Advocacy for Client Health
By Nancy Dail
When I graduated from massage school in 1974, I came back east with every intention of returning to the Southwest to work with Dr Scherer at his massage school in Santa Fe, New Mexico. Life and changes got in the way, the death of my mother on the heels of my return home, and somehow I melted into the Maine landscape and built a massage practice here. Jay, still directing me from the Southwest, expected me to explore emergency medicine and so I became an EMT. I actually had a “red emergency phone” in my house that was hooked up to the town of Waldoboro. This was even before pagers! I was glued to that phone and could only go as far as I could hear it when I was on call for the ambulance service.
I learned a lot being an EMT. I saw first-hand what trauma would do to the human body and how necessary immediate emergency care can make the difference between life and death. I performed CPR on human beings sometimes saving lives, but always working within the scope of emergency medicine. I got to know all the trauma physicians, respect emergency medicine in general and befriended RNs and the medical community. Our team would assist the physician if necessary in the ER and on several occasions with the permission of the patient, I was able to observe the subsequent surgeries in the operating room. Truly, this was the start of my thirst for anatomical knowledge.
Emergency medicine is where I first started taking blood pressure readings. So when I started a school in 1980, it made sense to me that massage students should know First Aid, CPR and should learn to take blood pressure readings. As an EMT, I did not diagnose. The blood pressure reading was an evaluation that was noted at the scene of the accident or trauma. A health professional or anyone for that matter, cannot tell if someone has high or low blood pressure by looking at the individual. Truly, the blood pressure reading may vary the very next time you measure it. Medication usually normalizes blood pressure readings so they do not vary much from each time it is measured. Individuals who have high blood pressure but who are on medication, need to be referred back to their physician. All clients who have multiple signs and symptoms, like headache, edema, and high blood pressure, need to be referred to medical.
Part of what we do for our clients is to help them help themselves. My Anatomy Coloring Book that I colored with my first class is held together with duct tape from showing clients muscles and bones in living color in those early years. Later on, I graduated to Travell, the Atlas of Anatomy, and to my own text Kinesiology for Manual Therapies. Knowledge is power, and the client is better able to advocate for themselves with more information.
In my practice, I strive to integrate with the health professional community around me. In our student clinic, we have clients who are seeing physicians, PTs, acupuncturists, chiropractors, etc who are more than willing to see the combination of massage therapy and health care for the benefit of their patients. I do take blood pressure readings in my practice and our students provide that service in the student clinic. We have been known to refer clients to their physicians for evaluation and diagnosis. Recently, we had a client who had just been in the hospital for low blood pressure. The bottom line is that our clients are not coming to us all normal and healthy. They are coming in with their new normal which may include diabetes, cancer, fibromyalgia, and a slew of other pathological conditions. We, the massage therapists are the ones who will have to come up to speed.
If we are going to accept clients who walk in the door, then it is our responsibility, with this direct access, to decide who has the ability to benefit or not. The BP cuff is a simple tool, easily mastered, that is another way to give information back to the client. We do seem to all agree that there are benefits and that there are contraindications for massage therapy and for bodywork. If those statements are true, than simple assessments to provide information would add to our tool belt. Science is the foundation of your art. Taking a blood pressure reading should just be part of our process to advocate for our clients.