By Dawn Whiteside
As spring begins, familiar phrases such as “April showers bring May flowers,” “Don’t forget to smell the roses,” and “Breathe big” remind us of an often-overlooked aspect of patient care – complementary and holistic care. Nursing plays a crucial role in implementing evidence-based practices to enhance the health and well-being of individuals (ANA, 2025).
The American Holistic Nurses Association (AHNA) defines holistic care as interventions that support the whole person – body, mind, emotions, and spirit (AHNA, 2017). To support this approach, the Association of periOperative Registered Nurses (AORN) has published the Complementary Care Guideline for Recommended Practices, ensuring that surgical patients have access to holistic wellness options. According to AORN, “optimal perioperative nursing practice promotes patient well-being, and implementing patient-centered complementary care interventions can improve the perioperative experience for patients, their families, and healthcare workers, as well as reduce healthcare costs” (AORN, 2025).
Integrating a holistic approach begins with assessment. Understanding a patient’s values, health beliefs, and past healthcare experiences is crucial for implementing complementary care options (AORN, 2025). One key aspect of preoperative education is evaluating whether a patient takes herbs or supplements, as certain substances must be discontinued before surgery to prevent adverse reactions. This preoperative discussion also presents an opportunity to determine whether complementary care interventions might be beneficial or welcomed. For example, patients who regularly take vitamins or supplements may be more receptive to complementary therapies. Additionally, for individuals with a history of postoperative nausea and vomiting, ginger could serve as a complementary adjunct to traditional anti-nausea medications.
Music therapy is a well-recognized complementary intervention that helps reduce postoperative pain. While opioid medications remain the first-line treatment for moderate to severe pain, concerns related to the opioid epidemic have led to limitations on prescription duration and dosage. Incorporating music therapy into postoperative pain management has shown promising results. Research indicates that music with a tempo of 60-80 beats per minute is particularly effective in reducing postoperative pain (Ferguson et al., 2024). Allowing patients to select their preferred genre while ensuring the volume does not disturb others – preferably through the use of headphones – enhances the effectiveness of this intervention (AORN, 2025; Ferguson et al., 2024).
Aromatherapy is another non-pharmacological method for reducing pain and stress. Lavender, in particular, is widely recognized for its sedative, antidepressant, relaxing, and antiemetic properties, with minimal toxicity risk (Silva et al., 2024). Postoperative pain is often exacerbated by sleep deprivation, physiological stress, and inflammation (Silva et al., 2024). A randomized controlled trial (RCT) involving cardiac surgery patients found that those who wore lavender oil-infused ceramic necklaces for 30-minute intervals experienced improved vital signs, including lower mean blood pressure and respiratory rate, as well as better sleep (Silva et al., 2024). Additionally, neroli oil, which has citrus overtones, has been shown to lower systolic blood pressure, though it did not significantly impact patients’ perceived anxiety or pain levels (AORN, 2025).
Guided imagery (GI) is another effective complementary intervention for reducing preoperative anxiety and postoperative pain. Recommended for both adult and pediatric patients, GI has been shown to shorten the length of stay in the post-anesthesia care unit (AORN, 2025). This technique involves generating or recalling mental images and using verbal suggestions, such as storytelling, drawing, or dream interpretation (Pinto et al., 2024). Pre-recorded GI sessions may guide patients through progressive muscle relaxation and deep breathing exercises, helping to reduce stress, pain, anxiety, heart rate, blood pressure, and overall psychological distress (Pinto et al., 2024).
Scientific research on complementary and integrative health approaches continues to expand, supported by the National Center for Complementary and Integrative Health (NCCIH). As part of the U.S. Department of Health and Human Services, the NCCIH investigates the safety, efficacy, and benefits of complementary care in improving healthcare outcomes (NCCIH, 2025). Perioperative patient care should encompass all possible strategies to optimize outcomes. When used appropriately and with patient consent, complementary care interventions can reduce stress and anxiety, alleviate pain, and ultimately enhance the overall patient experience. So, remember to “breathe big” and leave room to grow your practice by including complementary care interventions.
– Dawn Whiteside, DNP, MSN-Ed, RN, CNOR, NPD-BC, RNFA is the Director of Education and Professional Development of the Competency & Credentialing Institute. Dr. Whiteside has over 35 years of experience as a perioperative nurse in many roles including circulator, scrub, first assistant, team leader, charge nurse, manager, and educator. She serves on the ABSNC Board of Directors as well as the editorial board for OR Today. As an educator, Dr. Whiteside is passionate about developing educational materials for all members of the perioperative team.
References
American Holistic Nurses Association [AHNA]. (2017). Position Statement: Position on the Role of Nurses in the Practice of Complementary & Integrative Health Approaches (CIHA). https://www.ahna.org/Portals/66/Docs/Committees/Corrected%20Position%20Statment%20on%20the%20Role%20of%20Nurses%20in%20the%20Practice%20of%20Complementary%20%20Integrative%20Health%20Approaches%20(CIHA)%202016.pdf?ver=HNA-u5c6jHUDiJCXgifuZg%3d%3d. Accessed February 12, 2025.
American Nurses Association [ANA]. (2025). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/our-certifications/ana-code-of-ethics/
Ferguson, T., Taylor, C., Phillips, K., & Shannon, G. (2024). Music Listening: An Evidence-Based Approach to Managing Postoperative Pain. MEDSURG Nursing, 33(2), 73–78. https://doi.org/10.62116/MSJ.2024.33.2.73
Guideline for complementary care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2025.
National Center for Complementary and Integrative Health. (2025). About NCCIH. https://www.nccih.nih.gov/about
Pinto, B. M., Tavares, I., & Pozza, D. H. (2024). Enhancing Chronic Non-Cancer Pain Management: A Systematic Review of Mindfulness Therapies and Guided Imagery Interventions. Medicina (1010660X), 60(5), 686. https://doi.org/10.3390/medicina60050686
Silva, L. C. de M. A., dos Santos, K. V. G., dos Santos, J. J. de S., Camara, R. P. de P. O. A., Bezerra e Silva, S. Y., Silva, H. M. M. D., Ribeiro, K. R. B., Dantas, D. V., & Dantas, R. A. N. (2024). Efficacy of aromatherapy with Lavandula angustifolia oil on postoperative pain after cardiac surgery: A randomized clinical trial. EXPLORE, 20(6). https://doi.org/10.1016/j.explore.2024.103034
