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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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