A common belief expressed in nursing education and practice is that nursing practice is holistic. Current pressures to demonstrate person or patient centered care have raised questions such as “what is holistic nursing?” For many nurses, the answer is tied to their ability to blend technology, mind, and spirit with the goal of promoting healing. Nursing holistically means practicing with a view toward healing the whole person. Holistic nursing practice promotes healing by bringing together our care of the patient in the wholeness of mind, body and spirit, knowing that we cannot necessarily promote a patients optimal potential to heal physically when the patient is psychologically or spiritually distressed. This focus on healing the person as a whole being is a concept that goes back more than a century to nurses such as Florence Nightingale who argued that the nurse’s role was to create the optimal conditions for healing. [i]
Interest in holistic nursing practice has grown along with our advances in our knowledge bio-behavioral health, psycho-immunology and the review and integration of “traditional healing practices. Research in health and healing has given new credibility to a variety of holistic care practices.
For more than thirty years, nurses such as Barbara Dossey in the US have sought to bring a theory of holistic nursing to practice. Dossey and others have observed that “nurses as healers” use their own energies and interpersonal caring to facilitate growth and the process toward wholeness of body, mind and spirit, as well as assist people in recovery from illness or in the transition to death”. [ii]
According to Dossey:
Holistic nursing requires that nurses integrate self-care/self-responsibility in their lives in order to help facilitate healing and caring for others. In turn, this self-care/self-responsibility leads nurses to a greater awareness of the interconnectedness of all individuals and their relationships to the human and global community.
More recently, Dossey has developed a theory of integral nursing that places holistic care within a relational and environmental context of care-giving and community. [iii] This theory attempts to broaden our current paradigm of care to address not only patient centered-direct nursing care, but also how we work together and use our energy as health care providers within the health care system, and community action in support of health and healing.
The holistic nursing movement has grown over the past few decades to include nurses who practice broadly within a holistic framework, as well as nurses who have integrated a range of modalities now known as complementary or alternatives therapies to promote healing. Nurses play a central role as providers of complementary therapies; and this is a universal phenomenon with a growing interest in the use of complementary therapies around the world. In the United States alone, 38% of adults and even more (60%) of older adults report using some form, according to the NCHS. [iv] Many nurses who practice holistic nursing integrate complementary/alternative modalities (CAM) into clinical practice to treat people’s physiological, psychological, and spiritual needs (see the side bar listing). This integration serves to complement and/or aid conventional medical and nursing therapies. The intent of this not only enriches the scope of nursing practice, but also helps individual patients to access their greatest healing potential.
The recognition of the widespread use of complimentary therapies propelled the US National Institute of Health to fund research in these areas. The intent is to gather and analyze the evidence on the wide range of complementary therapies. [v] Evidence based complementary and alternative therapies is one means by which further support will be garnered. This effort has been helpful in identifying which therapies work most effectively in which situations; although future challenges remain to identify the “how and why”.
As the United States struggles to reform the national policies to support expanded care for its people, the value of promoting a range of complimentary healing options, along with traditional options, is an important concern. The challenge is for health care providers to unite to support policies that move beyond provider-centered care to a holistic approach that support patient centered healing. Dossey argues that, “nurses need to generate the vision, courage, and hope required to unite nurses and nursing.” Nursing unity in support of healthcare reform is needed to address the challenges in these troubled times from local to global. [vi] This action is a reflection of the integral theory, but hardly a matter of philosophy – rather it is pragmatically a matter of survival for health care.
[ii] See Babara Dossey’s discussion of holistic nursing retrievable at: http://www.dosseydossey.com
Also view the principles of holistic nursing as presented by the American Holistic Nursing Association at http://www.ahna.org/AboutUs/WhatisHolisticNursing/tabid/1165/Default.aspx
[iii] Dossey, B. (2008). A Theory of Integral Nursing. Advances in Nursing Science 31(1): E52-E73.
[iv] Barnes PM, Bloom B, Nahin RL. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. National health statistics reports; no 12. Hyattsville, MD: National Center for Health Statistics. 2008.
[v] The NIH National Center for Complimentary and Alternative Medicine provides a listing of current clinical practice guidelines, evidence based reviews, as well as basic fact sheets http://nccam.nih.gov/health/.
[vi] Dossey B. (2008). A Theory of Integral Nursing. Advances in Nursing Science 31(1): see p. 57.
For further reading/additional resources:
American Holistic Nursing Association: http://www.ahna.org/
Canadian Holistic Nursing Association: http://chna.ca/
Connor A, Howett. (2009). A Conceptual Model of Intentional Comfort Touch. Journal of Holistic Nursing 27(2): 127-35.
NIGH Website: http://www.nightingaledeclaration.net
Dossey, B. Keegan, L, (2008). Holistic Nursing: A Handbook for Practice, Fifth Edition. Boston: Jones & Bartlett.
Frisch, N. (May 31, 2001). "Standards for Holistic Nursing Practice: A Way to Think About Our Care That Includes Complementary and Alternative Modalities". Online Journal of Issues in Nursing. Vol. 6 No. 2, Manuscript 4. Available: www.nursingworld.org.