Perspectives, news, and announcements from the Center that will ignite your passion for wellbeing.
By Suzy Frisch
Megan Voss, D.N.P., R.N., knows the power of essential oils and aromatherapy to relieve pain, anxiety, and nausea. She saw it work frequently and effectively with her oncology patients, helping them relax and breathe easier during long and often arduous hospital stays.
Aiming to broaden her toolkit of palliative care beyond pharmaceuticals, Voss earned her doctor of nursing practice (DNP) degree in integrative health and healing in 2013 from the University of Minnesota School of Nursing. She wanted to do more to ease her patients’ physical, mental, and emotional suffering as they coped with cancer, while also caring for caregivers.
Through the program, Voss gained those skills and more. She bolstered her ability to evaluate research about aromatherapy and essential oils. She also learned to safely roll out integrative therapies for various patient populations and across large organizations. After being recruited by the University of Minnesota Masonic Children’s Hospital, Voss put these new capabilities to use right away.
As director of the Pediatric Blood and Marrow Transplant Integrative Therapy Program, Voss was first tasked with enhancing the existing aromatherapy program for kids on the unit. Though aromatherapy wasn’t new to the hospital, Voss found that some of its essential oils practices were outdated and not created specifically to suit the needs and safety of pediatric patients. Together with a pediatrician and nurse coordinator of integrative therapies, a group was formed to revitalize aromatherapy across the hospital.
Another part of her job involves teaching other nurses proper aromatherapy practices for use with patients and their own self-care, aiming to help them reduce stress and avoid burnout. “The DNP program taught me leadership skills and how to make changes on a systems level,” Voss says. “I was able to create education so nurses working at the bedside understand more about essential oils and create policies and infrastructure in the healthcare system so that everyone is practicing at a safe level.”
Healthcare professionals from diverse fields turn to the Center for education in the safe and effective use of essential oils and aromatherapy. It’s a focus area that goes back nearly 20 years. The seeds were planted when Center Director Mary Jo Kreitzer, Ph.D., R.N., F.A.A.N., and associate professor Linda Halcón, Ph.D., M.P.H., R.N. joined other faculty at a weekend retreat about aromatherapy.
Inspired and motivated, they decided that essential oils and their role in healing would be a fitting part of the Center’s mission.
Ever since, the Center has taught many people how to safely and effectively use aromatherapy to help patients relax during anxious times, reduce pain, fall asleep, or feel better during an illness. Also known as essential oil therapy, aromatherapy is a key part of integrative care and often patients and practitioners’ first brush with such practices.
“Aromatherapy, like other integrative therapies, empowers patients to be in charge of their healthcare, whether it’s for stress reduction or symptom management,” Voss says. “It’s our job as DNPs to tease out ways integrative practices align with patients’ healthcare goals and use them in effective ways.”
Many hospice and healthcare systems now offer aromatherapy, typically at the request of patients. Other times, they start programs based on practitioners’ interests in providing effective integrative care. One main driver is the evidence that it works—knowledge grounded in the scientific understanding of essential oils’ complex chemical properties and pharmacological effects, explains Halcón, who recently retired.
When Kreitzer endorsed introducing a clinical aromatherapy curriculum, Halcón raised her hand to develop and teach it. An aficionado of plants, gardening, and botanical medicine, she wanted to marry these interests with nursing. Halcón first took several courses in the agricultural, scientific, and medical uses of aromatherapy.
Then she created two clinical aromatherapy classes, totaling four credits, that aimed to give nursing and other health professions students enough training that they could sit for registration exams. About a decade ago, Halcón narrowed the focus but broadened its appeal to healthcare providers and others interested in clinical aromatherapy. The Center now offers it as a one-credit course online or in Hawaii in January, and has educated students from around the world. Some hospitals require their aromatherapy resource persons to take the class or an equivalent before implementing new clinical aromatherapy initiatives, Halcón says, and many facilities recommend that staff using essential oils complete the online aromatherapy module that can be found on the Center’s website.
Students in the one-credit course learn about six of the most common essential oils used in clinical settings and how best to employ them, as well as learning safety and practice principles for patient and self-care. For example, some essential oils are irritating when used directly on the skin but are safe to inhale. Other times, instructors are dispelling beliefs that it’s generally safe to ingest essential oils—not true—or that they should use too-high doses, which can be toxic, Halcón adds.
Through her DNP aromatherapy education, Voss gained a wealth of knowledge to share with other nurses. She stresses not using more than a 2 percent concentration of essential oils to avoid rashes or medication interactions. She also advocates for blends so that patients don’t associate scents like peppermint with chemotherapy-induced nausea. Voss suggests a blend including citrus, ginger, and peppermint in an aroma stick instead. Another essential part of the Center’s approach is making sure instructors don’t teach aromatherapy in isolation, Halcón says. Instead, practitioners must learn how to integrate the modality in a holistic and personalized way based on patients’ needs and circumstances. “The way we teach it in the Center is to use principles of integrative care for aromatherapy like you would with anything else,” she notes, adding that caregivers should collaborate with patients about their options. After trying aromatherapy, “talk to the person and observe their response. Pay attention to their needs and wants.”
Halcón recently retired, and was succeeded by Jan Tomaino, D.N.P., R.N., an associate professor who has been certified in aromatherapy for 13 years. She is updating some of the course modules, but its essence will remain the same: providing students with clinical and scientific knowledge about aromatherapy. Tomaino comes to the role with rich field experience, thanks to her DNP. She implemented aromatherapy programs at Essentia and Fairview hospitals and a hospice facility in northern Minnesota. Calling aromatherapy an entry to other integrative healing practices, she finds
teaching about essential oils challenging at times. Many people listen to companies that don’t always promote scientifically sound and safe practices. Armed with scientific expertise and clinical experience, Tomaino aims to challenge unfounded claims—and some healthcare practitioners’ skepticism about essential oils—through her teaching. “We want to provide students with current research and focus on the safe use and application methods of using essential oils with patients and for selfcare,” she says. “We provide the base understanding of essential oils and the chemical properties of them.”
Tomaino points to lavender and its nearly 100 chemical constituents; each one has the potential to interact and react in the human body. She aims to impart knowledge, such as research documenting that when someone inhales lavender, their heart rate, blood pressure, and other physiological metrics may improve, plus people feel calmer.
The Center’s aromatherapy education gives practitioners the tools they need to establish firmly rooted programs for people of all ages facing myriad circumstances. Johanna Gaskins, D.N.P., A.G.-P.C.N.P., C.C.A.P., a nurse practitioner with experience in critical care and home health, can attest to its real-world applications. She came to the University for a DNP in integrative health and healing, aiming to ladder her aromatherapy certification into preventive care work.
An advocate for essential oils after personally experiencing their healing power, Gaskins frequently uses them along with other healing arts like guided imagery or Reiki to relieve patients’ pain and reduce anxiety. She appreciates the additional expertise she gained from the Center about the evidence backing essential oils. Living in Northern Virginia, Gaskins relies on her knowledge of the science of aromatherapy when explaining the practice to other healthcare providers and advocating for its use for patients.
“When I’m talking with providers who pooh-pooh the idea of this kind of practice, having research and evidence supports my practice and position,” says Gaskins, who recently started her own consultancy, Seek Wellbeing, an online platform of self-discovery and healing. “That helps me support my patients and it helps me help other clinicians grow in their knowledge base.”
Essential oils are powerful tools for healthcare practitioners, with dangers around the corner if used incorrectly. That makes the Center’s role in helping healthcare practionioners learn to use aromatherapy properly, safely, and effectively more integral than ever. +++
The Center’s aromatherapy program found vital allies in the husband-wife team of Bill McGilvray and Jill Rivard at Plant Extracts International in Hopkins. For the past decade, they have hosted classes and workshops on essential oils taught by authorities in the field, including a recent event about essential oil chemistry with E. Joy Bowles. They continue to mentor many nurses, DNP students, and graduates. Because their company is in compliance with all FDA guidelines governing the use of essential oils in manufacturing, they don’t offer health information to the general public. They do enjoy answering questions and working with healthcare professionals, and sharing expertise gathered from being in the industry for more than 30 years. McGilvray and Rivard aim to promote safety, such as minimal use of essential oils, and address questions or needs from healthcare practitioners by formulating essential oils into specific products. It’s rewarding for them to be involved with the Center and support its pursuit of embedding essential oils and aromatherapy more deeply into healthcare settings. “We would love to see essential oils fully researched and incorporated into healthcare as adjunctive materials,” McGilvray says. “The leadership and encouragement from the Center has moved things forward enormously.”
Mandala is a biannual magazine produced by Bakken Center for Spirituality & Healing. It captures the core aspects of the Center: reflection, transformation, spirituality, creation, and the ongoing journey that continues to shape what we are to become.