A State by State Massage Therapist Licensure Guide

Why do some Nurses Study Massage Therapy?

Why do nurses practice massage? Massage can promote healing and enhance well-being. According to a survey by the American Massage Therapy Association (AMTA), 43% of the population had their most recent massage for medical reasons (https://www.amtamassage.org/career_guidance/detail/193?typeId=10).

AMTA points to numerous studies that have found improvements in symptomology. The effects go beyond relief of achy muscles. Massage may lower blood pressure and improve cardiovascular health (https://www.amtamassage.org/research/Massage-Therapy-Research-Roundup/Research-Roundup--Cardiovascular-Health---Massage.html). A 2013 study found a reduction of fatigue in cancer patients (https://www.amtamassage.org/articles/1/News/detail/3257). In situations where there is no cure possible, massage may bring a greater sense of well-being. Among those who may experience comfort are end-of-life hospice patients.

Nurses are, by and large, responsive to therapies that promote well-being, even when well-being is difficult to quantify. Noreen Frisch, PhD and RN, notes that nursing is, at its core, a holistic discipline (http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No2May01/AlternativeComplementaryModalities.html).

The Louisiana State Board of Nursing noted, in a declaratory statement about complementary therapies, a long history of the use of massage in healthcare, a history that went back as far as 1815 (http://www.lsbn.state.la.us/). The Art of Massage, A Practical Manual for the Nurse, the Student and the Practitioner was written in 1895.

Today’s nurses are taking advantage of an opportunity that their predecessors often didn’t have: the opportunity to receive formal education and training in massage therapy.

Scope of Practice Issues

In many cases, nurses are authorized to perform some massage by virtue of their license. The particulars vary from state. In some cases, there may be a distinction between relaxation massage and more targeted therapy. Several themes emerge, including limitations on practice, requirements for obtaining informed consent, and adherence to written guidelines. The Louisiana Board has stated that a registered nurse may provide massage as part of a care plan for purposes such as relief of pain or moderation of stress. The New Hampshire Board has stated that massage, as a nursing intervention, is within the scope of registered nurses, licensed practical nurses, and licensed nursing assistants if they have the competency, and if the intervention is performed as part of a care plan (http://www.nh.gov/nursing/faq/reiki.htm). The Oregon Board has stated that it may be within a nurse’s scope of practice to provide massage as an element of care within a broader plan of care (http://www.oregon.gov/OSBN/pdfs/policies/complementary-alternative_modalities.pdf).

Studying Massage as a Discipline

Regulations and policies are subject to change. But whatever theoretically may be in a nurse’s scope of practice, one is limited by one's own competency. The Oregon Board notes that with complementary modalities, it is important to understand theoretical underpinnings, practical applications, and risks -- and to be able to document competency if it's called into question.

The training received in a nursing program may be minimal, especially if the nurse has not studied at the graduate level. Most people know how to perform a simple back or shoulder rub, but they don't know how to use massage to its full healing potential. Massage therapists typically have 600 or more hours of initial training; this includes concepts such as indications and contraindications as well as guided instruction in use of particular modalities. Techniques used to decrease agitation in Alzheimer's patients might be relatively simple. However, techniques used to alleviate symptoms in some other health conditions are difficult to master. Massage is its own discipline. Trained, licensed massage therapists pursue continuing education in their areas of specialization and may ultimately have far more hours than what is required for licensure.

Forging New Career Paths

It takes more formal education to become an RN than a massage therapist. However, this doesn't mean that a career in massage is a step backwards. Sometimes professionals with backgrounds in healthcare become leaders in integrating massage within medical/ healthcare settings. Those who go into independent practice may also benefit from the dual training. Massage therapy is a field where many are in business for themselves but where the level of success and the earning vary a good deal.

Individuals with dual training in massage therapy and nursing may be sought after in the medical massage arena. The American Massage Therapy Association has provided profiles of massage therapists who work in the healthcare arena (https://www.amtamassage.org/career_guidance/detail/193?typeId=10). Among those profiled: a professional who worked as an advanced practice nurse for a number of years before becoming a massage therapist. After receiving her massage credential, she went to work for a hospital that had recently implemented a massage therapy program for post-surgery cardiac and orthopedic patients. She brought to her new position a knowledge of healthcare systems – and an awareness of the emotional distress hospitalized patients can experience.