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Holistic Nursing: Remembering Our Nursing Roots Written by Veda Andrus, EdD, MSN, RN, HN-BC
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 heart-full 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 anintention to enter into relationship from a place of a loving and caring heart, with fullpresence, compassion, andkindness, 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 ofAn Introduction to the Theoretical Basis of Nursing in
- 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
