Even before Andrea Heggem, RN, BSN, CCRN-K, became a certified nurse aromatherapist, she noticed that the anxiety many surgical patients felt manifested in a peculiar way. “I think the prospect of surgery is so scary that their nervousness
makes them detach and they start to get the feeling that they’re floating above their body,” she says.
That’s why Ms. Heggem, nurse educator at Stanford Health Care in Mountain View, Calif., thinks mind-body practices combined with the use of essential oils is uniquely and perfectly suited to soothe anxious patients before surgery.
“It grounds them back into feeling the sensations of their body,” says Ms. Heggem. “Aromatherapy, during which patients focus on the scent they’re smelling, and mindful breathing exercise, when they’re focusing
on the air going in and out of their lungs, does the trick.”
Aromatherapy certainly has in-the-moment benefits, such as reducing PONV. The oils counteract a patient’s reaction to general anesthesia and provide a simple pleasant distraction to the nausea they’re experiencing. Some combination
of peppermint, lavender, ginger or spearmint are effective natural alternatives that can at least assist traditional pharmaceutical PONV treatments. They’re also a wonderful adjunct therapy to mind-body exercises.
When patients are fully present in their bodies, actual physiological changes take place. Blood pressure drops, anxiety is reduced and nausea is relieved, all of which contribute to faster recoveries and better outcomes. Ms. Heggem says holistic
therapies are simple and inexpensive to implement and add significant value to surgical care.
These types of practices can include energy therapy such as reiki, guided imagery or physical activities such as yoga, massage therapy, tai chi and qigong. Ms. Heggem focuses on a combination of mindfulness, meditation and breathwork when
teaching fellow nurses how to calm surgical patients preoperatively.
Patients can attain a state of calm in minutes by following a simple process, she says. First, have them focus their attention on the area of their heart and breathe in a rhythm that’s comfortable for them, deeper and slower than usual.
Ask them to envision their breath going in and out of their chest. If patients need help getting comfortable with the exercise, suggest they inhale for five seconds, then exhale for five seconds for a total of about six full breaths each
minute. This alone can have a powerful soothing effect on the entire body and make the prospect of a stressful event such as an upcoming surgery easier to accept and handle.
Next, add a gratitude-based thought or pleasant memory — such as a loved one, or their favorite place or activity — into the exercise. Then encourage them to re-experience the feelings they have when they’re with that person,
in that place or doing that thing. For Ms. Heggem, it’s walking along her favorite hiking trail. “These thoughts produce regenerative, joyful feelings,” she says. “The original experiences produced endorphins when
they happened, and the memories will do the same as patients are approaching and recovering from surgery.”
These techniques can be especially helpful for people who have PTSD, which sometimes originates from arduous medical histories. “Patients at VA hospitals or those who have had multiple repeat surgeries are often extremely afraid of returning
to the operating room, so getting them reconnected to their body on a regular basis before they come back for another procedure is very helpful,” says Ms. Heggem.