Nurses experiences of participating in leech therapy in plastic and reconstructive surgery in Ireland

TITLE: Leech therapy in Ireland. BACKGROUND: Leech therapy is administered by nurses in plastic and reconstructive surgery wards in Ireland. Some nurses are reported as having “Qualms” about participating in this therapy.... [ view full abstract ]

TITLE: Leech therapy in Ireland.
BACKGROUND: Leech therapy is administered by nurses in plastic and reconstructive surgery wards in Ireland. Some nurses are reported as having “Qualms” about participating in this therapy.
Aim: To investigate nurses’ experiences of participating in leech therapy in plastic and reconstructive surgery.
METHOD: Qualitative descriptive semi-structured interviews explored nurses’ experiences of using leech therapy.
SAMPLE: A purposeful sample of 7 nurses was drawn from a busy 30 bed plastic surgical ward in a major Dublin teaching hospital.
RESULTS: Four themes emerged
(i) Nurses reaction to leeches
(ii) Emotional coping
(iii) Patient reaction to leeches
(iv) Leech practicalities.
FINDINGS: Self-awareness is a key part in preparation for the administration of leech therapy. The nurse needs to be conscious of his/her own emotions towards the leech. This is important because the nurse needs to put feelings of disgust and revulsion aside in order to carry out the therapy and remain professional. Many of the practicalities of the therapy such as migration, handling and disposal can evoke a variety of aversive reactions from the nurse. Nurses report feeling that these emotions have to be hidden from the patient in order to ensure confidence in the therapy. Nurses report that patients also share feelings of disgust and identify other issues such as particularly problematic body parts for leech therapy.
RECOMMENDATIONS: It is recommended that guidelines be complied for administration of leech therapy. It is also recommended that educational preparation for the role be made more formal than the current as hoc arrangements for on the ward learning. The plastics course which used to be in place, be reinstated as nurses requested greater education in this area. Open discussion about the aversive nature and emotion-management aspects of the role should form part of that education package.