TAN Issue: September/October 1998: Features: Holistic Nursing: The Goal is the Whole Person

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by Susan Trossman, RN

Partners in Care

It probably has happened to anyone who's ever worked as a staff nurse. You're changing the dressing on one patient, but you're also thinking about another patient's IV anti-biotic that is due to run out any minute and a blood glucose that has to be rechecked in 15.

Over the past few years, a small, but steadily growing, number of RNs are learning more about holistic nursing and how it can help them be truly present for their patients in body, mind and spirit -- even when time is limited.

This trend, coupled with consumers' escalating interest in alternative, or complementary, therapies, is likely to impact nursing by increasing future opportunities and enhancing current professional practice, according to nurse experts.

Often the practice of holistic nursing and alternative therapies, such as therapeutic massage, biofeedback and reflexology, are intertwined.

The American Holistic Nurses' Association (AHNA) defines holistic nursing as one that "embraces all nursing practice that has healing the whole person as a goal." Holistic nurses can practice in any setting, from hospitals to private practice. They frequently use alternative/complementary healing therapies, or modalities, according to Veda Andrus, EdD, MSN, RN, HNC, program director, AHNA Certificate Program of Holistic Nursing. For holistic nurses, however, the modality is just a vehicle for the nurse to connect with the patient, she said. Connecting with the patient is what holistic nursing is all about. When Andrus speaks of this practice, she uses terms such as "intention," "presence" and "consciousness."

"When entering a patient's room, a holistic nurse walks in with an intention of being present for that person and of coming from a place of love, of caring. The patient is not the broken leg in Room 302, but a whole person," said Andrus, a Massachusetts Nurses Association member and former AHNA president. "And what the patient really wants is to be heard, and to be touched -- physically or emotionally."

Another vital aspect of holistic nursing is self-care.

"If nurses do not care well for themselves, they do not have energy to attend to their patients," Andrus said.

AHNA proposes that most nurses are holistic nurses. RNs have been taught to view the patient as multi-dimensional. But other factors -- increased technology, sicker patients, higher patientloads and time constraints -- have led some to veer away from true holistic practice, according to Andrus. By participating in programs that explore holistic nursing, RNs return to the "heart and spirit of the way nursing was," she said.

AHNA currently offers a four-phase certificate program, which typically takes 18 months to complete and includes a self-designed practicum. It's based on a foundation of holistic nursing theory and holistic philosophy. Course work covers a range of topics: nutrition and its effect on the immune system; beliefs about health and illness and their influence on the healing process; and building effective communication skills, to name a few.

Andrus estimates that 4,000 nurses have completed one of more phases of the program.

"We're forming a wonderful community of holistic nurses, and holistic nursing is a specialty that's growing big time," Andrus said. "We're both grass roots and on the cutting edge."

Andrus said she already has seen employment ads looking for holistic nurses. "In time we'll see even more of a demand. Many people want to learn the art of living well. Nurses can teach them."

In terms of job growth for nurses who specifically practice alternative, or complementary therapies, "opportunities are huge," said AHNA member Barbara Dossey, MS, RN, HNC, FAAN.

"What I'm beginning to see is hospitals opening wings that offer alternative and complementary therapies. The lay public wants this. They know scientific data support the effectiveness of alternative therapies," said Dossey, a New Mexico Nurses Association member and editor of AHNA's Core Curriculum for Holistic Nursing, the study guide for national certification in holistic nursing and curriculum development guide for the integration of holistic nursing.

"Complementary therapies, like relaxation and imagery, music therapy, and healing touch, are things nurses have done for a very long time," she said. "What nurses need to do now is determine what kind of setting they want to practice in, such as acute care or working in collaboration with a physician."

Dossey, however, does caution nurses to determine if practicing alternative therapies, such as biofeedback, are permitted in their state nurse practice acts.

Alternative therapies will be explored further in an upcoming issue of The American Nurse. For more information on holistic nursing, check out AHNA's website at www.ahna.org or call 1-800-278-AHNA. The AHNA certificate program can be found at www.cyberc.com/cphn/.

Susan Trossman, RN, is the senior reporter for The American Nurse.