Tessa Therkleson, RN, MSocSci, MCNA(NZ)
 
Anthroposophical nursing evolved out of a striving to maintain the human
caring and loving warmth of nursing practice whilst having cognisance
of academic rigour and scientific nursing research. It is an extension
of traditional nursing requiring inner personal development to accompany
a modern scientific approach. Anthroposophical nursing first developed
in the Ita Wegman Clinic in Arlesheim, Switzerland (1928-2005). The foundations
for the philosophical theories are given in Fundamentals of Therapy (R
Steiner & Wegman 1925/1967). Complex relationships exist between how
we think, feel and act and holistic models in Anthroposophy give insight
into all aspects of the human individuality. By broadening the understanding
of the human being, as given in Anthroposophy, different aspects previously
unknown through the physical senses are revealed. Nursing is enabled to
develop and include the spiritual, biographical, soul and physical aspects
for both the nurse and the person being cared for. By acknowledging the
person in this extended way, the nurse’s approach can respond to
the individuality of everyone they meet. When nurses speak of holism in
health care they include social, emotional and spiritual concerns as well
as physical and psychological needs. Through following a course of academic
study, inner development and education in external applications the Anthroposophical
Nurse imbues the intention of offering truly holistic nursing care (Fingado
2001; 2002; Heine & Bay 1995/2001).
EDUCATION
Anthroposophical Nurses are registered nurses who are recognised at the
Anthroposophical Institutions around the world. Today there are at least
26 hospitals in Europe specialising in Anthroposophical Medicine and Nursing
- 16 in Germany, five in Switzerland, two in the Netherlands, one in Sweden
and one in the United Kingdom. In Europe, generally, Anthroposophical
Nurses work in the Anthroposophical Institutions while in Australia and
New Zealand they work in hospitals, medical practices or are independent
nurses in private practice. Ritchie (2001) has prepared a comprehensive
study on Anthroposophical healthcare in the primary care setting of the
United Kingdom (Medical Section of the General Anthroposophical Society
2000; Ritchie 2001).
There are four nurse-training hospitals in Germany, two in Switzerland
and a part-time three-year graduate diploma course in New Zealand. European
Anthroposophical Nurses have access to a range of texts supporting their
practice, for example Fingado (2001; 2002) & Heine & Bay (1995/2001).
These texts were written in German and consequently the education of Anthroposophical
Nurses in New Zealand has necessitated the development of English manuals
that supplement the large volume of required reading (Anthroposophical
Nurses Association New Zealand 1995/2002; 1996/2003; 1997/2004; Medical
Section of the General Anthroposophical Society 2000).
The nurse receives an education that leads towards a personal journey
encompassing streams of academic rigour, botany, human development, the
arts, research, the Anthroposophical model of the human being, inner development
and clinical practice. Clinical practice includes competence with a wide
range of external applications: wound management using pure organic substances
and Weleda remedies, compresses, rhythmical body oiling, massage and hydrotherapy.
The primary contributions offered by Anthroposophical nursing to nursing
in general lie in the realms of the Anthroposophical model of the human
being, the nurse’s path of inner development and the practice focus
on external applications which are more fully explained in ’Nursing
the Human Being: an anthroposophical perspective’ (Therkleson 2005).
Some clinical vignettes from practice follow.
CLINICAL VIGNETTES
Following are some examples of cases supported by Anthroposophical Nursing
external applications. Names used are fictitious and all treatments were
given in the nurse’s clinic while each person continued to live
at home with family and friends. Anthroposophical / Allopathic medicines
are noted where relevant; all ointments, oils and footbath essences were
obtained from Weleda NZ Ltd.
Chronic Glandular Fever
Ros, a professional, well-spoken woman of 30 years, presented herself.
She was of solid build with fair hair and skin, wearing glasses, aware
of poor circulation with consistently cold feet. Her general mood was
tired, despondent and depressed. There was a history of positive blood
tests for glandular fever over the previous two years with accompanying
lack of vitality and libido. For five years she had been prone to throat
and sinus infections.
Ros came once a week for four weeks to the clinic. She began a three-month
course of Weleda Hepatodoron and Chelidonium Comp., Weleda remedies to
strengthen the liver and general digestion. At each appointment a lavender
footbath was given and a yarrow compress to the liver.
On the second appointment, she said she was “feeling miles better,
best in weeks today”, her sinuses which had previously been a problem
also felt clearer. This sense of improvement and general well being continued
such that at the end of the month she had resumed regular physical activity
and had a more positive outlook on life.
Hyperemesis Gravidarum
Jenny, a mother of 37 years presented at nine weeks gestation. She was
a softly spoken, slender and intelligent woman, fair-haired with pale,
cold, drawn skin of yellowy tone. Her mood was anxious, burdened and depressed.
She was weary through the day and at night experienced restless and disturbed
sleeps.
Hyperemesis necessitated hospitalisation at 5½ and 6½ weeks
gestation for intravenous hydration. Jenny lost 8.5kg in the previous
weeks of the pregnancy and now, whilst taking Ondansatron 4mgs BD, continued
to vomit daily at least once and had constant nausea when trying to eat
or drink.
Four treatments were given, two each week before lunchtime. At each appointment,
Jenny received a lavender footbath, rhythmical body oiling with hypericum
massage oil, heart massage with aurum ointment and an oxalis ointment
cloth to the abdomen. She continued to use the oxalis cloth at home to
calm her digestion, especially before consuming fluid or food.
Following the first appointment, she said “there was no further
vomiting, this is amazing”. Now Jenny carried an air of confidence
that “this nausea will pass”. By the second appointment, the
Ondansatron could be reduced to 6mgs daily. She was now warmer and more
relaxed, smiling and talking positively about her toddler and the pregnancy.
By four months gestation she had returned to work part time. Jenny delivered
a healthy male at 36 weeks gestation by caesarean section.
Angina
Peter, 51 years, is married with three sons - the eldest (14 years) is
autistic while the youngest is still a toddler. He has a friendly open
manner and a demanding profession in the computer business. He presented
as a man of solid, stocky stature, dark greying hair and a florid complexion
with a tendency to breathlessness on exertion.
He has long-standing chest discomfort related to exertion with accompanying
angina, which he experienced at least once a week, and was on the public
hospital waiting list for an angiogram. He was prescribed Nitrolinqual
spray, Weleda Cardiodoron, Arnica Aurum and Scleron.
Four treatments were given, one each week late afternoon after work.
Each appointment comprised a lemon footbath, hypericum massage to the
calves and feet and an arnica compress over the heart region.
During the course of treatments, Peter experienced the usual episodes
of chest tension on exertion but now no angina. He commented he appreciated
the treatments, as it was an “opportunity to breathe out…since
the first compress I have felt more relaxed”. Whilst he said his
blood pressure lowered during the month of treatments, this was not confirmed
when checked each visit.
Child refusing to go to school
David, a child of six years presented. He was dark haired and eyed with
olive skin and a sensitive, quiet and gentle manner. He was the eldest
in a family of three boys and refused to go to school after visiting relatives
overseas. He said he was afraid of the bigger boys at school hurting him
and clung to his mother when she attempted to leave him. He was of slight
agile build with a tendency to mild asthma and colds going to his chest.
Occasionally he used a Ventolin inhaler. Normally David was comfortable
with his peers and happy socially, it was just that the time away had
eroded his confidence.
Three treatments were given, one each week for three weeks. Each appointment
included a lemon footbath, rhythmical body oiling with solum uliginosum
oil and an aurum cloth over the heart region.
After the first treatment, he was happy to return to school and no longer
clung to his mother. After three appointments, he was noticeably more
confident at school and unperturbed by a new relieving teacher.
These vignettes offer a brief picture of Anthroposophical Nursing care.
Whilst these examples describe short courses over a matter of weeks, often
in chronic conditions, care may extend over many months. The intention
of the Anthroposophical Nurse is to offer support and complement existing
nursing and medical care rather than act as an ‘alternative’.
There are occasions when what is needed is a rhythmical body oiling or
compress and no additional medical remedy, allopathic or Anthroposophical,
as with the young child ‘refusing to go to school’.
CONCLUSION
Nursing the human aspect in those we care for inspires the nurse to acknowledge
the uniqueness of every person met, striving to preserve and care for
their individuality. Such an approach requires an understanding of the
essence of the human being. Rudolf Steiner founded Anthroposophy, meaning
wisdom of the human being, a science of the spiritual world, offering
insights into the spiritual and physical nature of humans and their relationship
to the earth and cosmos. Out of this understanding developed a new way
of caring for people and the world in which we live; a way of wisdom and
love inspired by spiritual knowledge and inner personal development. The
Anthroposophical Nurse’s understanding of the human being, including
the Anthroposophical perspective and the development of an inner meditative
life, accompanied by education in the appropriate use of external applications
has the potential to lead towards a truly healing and holistic practice.
BIBLIOGRAPHY
Anthroposophical Nurses Association New Zealand. (1995 / 2002). Anthroposophical
nurses training handbook year 1. Unpublished manuscript.
Anthroposophical Nurses Association New Zealand. (1996 / 2003). Anthroposophical
nurses training handbook year 2. Unpublished manuscript.
Anthroposophical Nurses Association New Zealand. (1997 / 2004). Anthroposophical
nurses training handbook year 3. Unpublished manuscript.
Fingado, M. (2001). Therapeutische wickel und kompressen (therapeutic
cloths and compresses). Goetheanum, Dornach, Switzerland: Natura Verlag.
Fingado, M. (2002). Rhythmische einreibungen (rhythmical oiling). Goetheanum,
Dornach, Switzerland: Natura Verlag.
Heine, R., & Bay, F. (1995/2001). Anthroposophische pflegepraxis
(anthroposophical nursing). Stuttgart: Hippokrates Verlag.
Medical Section of the General Anthroposophical Society. (2000). Arlesheim,
Switzerland: Goetheanum.
Ritchie, J. (2001). A model of integrated primary care: anthroposophical
medicine. London: National Centre for Social Research.
Steiner, R., & Wegman, I. (1925/1967). Fundamentals of therapy. London:
Rudolf Steiner Press.
Therkleson, T. (2005). Nursing the human being - an anthroposophical
perspective. Lower Hutt, New Zealand: RATO Health.
Biographical details of Tessa Therkleson
In 1972, I graduated as a Registered General and Obstetric Nurse from
the Hutt Hospital. For the following 25 years, as a mother of five children,
I juggled caring for children and extended family with part-time nursing.
The nursing practice included work in hospices, rest homes, private surgical
clinics and occupational health nursing in a factory. Whilst I appreciated
the challenges of surgical nursing it was when caring for the elderly
and dying that a deeper question arose in my consciousness - who is this
person and how best can I meet their need?
In 1998, I graduated as an Anthroposophical Nurse in New Zealand, the
answer to my question was now clear. I left the private surgical clinic
where I was working at the time and established an independent nursing
practice, RATO Health. Anthroposophical nursing is both challenging and
inspiring particularly as there is so little information in English. Translating
became essential, as well as the need to visit hospitals and clinics in
Europe which specialise in Anthroposophical nursing; of the 26, I visited
seven.
During these past four years, I have been committed to analysing and
evaluating the Anthroposophical Nurses’ external applications. These
interests lead to the completion of a Masters in Social Science at Edith
Cowan University in Western Australia when I researched the external application
of ginger using a Husserlian phenomenological methodology. The phenomenological
methodology opens the door to researching external applications for it
considers the nature of the whole human experience, including all physical,
emotional, mental and spiritual aspects. Last year I wrote a book ‘Nursing
the Human Being - an Anthroposophical perspective’ by way of an
introduction to Anthroposophical nursing. My intention is to increase
understanding as well as stimulate an interest in a fresh, insightful
approach to nursing the human aspect in those we care for.
Today a research consciousness is the cornerstone of my nursing practice
in Lower Hutt.
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