NYC Health + Hospitals/Gouverneur has been providing health services since 1885, when it opened as a community hospital in an abandoned police station on Manhattan's Lower East Side. In 1972 Gouverneur moved to its present location at the crossroads of Chinatown and the Lower East Side and in 1976 added a skilled nursing facility.
Currently NYC Health + Hospitals/Gouverneur serves approximately 50,000 patients a year, reaching out to the neighborhood's large Asian population in Cantonese, Mandarin, and Vietnamese, and the large Hispanic populations in Spanish. Gouverneur's skilled nursing facility provides short-term rehabilitation and long-term skilled nursing services. Its newly renovated building is filled with sunlight and offers a welcoming presence to the community, with programs focused on patient education and wellness with an emphasis on healthy lifestyles, and a peaceful, relaxing atmosphere for the patients and long-term residents.
New York College of Traditional Chinese Medicine
In Fall 2010, interns from the New York College of Traditional Chinese Medicine (NYCTCM) began offering acupuncture services to the patients of the Gouverneur short-term rehabilitation center in its skilled nursing facility. Director of Rehabilitation Services Danny Wong, DPT has welcomed the addition of acupuncture for the many patients who might otherwise not receive this treatment. Under the direction of clinic supervisor Ada Wang, PhD (China), LAc, the NYCTCM interns treat approximately 7-8 patients per day. The facility provides private rooms for all of the patients, and the treatments are administered in the patient's bed, which allows the patient to rest and relax undisturbed afterward. Each treatment lasts about 45 minutes.
Acupuncture is most frequently administered for pain and for post-stroke rehabilitation. According to Jeffrey Nichols, MD, chief medical officer of post-acute care, approximately 80 percent of the patients receiving acupuncture report improvement. "Some of our nursing home residents have experience with acupuncture from before admission and are thrilled that it is available to them here as well. For others, we are pleased to have non-pharmacologic approaches to offer, particularly since narcotic and non-narcotic pain medications all have significant risks in an elderly population."
In addition to providing a beneficial service to the patients, the clinic has been valuable in teaching the students the skills necessary to treat patients in a nursing facility setting. Clinic supervisor Ada Wang states that at Gouverneur "the students learn how to work together with the doctors, nurses, physical therapists and other staff in the hospital. They gain valuable experience of treating patients with stroke and those suffering from pain following orthopedic surgery."
The Student Interns
Student intern, Qixia Kuang notes that the students are treating patients with more severe conditions than they would usually see at the school clinic.
Student intern, Eikazu (Kazu) Nakamura described the challenges and rewards in treating patients in the skilled nursing facility setting. "Since we see patients with serious conditions compared to those in regular clinics, we need to comply with many requirements and regulations. However, almost all the patients exhibit a sense of relaxation and relief from pain to some extent after each treatment, which is very rewarding."
NYCTCM clinical director Mona Lee-Yuan, MS, LAc, PT, a dual licensed professional in both physical therapy and acupuncture, describes the benefit of acupuncture in a short-term rehabilitation setting. "As a physical therapist, it was extremely frustrating when a patient's progress would plateau because of pain. Acupuncture is the perfect complement to physical therapy, and is especially useful in pain syndromes; often pain is the major limiting factor in a patient's ability to move and to function. Acupuncture is able to harmonize the patients' body system with TCM techniques so that the patient can then reach their maximal functional potential using physical therapy techniques."
Mona Lee-Yuan coincidentally had her first PT job at Gouverneur. "When I worked there over 30 years ago, Gouveneur Hospital was always on the forefront as far as treating their Skilled Nursing Facility patients with compassion, and maintaining their dignity. The new Gouveneur Hospital is offering the best of both worlds to their Skilled Nursing Facility patients — Eastern and Western Medicine."
Student intern, Rebecca Chang stated "It's particularly gratifying to see many first-time acupuncture patients leave Gouverneur asking for our business card, wanting to continue treatment. In a sense we are "Acupuncture Ambassadors" to a public unfamiliar with the benefits of TCM. Furthermore, seeing a patient on a consistent weekly basis ensures regular treatment and timely feedback which are essential to progress and lead to better overall treatment. I suppose that's why they keep asking for our card!"
Acupuncture Ambassadors
NYCTCM is working with Gouverneur to arrange for students to participate more fully in the Grand Rounds and in the discussions regarding the planning of patient care. The hospital has extended an invitation to the students to continue their role as "Acupuncture Ambassadors" and has requested that they provide in-service training about acupuncture and Chinese medicine to the nursing staff.
However, the students are not the only ambassadors for acupuncture at Gouverneur. Intern Kazu Nakamara tells of one memorable patient who, prior to treatment, was able to turn his body from supine to prone by himself, but no had movement in his legs. "Gradually, with treatment he regained sensory and strength of his legs, standing with a walker. Eventually, he became able to stand and take 6-7 steps with a cane by himself. He showed genuine gratitude to each one of us on the day he was discharged. He had been one of our great ambassadors of acupuncture to other patients in the hospital."
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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