Running head: OUTSIDE THE BOX

Therapeutic Nursing Interventions:

Healing Outside the Box
Jack L. Kaczmarczyk
Baker College

Definition of Therapeutic Nursing Interventions

An elderly man admitted to the ED has dysfunctional lungs that inadequately exchange
carbon dioxide and oxygen, leading to an increased level of serum bicarbonatecompensated
respiratory acidosis. After briefly seeing the elderly man, the ED doctor starts treatment:
bronchodilators or anti-inflammatories and possible oxygen therapy (Ignatavicius & Workman,
2013). As a result, the elderly mans chances of recovery increase. In the meantime, though, a
human being has been subjected to a frightening situation outside of his control. The doctor may
have addressed his affliction, but his anxieties have gone unaddressed and, if left unchecked, can
become the source of complication in the form of a major cardiac event. Anxiety, along with
other factors like old age and cardiovascular problems, increases the risk for cardiac events
(Ackley & Ladwig, 2010). Therefore, decreasing the elderly mans anxiety decreases the risk.
The medical professional best suited to this task, and the key element missing in the foregoing

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example, is the registered nurse (RN). By using therapeutic interventions outside the box of a
physicians practice, but within the scope of nursing practice, a nurse improves patient outcomes
by treating not only the disease, but the human response to disease (Taylor, 2011).
To better understand therapeutic nursing interventions, and to continue to differentiate
them from medical interventions, consider the options available to the RN to reduce the anxiety
of the elderly from the foregoing example. Certainly the RN can have administered anxiolytics if
any were listed in the medical administration record under as needed. Administering ordered
medicines, along with performing assessments and collaborating with other medical staff, is in
keeping with the professional duties of an RN. Supposing no such drug order existed, however,
once the physician was contacted to place the order, an array of therapeutic interventions
remained at the RNs disposal. In order to contradict the patients irrational fears or thoughts, the
RN can offer accurate information regarding the situation. The RN can encourage the patient to
use positive self-talk. Music of the clients choice can be made available (Ackley & Ladwig,
2010). None of these examples are curative in comparison to a physicians interventions, like the
prescription of anxiolytics, but achieve the same end, which is to restore health. All nursing
interventions should either restore health, promote it, prevent illness, when these goals cannot be
met, facilitate patient and family coping with altered function, life crisis, and death, (Taylor,
2011, p. 14).
One of the best interventions to meet any of these goals, and thereby improve patient
outcomes, is education. Patient teaching helps patients gain knowledge, learn skills, and change
attitudes to better manage, cope with, or even prevent illness (Falvo, 2011). A long-term study of
children suffering from asthma shows that mortality rates have dropped, over time, despite an
increase in the prevalence of the disease, thanks to patient education regarding recognition of
environmental triggers (Comino, 2001). A more recent study offers another illustration of how
strongly a nursing intervention like patient education can improve patient outcomes. Registered

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Nurses educated patients on self-care of leg ulcers for several sessions. Three months later,
improvement was shown in the patients knowledge of ulcers and treatment and adherence to the
treatment. Patients even showed an improvement in their overall outlook regarding their
condition and showed a greater level of independence (Van Hecke et al., 2011).
In a healthcare system increasingly concerned about minimizing cost, therapeutic nursing
interventions are a relatively inexpensive way to improve patient outcomes. According to The
Joint Commission (2014), out of the $2.5 trillion spent every year in the healthcare industry,
almost 30%, or $745 billion, is wasted; $20 billion is being spent on unnecessary services (The
Joint Commission, 2014). Using several ways to measure the cost-effectiveness of nursing
interventions, it has been shown that nursing interventions are nearly half as expensive as usual
care (Vanhook, 2007).
Therapeutic nursing interventions define the profession. Feasibly, a position can be
created in which duties are to pass medications and perform routine assessments, requiring no
certification, little expertise, and no independence. As for physicians, their scope of practice
includes the diagnosis and treatment of disease, thereby defining the interventions they are
allotted and limiting the kind of patient interaction possible. What makes the role of the RN
unique is the ability to perform independent therapeutic interventions aimed at restoring and
promoting health, preventing disease, and if the disease cannot be treated by methods inside the
box, then an RN can help the patient cope.

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References
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Vanhook, P. (2007). Cost-utility analysis: a method of quantifying the value of registered nurses.
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