Holistic
Nursing: Remembering Our Nursing Roots
Written
by Veda Andrus, EdD, RN, HNC
Nursing
is an art, but if it is to be an art, it requires as exclusive
a devotion and as hard a preparation as any painter’s
or sculptor’s work; for what is having to do with dead
canvas or cold marble compared with having to do with the
living body, the temple of God’s spirit? It is one of
the Fine Arts; I had almost said, the finest of Fine Arts.
(1).
Florence
Nightingale
The Scientific Art of Holistic
Nursing Practice
Holistic
Nursing has emerged as a specialty in professional nursing
practice over the past twenty years. Derived from a Greek-Indo-European
root ‘holos’ or ‘hale’, meaning “whole,
healthful, healing, holy”, the word holism implies a
sacred, relational perspective of the universe. Nurse, defined
as both a noun and a verb, means “one who cares for”
and “the act of caring.” When the two words are
combined as in ‘holistic nursing’, it is the artistry
of a sacred relationship, based upon transpersonal caring,
that reveals itself.
Many
nurses (and other health care professionals) have defined
holistic nursing as an integration of various alternative/complementary
modalities within nursing practice. There is a wide range
of these modalities including Therapeutic Touch, massage therapy,
aromatherapy, and guided imagery. These modalities provide
valuable healing connections for nurses to share with their
patients, however, it is not the modality that defines the
essence of holistic nursing practice. Holistic nursing is
a scientific art with a body of knowledge grounded in a philosophical
and theoretical framework that assists nurses in remembering
the heart of their nursing practice.
The
art of practicing holistic nursing is to consciously and creatively
apply the philosophy and theory in professional caring relationships.
Therefore, the core of holistic nursing is about the quality
of relationship between the nurse and person (patient, nursing
colleague, other health care professionals, family, friends).
It is about the nurses’ way of being … their intention,
presence, and heartful caring.
Grounding
our nursing practice in a philosophical and theoretical foundation
can serve as a springboard for a relationship-centered therapeutic
partnership with our patients. Creating an intention to enter
into relationship from a place of a loving and caring heart,
with full presence, compassion, and kindness, becomes integral
with the quality of care we provide for our patients.
Theoretical Foundation for
Holistic Nursing
Nursing
theory provides nurses with a framework on which to relate
to their nursing practice. Rather than a stagnant statement
of absolute truth, theory is a dynamic and evolving guide
to be brought alive within the context of practice.
The
roots of holistic nursing emerged from the vision of Florence
Nightingale. In her book, Notes on Nursing, first published
in 1860, Nightingale described the work of nursing as putting
patients in the best condition for nature to act upon them,
emphasizing touch and kindness along with the healing properties
of the physical environment, including fresh air, sunlight,
warmth, quiet, and cleanliness. (2) Nightingale viewed people
as multidimensional beings inseparable from their environment.
Three
contemporary nursing theorists have contributed to the evolution
of holistic nursing: Martha Rogers, Margaret Newman, and Jean
Watson. Rogers’ theory, the Science of Unitary Human
Beings, has evolved since her earliest publication of An Introduction
to the Theoretical Basis of Nursing in 1970. She viewed nursing
as an unfolding study of pandimensional human and environmental
fields. Human beings are irreducible, unified energy fields
and evolve irreversibly and unilaterally in space and time.
The environmental energy field is in constant and meaningful
interaction with the human energy field.
Newman,
a student of Martha Rogers, first published her theory of
‘Health as Expanding Consciousness’ in 1994. She
continues to evolve her understanding of “mutuality of
interaction between nurse and client; uniqueness and wholeness
of pattern in each client situation; and movement of the life
process toward higher consciousness.” (3)
The
theory of Human Science and Human Care was developed by Jean
Watson. She proposes assumptions about the science of caring
along with primary carative factors that comprise the framework
for her theory. The transpersonal caring relationship along
with the nurse-patient encounter expressed as a caring moment
(authentic presencing), are core within her theory. Watson
acknowledges the human spirit or soul in the presentation
of her work.
These
three theorists embrace the essential value of nurse-client-environment
as integral in quality nursing care. In addition to viewing
people as whole in their body-mind-spirit, the focus is on
remembering a unitary perspective within the healing relationship
of the nurse-person-environment.
Caring Well for Ourselves
Our
intention to provide quality care for our patients is the
core essence of our nursing practice. When considering Benner’s
progression of novice to expert (4), we can acknowledge that
nurses are experts at caring well for others and novices at
caring well for ourselves. We see effects of this reality
in the growing concerns of burnout, personal illness, chemical
abuse, and use of worker’s compensation.
Remembering
to place attention on our own self-care is integral with holistic
nursing practice. As we care well for ourselves (through nourishing
ourselves with a healthy diet, adequate rest and sleep, creative
expression, movement/exercise, quiet reflective time, a professional
support system, etc.), we can enhance the quality of our personal/professional
relationships.
As
we consciously choose to create this shift of seeing self-care
as integral with quality patient care, we can anticipate enhanced
nursing and patient satisfaction. Caring well for ourselves
also provides a model of self-care for our families, co-workers,
patients, and others. The ripple effect of this may be beyond
the scope of our imagination!
Opportunities for Holistic
Nursing Education
There
are a growing number of opportunities for holistic nursing
education within the US. From an academic perspective, many
undergraduate schools of nursing are offering elective courses
in holistic nursing and there are a growing number of graduate
programs in holistic nursing as well. Some continuing education
courses in this nursing specialty are offered in local communities.
In addition, although we recognize that holistic nursing has
a philosophical and theoretical foundation in its educational
process, there are many courses of study in an array of modalities
which nurses may select to weave within their nursing practice.
Remembering Our Nursing Roots
Holistic
nursing, as the foundation for nursing practice, creates an
opportunity for nurses to deepen their connection with their
own wholeness (mindbodyspirit) in relationship with their
patients, the environment, and with this planet. We come to
experience a shift in our worldview to one that brings alive
our innate relationship with all beings. We can, indeed, cultivate
our practice of presence by remembering the sacred artistry
of our nursing practice and consciously choosing to engage
in this ‘great work.’
References
(1)
Tooley, S. (1910). The Life of Florence Nightingale.
pp. 298. London: Cassell.
(2) Nightingale, F. (1969). Notes on Nursing. New York:
Dover Publications.
(3) Newman, M. (1997). Experiencing the Whole. Advances
in Nursing Science. 20(1), 35.
(4) Benner, P. (1984). From Novice to Expert. Menlo
Park, CA: Addison-Wesley.
Related
Readings
Newman,
M. (1994). Health As Expanding Consciousness. New York:
National League for Nursing.
Nightingale, F. (1969). Notes on Nursing. New York:
Dover Publications.
Rogers, M. (1970). An Introduction to the Theoretical Basis
of Nursing. Philadelphia: F.A. Davis.
Watson, J. (1988). Nursing: Human Science and Human Care.
New York: National League for Nursing.
Veda
Andrus, EdD, RN, HNC is President/CEO of Seeds & Bridges
Center for Holistic Nursing Education and co-developer of
The Certificate Program in Holistic Nursing. She is former
President of the American Holistic Nurses’ Association.
Reprinted by permission from the Newsletter of the Nurse Healers-Professional
Associates International, Vol. XXI, no. 4 Oct.-Dec. 2000.
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