Holistic nursing

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Holistic nursing is a way of treating and taking care of the patient as a whole body, which involves physical, social, environmental, psychological, cultural and religious factors. There are many theories that support the importance of nurses approaching the patient holistically and education on this is there to support the goal of holistic nursing. The important skill to be used in holistic nursing would be communicating skills with patients and other practitioners. This emphasizes that patients being treated would be treated not only in their body but also their mind and spirit. [1] . Holistic nursing is a nursing speciality concerning the integration of one's mind, body, and spirit with his or her environment. This speciality has a theoretical basis in a few grand nursing theories, most notably the science of unitary human beings, as published by Martha E. Rogers in An Introduction to the Theoretical Basis of Nursing , and the mid-range theory Empowered Holistic Nursing Education, as published by Dr. Katie Love. Holistic nursing has gained recognition by the American Nurses Association (ANA) as a nursing specialty with a defined scope of practice and standards. Holistic nursing focuses on the mind, body, and spirit working together as a whole and how spiritual awareness in nursing can help heal illness. Holistic medicine focuses on maintaining optimum well-being and preventing rather than just treating disease.

Contents


Symbol of Nurse hat in cartoon Eucalyp-Deus Nurse.png
Symbol of Nurse hat in cartoon

Core values

The holistic philosophy: theory and ethics

Holistic nursing is based on the fundamental theories of nursing, such as the works of Florence Nightingale and Jean Watson as well as alternative theories of world connectedness, wholeness, and healing. Hohistic nurses respect the patient as the decision-maker throughout the continuum of care. The holistic nurse and patient relationship is based on a partnership in which the holistic nurse engages the patient in treatment options and healthcare choices. The holistic nurse seeks to establish a professional and ethical relationship with the patient in order to preserve the patient's sense of dignity, wholesomeness, and inner worth. [2] [3]

Theories of holistic nursing

The goal for holistic nursing is in the definition of holistic where it is to treat the patient in whole not just physically. [4] Various nursing theories have helped on viewing the importance holistic nursing. These theories may differ on the views of holistic nursing care but have common goal which is to treat the patient in whole body and mind. [5] One of the theories is The Intersystem Model, explaining that individuals are holistic being therefore their illness are interacted and adapted them as a whole not just physically. [6] Also as health can be a different value to individuals which ranges constantly from well-being to disease.[ citation needed ] For example, despite their chronic condition the patient is satisfied with the changed healthy life for their living.[ citation needed ] In holistic nursing knowing the theory does not mean that this will be implanted in doing in real life practice many nurses are not able to apply the theory in real life. [7]

Holistic caring process

Holistic nursing combines standard nursing interventions with various modalities that are focused on treating the patient in totality. Alternative therapies can include stress management, aroma therapy, and therapeutic touch. The combination of interventions allows the patient to heal in mind, body, and spirit by focusing on the patient's emotions, spirituality, and cultural identity as much as the illness. The six steps of the holistic caring process occur simultaneously, including assessment, diagnosis, outcomes, therapeutic plan of care, implementation, and evaluation. The holistic assessment of the patient can include spiritual, transpersonal, and energy-field assessments in combination with the standard physical and emotional assessments. The therapeutic plan of care in holistic nursing includes a highly individualized and unique plan for each patient. Holistic nurses recognize that the plan of care will change based on the individual patient, and therefore embrace healing as a process that is always changing and adapting to the individual's personal healing journey. Therapies utilized by holistic nurses include stress management techniques and alternative or complementary practices such as reiki and guided imagery. These therapy modalities are focused on empowering individuals to reduce stress levels and elicit a relaxation response in order to promote healing and well-being. [2] [3]

The caring for patients in holistic nursing may differ from other nursing care as some may lack in caring for the patient as a whole, which includes spiritually. In holistic nursing, taking care of the patient does not differ from other nursing, but is focused on mental and spiritual needs as well as physical health. [1] In holistic nursing there should be a therapeutic trust between the patient and nurse, as caring holistically involves knowing the patient's illness as whole. This can be only done by the patient who is the one to tell the nurse about the social, spiritual and internal illness that they are experiencing. [1] Also as caring could be involved as assertive action, quiet support or even both which assist in understanding a person's cultural differences, physical and social needs. Through this the nurse is able to give more holistic care to meet the social and spiritual needs of the patient. [1] The attitude of nurse includes helping, sharing and nurturing. [1] In holistic caring there is spiritual care where it needs an understanding of patient's beliefs and religious views. [1] This is the reason why there should be therapeutic trust between nurse and patient, as in order to understand and respect the patient's religious beliefs the nurse has to get information from the patient directly which is hard to get when there is not therapeutic trust. [8] There is no specific order or template for how to care holistically, but the principle of holistic caring is to include patient's social and internal needs and not just focus on treating the physical illness. [1]

Holistic communication

Holistic nurses use intentional listening techniques ("Focus completely on the speaker") [9] and unconditional positive regard to communicate with patients. The goal of using these communication techniques is to create authentic, compassionate, and therapeutic relationships with each patient. [2] [3]

In holistic nursing having therapeutic trust with patient and nurse gives great advantage of achieving the goal of treating patients as a whole. [1] [10] Therapeutic trust can be developed by having conversation with the patient. [10] In communication the sender can also become a receiver or vice versa which in holistic nursing the nurses are the receiver of patients concern and the pass the information on to the doctor and do the vice versa.[ citation needed ] As communication is vital element in nursing it is strongly recommended to nurses to understand what is needed and how to communicate with patients. Communicating with patients can help in the performances of nurses in holistic nursing as by communicating the nurses are able to understand the cultural, social values and psychological conditions. Through this the nurses are able to satisfy the needs of a patient and as well as protecting the nurse for doing their roles as a nurse. In holistic nursing non-verbal communication is also another skill that is taught to nurses which are expressed by gestures, facial expression, posture and creating physical barriers.[ citation needed ] In holistic nursing as all individuals are not all the same but their social and psychological illness should be treated it is up to the nurse on how they communicate in order to build a therapeutic trust.[ citation needed ] To achieve the goal of holistic nursing it is important to communicate with the patient properly and to this successfully between the nurse and patient is freakiness and honesty.[ citation needed ] Without these communicating skills the nurse would not be able to build therapeutic trust and is likely to fail the goal of holistic nursing.

Building a therapeutic environment

Holistic nursing focuses on creating not only a therapeutic relationship with patients but also on creating a therapeutic environment for patients. Several of the therapies included in holistic nursing rely on therapeutic environments to be successful and effective. A therapeutic environment empowers patients to connect with the holistic nurse and with themselves introspectively. [2] [3]

Depending on the environment of where the patient is holistic approach may be different and knowing this will help nurses to achieve better in holistic nursing. [11] For patients with illness, trauma and surgery increasing sleep will benefit in recovery, blood pressure, pain relief and emotional wellbeing. [11] As in hospital there are many disturbances which can effect patients’ quality of sleep and due to this the patients are lacking in aid for healing, recovery and emotional wellbeing. [11] Nurse being able note or take care of patient's sleep will determine how closely they are approaching to holistic nursing. [11] Depending on disease some of the treatment may differ and may need further check-ups or programs for patients. For example, there are higher chances for women to experience cardiovascular disease but there are fewer enrollments for cardiac rehabilitation programs compared to men. [12] This was due to the environment of hospital not being able to support females in completing the CR programs. [12] Some examples are physicians are less likely to refer CR programs to women and patient's thought against safety of the program. [12] In situation like this from the knowledge and education that comes from holistic nursing the nurses will be able to approach the patient as they can relate to what the patient is going through which gives more comfort and safety to patients in doing the programs.[ citation needed ] [12]

Cultural diversity

Part of any type of nursing includes understanding the patient's comprehension level, ability to cope, social supports, and background or base knowledge. The nurse must use this information to effectively communicate with the patient and the patient's family, to build a trusting relationship, and to comprehensively educate the patient. The ability of a holistic nurse to build a therapeutic relationship with a patient is especially important. Holistic nurses ask themselves how they can culturally care for patients through holistic assessment because holistic nurses engage in ethical practices and the treatment of all aspects of the individual. [2] [3]

Australia has many different cultures as they are many people who were born overseas and migrated to Australia, which we can experience many cultural diversities. [13] Culture can be defined as how people create collective beliefs and shared practices in order to make sense of their lived experiences which how concepts of language, religion and ethnicity are built in the culture. [14] As the meaning of holistic nursing to heal the person as a whole knowing their cultural identities or backgrounds will help to reach the goal (Mariano, 2007). Understanding peoples culture may help to approach treatment correctly to the patient as it provides knowledge to nurses how patient's view of the concept of illness and disease are to their values and identity. [3] As in holistic approach culture, beliefs and values are essential components to achieve the goal. [3] People's actions to promote, maintain and restore health and healing are mainly influenced by their culture which is why knowing other cultures will assist in holistic nursing. [3] By developing knowledge, communication, assessment skills and practices for nurses it guides to provide better experiences to patients who have diverse beliefs, values, and behaviors that respects their social, cultural and linguistic needs. [14] As for most patients and families their decision on having treatment against illness or disease are done from cultural beliefs. [14] This means if the nurses are unable to understand and give information relating to what they believe in the patients will most likely reject the treatment and give hardship on holistic nursing. [14]

Holistic education and research

Holistic registered nurses are responsible for learning the scope of practice established in Holistic Nursing: Scope and Standards of Practice(2007) [3] and for incorporating every core value into daily practice. It is the holistic nurse's responsibility to become familiar with both conventional practices as well as alternative therapies and modalities. Through continuing education and research, the holistic nurse will remain updated on all treatment options for patients. Areas of research completed by holistic nurses includes: measurements of outcomes of holistic therapies, measurements of caring behaviors and spirituality, patient responsiveness to holistic care, and theory development in areas such as intentionality, empowerment, and several other topics.

The goal of holistic nursing is treat the patient's individual's social, cognitive, emotional and physical problems as well as understanding their spiritual and cultural beliefs. [15] Involving holistic nursing in the education will help future nurses to be more familiar in the terms holistic and how to approach the concept. [15] In the education of holistic nursing all other nursing knowledge is included which once again developed through reflective practice. [15] In holistic nursing the nurses are taught on the five core values in caring, critical thinking, holism, nursing role development and accountability. [15] These values help the nurse to be able to focus on the health care on the clients, their families and the allied health practitioners who is also involved in patient care. [15] Education in holistic nursing is continuous education program which will be ongoing even after graduation to improve in reaching the goal. [15] Education on holistic nursing would be beneficial to nurses if this concept is introduced earlier as repetition of educating holistic nursing could also be the revision of it. [16] There is different education on commutating skills and an example would be the non-verbal and verbal communication with patients. This is done to improve when would the right or wrong to use the communication skill and how powerful skills this could be.[ citation needed ]

Holistic nurse self-care

Through the holistic nurse's integration of self-care, self-awareness, and self-healing practices, the holistic nurse is living the values that are taught to patients in practice. Holistic "nurses cannot facilitate healing unless they are in the process of healing themselves." [3]

In order to provide holistic nursing to patient it is also important for nurses to take care of themselves. [3] There are various ways which the nurses can heal, assess and care for themselves such as self-assessment, meditation, yoga, good nutrition, energy therapies, support and lifelong learning. [3] By nurses being able achieve balance and harmony in their lives it can assist to understand how to take care of patient holistically. [3] In Florida Atlantic University there is a program that focus on all caring aspects and recognize how to take care of others as well as on how to start evaluation on their own mind, body and spirit. [17] Also there is Travis’ Wellness Model [18] which explores the idea of “self-care, wellness results from an ongoing process of self-awareness, exploring options, looking within, receiving from others (education), trying out new options (growth), and constantly re-evaluating the entire process. Self-awareness and education precede personal growth and wellness”. [19] This model of concepts shows being able to understand own status of health can benefit to patients and reach the goal of holistic nursing. [3]

Certification

National certification for holistic nursing is regulated by the American Holistic Nurses Certification Corporation (AHNCC). [20] There are two levels of certification: one for nurses holding a bachelor's degree and one for nurses holding a master's degree. Accreditation through the AHNCC is approved by the American Nurses Credentialing Center (ANCC). [20]

Global initiatives

United States

American Holistic Nurses Association (AHNA): Mission Statement

"The Mission of the American Holistic Nurses Association is to illuminate holism in nursing practice, community, advocacy, research and education." [21]

Canada

Canadian Holistic Nurses Association (CHNA): Mission Statement

"To support the practice of holistic nursing across Canada by: acting as a body of knowledge for its practitioners, by advocating with policy makers and provincial regulatory bodies and by educating Canadians on the benefits of complementary and integrative health care." [22]

Australia

Australian Holistic Nurses Association (AHNA)

"The Mission of the Australian Holistic Nurses Association (AHNA) is to illuminate holism in nursing practice, research, and education; act as a body of knowledge for its practitioners; advocate with policymakers and regulatory bodies; and educate Australians on the benefits of Complementary and Alternative Medicine (CAM) and integrative health care." [23]

See also

Related Research Articles

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.

Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's ability to fulfill their daily routines and roles. OTs have training in the physical, psychological, and social aspects of human functioning deriving from an education grounded in anatomical and physiological concepts, and psychological perspectives. They enable individuals across the lifespan by optimizing their abilities to perform activities that are meaningful to them ("occupations"). Human occupations include activities of daily living, work/vocation, play, education, leisure, rest and sleep, and social participation.

<span class="mw-page-title-main">Music therapy</span> Health profession

Music therapy, an allied health profession, "is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program." It is also a vocation, involving a deep commitment to music and the desire to use it as a medium to help others. Although music therapy has only been established as a profession relatively recently, the connection between music and therapy is not new.

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.

<span class="mw-page-title-main">Curandero</span> Traditional healer found in Latin America and the United States

A curandero is a traditional native healer or shaman found primarily in Latin America and also in the United States. A curandero is a specialist in traditional medicine whose practice can either contrast with or supplement that of a practitioner of Western medicine. A curandero is claimed to administer shamanistic and spiritistic remedies for mental, emotional, physical and spiritual illnesses. Some curanderos, such as Don Pedrito, the Healer of Los Olmos, make use of simple herbs, waters, or mud to allegedly effect their cures. Others add Catholic elements, such as holy water and pictures of saints; San Martin de Porres for example is heavily employed within Peruvian curanderismo. The use of Catholic prayers and other borrowings and lendings is often found alongside native religious elements. Many curanderos emphasize their native spirituality in healing while being practicing Catholics. Still others, such as Maria Sabina, employ hallucinogenic media and many others use a combination of methods. Most of the concepts related to curanderismo are Spanish words, often with medieval, vernacular definitions.

Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.

Nursing assessment is the gathering of information about a patient's physiological, psychological, sociological, and spiritual status by a licensed Registered Nurse. Nursing assessment is the first step in the nursing process. A section of the nursing assessment may be delegated to certified nurses aides. Vitals and EKG's may be delegated to certified nurses aides or nursing techs. It differs from a medical diagnosis. In some instances, the nursing assessment is very broad in scope and in other cases it may focus on one body system or mental health. Nursing assessment is used to identify current and future patient care needs. It incorporates the recognition of normal versus abnormal body physiology. Prompt recognition of pertinent changes along with the skill of critical thinking allows the nurse to identify and prioritize appropriate interventions. An assessment format may already be in place to be used at specific facilities and in specific circumstances.

A nursing care plan provides direction on the type of nursing care the individual/family/community may need. The main focus of a nursing care plan is to facilitate standardised, evidence-based and holistic care. Nursing care plans have been used for quite a number of years for human purposes and are now also getting used in the veterinary profession. A care plan includes the following components: assessment, diagnosis, expected outcomes, interventions, rationale and evaluation.

Faith Community Nursing, also known as Parish Nursing, Parrish Nursing, Congregational Nursing or Church Nursing, is a movement of over 15,000 registered nurses, primarily in the United States. There are also Parish nurses in Australia, the Bahamas, Canada, England, Ghana, India, Kenya, Korea, Madagascar, Malawi, Malaysia, New Zealand, Nigeria, Palestine, Pakistan, Scotland, Singapore, South Africa, Swaziland, Ukraine, Wales, Zambia and Zimbabwe. Faith community nursing is a practice specialty that focuses on the intentional care of the spirit, promotion of an integrative model of health and prevention and minimization of illness within the context of a community of faith. The intentional integration of the practice of faith with the practice of nursing so that people can achieve wholeness in, with, and through the population which faith community nurses serve.

<span class="mw-page-title-main">Energy medicine</span> Pseudo-scientific alternative medicine

Energy medicine is a branch of alternative medicine based on a pseudo-scientific belief that healers can channel "healing energy" into patients and effect positive results. The field is defined by shared beliefs and practices relating to mysticism and esotericism in the wider alternative medicine sphere rather than any sort of unified terminology, leading to terms such as energy healing, vibrational medicine, and similar terms being used synonymously. In most cases, no empirically measurable "energy" is involved: the term refers instead to so-called subtle energy. Practitioners may classify their practice as hands-on, hands-off, or distant wherein the patient and healer are in different locations. Many approaches to energy healing exist: for example, “biofield energy healing”, “spiritual healing”, “contact healing”, “distant healing”, therapeutic touch, Reiki, and Qigong.

<span class="mw-page-title-main">Madeleine Leininger</span>

Madeleine Leininger was a nursing theorist, nursing professor and developer of the concept of transcultural nursing. First published in 1961, her contributions to nursing theory involve the discussion of what it is to care.

<span class="mw-page-title-main">Nurse–client relationship</span>

The nurse–client relationship is an interaction between a nurse and "client" (patient) aimed at enhancing the well-being of the client, who may be an individual, a family, a group, or a community.

A registered psychiatric nurse (RPN) specialises in a field of nursing that focuses on the mental health of patients. Psychiatric nurses assist the interdisciplinary team in the assessment and treatment of the patient's psychiatric illness and symptoms. They treat a variety of mental health disorders such as bipolar, depression, schizophrenia, anxiety, substance abuse addiction and eating disorders such as bulimia and anorexia. However, they do not diagnose the patient, this is the responsibility of a qualified psychologist or a psychiatric doctor. Psychiatric nurses are in charge of dispensing medication and the overall care of patients. Registered psychiatric nurses work under the supervision of doctors’ and they practice within the health care industry, mostly in mental health clinics, outpatient facilities, mental health agencies, long-term care centres or hospitals.

Wendy L. Watson Nelson is a Canadian-American marriage and family therapist, and professor. She worked with the Family Nursing Unit (FNU) at the University of Calgary from 1983 to 1992, training graduate students to use family systems therapy with families of patients. Her academic work in articles and in the book Beliefs: The Heart of Healing in Families and Illness helped develop a practical and theoretical framework for family systems nursing. She is the wife of Russell M. Nelson, president of the Church of Jesus Christ of Latter-day Saints.

<span class="mw-page-title-main">Family nurse practitioner</span> Type of certified nurse practitioner

A family nurse practitioner (FNP) provides continuing and comprehensive healthcare for the individual and family across all ages, genders, diseases, and body systems. Primary care emphasizes the holistic nature of health and it is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion.

<span class="mw-page-title-main">Nursing</span> Health care profession

Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. There are shortages of qualified nurses in many countries.

<span class="mw-page-title-main">Cultural competence in healthcare</span> Health care services that are sensitive and responsive to the needs of diverse cultures

Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. This process includes consideration of the individual social, cultural, and psychological needs of patients for effective cross-cultural communication with their health care providers. The goal of cultural competence in health care is to reduce health disparities and to provide optimal care to patients regardless of their race, gender, ethnic background, native languages spoken, and religious or cultural beliefs. Cultural competency training is important in health care fields where human interaction is common, including medicine, nursing, allied health, mental health, social work, pharmacy, oral health, and public health fields.

Empowered Holistic Nursing Education - Mid-range Nursing Theory

A mental health nurse (MHN) refers to a nurse in the UK, who specializes in the care of patients with mental health issues. The practice of MHNs is called mental health nursing.

Healthcare chaplaincy is the provision of pastoral care, spiritual care, or chaplaincy services in healthcare settings, such as hospitals, hospices, or home cares.

References

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