology care are from Traditional Chinese Medicine(TCM) theory base. Both of the techniques utilize the concept of stimulating the body's vital force energy of "qi" to facilitate the resolution of symptoms.

Magnets

In TCM theory base magnets supply vital force energy to the body and unblock stuck energy by re-directing the energy with their own natural magnetic-electrical energy(Xinnong,1987). The energy is considered to be self-regulating. I recommend the use of magnetic insoles to be worn on the feet in between reflexology sessions to help move along the sessions more rapidly. Please recommend that the client slowly work up to a full day or night of wearing the magnets, as I note anecdotally from my practice that too rapid progression to several hours of magnet exposure will likely increase the chance of temporary worsening of symptoms. The rate of progression of increasing the time of wearing that I use is roughly 10 minutes per week. If you are working with an extremely weak client, you may want to have the client start out wearing the magnets while having the feet elevated. Although the literature contains contradictory information on the effectiveness of magnet use, anecdotally I have had very good results with my clients' use of the magnets.

Tape seeds

Acupressure therapy in the form of tape seeds is an effective energy modality that has a long history in TCM practice. Some clinics in China provide tape seeds to the ears as the only form of health care. Generally the TCm providers tape seed one ear at a time.I, also, usually tape seed one ear at a time to allow the skin to rest between tape seed applications. In TCM the placement of the tape seeds in the ear is based on TCM physiology. The TCM providers will place tape seeds in the ears to resolve, for example, a kidney yin disorder. However, the ears also reflect Western physiology.It is effective and appropriate to place tape seeds in the ears for the organs that you and your client note to be functioning poorly. So for a stomach disorder, you may place the tape seed to the stomach area. The tape seeds work to supply continuous stimulation to the affected area between sessions,thereby working to resolve symptomatology more quickly. The information about how long to keep the seeds in one place is variable. The clinics in China usually have the tape seeds in place for one week for the clients. If I am seeing my client once a week, I often will leave them in place that long. I caution the client to watch for signs of irritation such as redness. It is okay for the client to shower or wash with the tape seeds in place. Sometimes the clients report that they feel as if the tape seeds do not "last" the full week. Then I will instruct the client on placement and have the client change the tape seeds more frequently. Tape seeds are available from Oriental medical supply companies. They have vaccaria seeds placed on surgical tape or tan tape. One Oriental medical supply company is OMS(www.omsmedical.com).You can also make your own tape seeds by placing mustard seeds on transpore-type tape in a clean manner, as sterile technique is not required. Tape magnets and tape needles are available as well. However, I feel that the use of these accessory modalities is not within the scope of basic reflexology. They function in the same manner as the tape seeds. Their use has a slight risk of infection. Since I find the tape seeds very effective, low in cost, and with a very low risk of infection, I utilize these in my reflexology practice and recommend them for your use, as well.

Summary

From this description of the method and previous lectures on the definition, uses, history of reflexology and its place in nursing care as a type of massage you note that incorporation of this modality into your nursing care is not difficult and can improve your clients' health. As a form of massage it has a place in routine nursing care in any setting. Reflexology is safe with the only side effect being a possible temporary worsening of symptoms. This modality can be easily used, since it need not be time consuming. Nurses do not need any special supplies to deliver this care. The technique is not complex. As a nurse you can easily bring this modality to your clients in any setting. In the inpatient setting, you can add the reflexology to your bedside care without any special orders, etc. In the outpatient setting, you can provide the reflexology as part of a holisitic or wellness practice.

The accessory techniques are also safe and effective in strengthening the reflexology sessions. In the inpatient setting, you can educate the client about the use of the tape seed pressure and magnet insoles as part of the client's wellness care. In the outpatient setting you can describe to the client about the use of these accessory techniques as part of your holistic and wellness educational plan.

Reflexology and its accessory techniques can be significant adjuncts to your standard nursing care and can work to improve your clients' level of wellness dramatically in both the inpatient and outpatient setting. With this course and your practicum, you should be able to begin providing reflexology care to your clients.

Patient/Client educational handout -sample

Reflexology is a form of massage therapy. Reflexology has been used for hundreds of years to help people feel better. With reflexology the person receives direct fingertip pressure to areas of the body to help other areas of the body feel better. This form of therapy helps you to feel better by re-aligning your subtle life force energy. In re-aligning your energy the reflexology may work to stimulate the nervous system, lymphatic system, or circulatory system to help your body feel better. Areas of the body that are typically used to treat the whole body are the feet, the hands, the ears and the scalp, as it has been shown by patient response that these body areas reflect the entire body. Reflexology may be used as an adjunctive treatment to help any health issue to improve.

A reflexology session may last 5-60 minutes. It usually lasts about 30-45 minutes. When you receive reflexology, you may wear your clothes. You are in a comfortable position, either lying or sitting down. The reflexology pressure may be uncomfortable. You will feel relaxed after treatment,as you do after a full body massage. A possible side effect is that any symptoms that you have may worsen for 24-48 hours. You may lessen this effect by pushing fluids, unless you are on a fluid restricted diet.

While one session may help you feel better, you should expect to require 1-3 sessions per week for several weeks to get results that last a long time. The time frame and schedule is similar to that of physical therapy. If you are using reflexology to prevent health problems, you probably want to have a reflexology session once a month or so.

Your provider may recommend the use of the accessory techniques of magnets and/or tape seeds to improve your health more quickly. These techniques are safe and effective with no long lasting effects.

Sample Reflexology wellness plan
A 36 year female client presents to you in your clinic with a history of chronic headaches. Otherwise her history is negative.

Reflexology wellness plan
  1. Refer to or consult with primary health care provider to assure that all western medical care options have been explored. Client states that she is in regular contact with her provider and that they are considering beginning medication if the reflexology does not diminish the headaches. You offer
    2. to contact directly her provider and give the client your contact information for her use and for her provider's use.
  2. Instruct client on reflexology and general course of treatment. Determine with client the number of sessions and frequency of sessions. Client reads the handout. You and she discuss the information. The majority of the evaluation of the headache quality will occur with the primary provider.You and she set up a series of sessions to be as follows: 2 sessions per week for 5 weeks. You agree to start the accessory techniques during week 2 of the session.
  3. Begin the sessions. Reinforce primary provider follow-up and next appointment session.
References Online Bookstore

Carter, M. (1981). Hand reflexology:key to perfect health. West Nyack, N.Y.: Parker Publishing Company,Inc. ISBN #: 0133836045
Donahue, M.(1985). Nursing the finest art an illustrated history. St. Louis,Missouri: The C.V. Mosby Company. ISBN #: 0801614244
Gach, M.(1990). Acupressure's potent points a guide to self-care for common ailments. New York:Bantam Books. ISBN #: 0553349708
Henderson, V. & Nite, G. (1978).(6th ed.). Principles and practice of nursing. New York: Macmillan Publishing Co. Inc. ISBN #: 0023535806
Kunz,K. & Kunz,B. (1982). The complete guide to foot reflexology. Englewood Cliffs, N.J.: Prentice-Hall, Inc. ISBN #: 0131605984
Xinnong,C. (ed.) (1987). Chinese acupuncture and moxibustion. Beijing: Foreign Languages Press.



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