Alignment of Holistic Nursing Practice with Nursing Care Theory
Holistic Nursing Practice
Holistic nursing practice was derived from the concept of humanism and holism and focused on a patient’s personalized care by understanding an individual’s multidimensional state. When taking care of a patient, nurses should not only focus on the technical aspects of the disease process but also on the physical, psychological, emotional and spiritual; aspects of the patient. Holistic nursing practice, therefore, understands the harmony among the mind, body, emotions and spirit in a dynamic environment. Holistic nursing practice is, therefore, all practices that provide healing to a person and improve the harmony among the multiple dimensions of the individual. For instance, an individual might get involved in an accident and have a fractured femur. The orthopaedic surgeon will fix the fracture, but the holistic care nurse will understand the diverse nature of the patient to provide wholesome healing. Holistic care includes a wide variety of approaches its care, including drugs, surgery, education, self-care, and complementary and alternative medicine.
The practice and principle of holistic care in nursing have been in place since the 1700s. However, the practices and principles of holistic care were abandoned from the mid-1900s until the later 1900s. The use of technology in health care became common, making human connection decline. Health care slowly transformed from a service profession to a profit-making entity, frustrating the ability of the nurse to deliver quality care and to tend to the needs of the person as a whole. On January 17, 1981, the inaugural meeting of the American Holistic Nurses Association was held in Texas. In 1977 the American Holistic Nurses Certification Corporation was formed. It aimed to provide credentialing programs in holistic nursing. In 2006, the American Nurses Association recognized holistic nursing as a distinct speciality with a defined scope and standards of practice.
Five core values summarize the ideals and principles of holistic nursing practice. They include Philosophy, Theory and Ethics; Holistic Caring Process; Holistic Communication, Therapeutic Environment and Cultural Diversity; Holistic Education and Research and Holistic Nurse Self-Care. Healing is the desired outcome in holistic nursing that recognizes the dynamic relationship between health, illness and wellbeing. Holistic nursing is grounded in skill and knowledge and therefore uses theory and philosophies of wholeness to guide its practice. Holistic nursing also gives options of treatments to the patient hence honouring the ethic that a person gives the ultimate decision of their health experience. A holistic caring process is an integrated approach based on the fact that the nurse recognizes and recognizes the multidimensional state of a person. The holistic caring plan involves six steps: assessment, diagnosis, outcomes, therapeutic plan of care, implementation and evaluation. The holistic nurse ensures that the patient’s personalized treatment is personalized, understanding the patient’s culture, beliefs and values and providing a wide range of information as regards health promotions. They have a rich understanding of different cultures and value personal skills and knowledge development. Nurses work busy schedules that might contribute to their burnout, leading to a lack of focus and increased medical errors. Self-care is a concept that involves nurses promoting their health. It aims to improve the wellbeing of a nurse and patient outcomes. By caring for themselves, they can achieve harmony in their lives and assist others in doing the same.
Holistic care, therefore, aims to improve patient outcomes and contribute to patient satisfaction. It also leads to a better understanding of the disease process, the effects of the disease on the patient and their actual needs during treatment. Holistic care balances the multiple dimensions of the patient hence improving their lives.
Caring in Nursing
Nurses play a significant role in caring for patients. Caring involves actions concerned with the well-being of a patient. Caring in nursing are behaviours that provide emotional comfort to a patient and include attentive listening, nonjudgemental acceptance, sensitivity and honesty.
Some theorists that have described caring in nursing include Watson and Leininger. The theme of care described by each theorist is based on their views of the nature of nursing, the use of theory development strategies and their contributions to the development of nursing knowledge. Both theories identify nursing as a humanistic science, with caring as the core feature of nursing. Leininger, however, believes that care must be done in a cultural context due to the differing patterns of the concept of care transculturally. Watson has emphasized the philosophical and spiritual basis of caring. She sees caring as the ethical and moral ideal of nursing.
Caring in nursing involves practices that address the patient’s mind, body and spirit to provide comfort as opposed to nursing care which might only focus on the job description of a nurse, for instance, medication administration to patients. Caring, therefore, empowers a nurse to bring their humanity to health care and respect the patient’s autonomy. It reduces stress, increases happiness and improves the sense of social connectedness.
Nursing Care Theory
The Watson caring theory defines caring as the moral ideal of nursing and emphasizes the spiritual and philosophical basis of caring. The end goal of caring is protecting, enhancing and preserving human dignity. Watson believes that the action of caring is grounded in the self-transcending nurse, and human caring is related to the environmental-personal interaction, the knowledge of the nurse in the caring process and transactional limitations. She acknowledges the difference between traditional and human science and states that human-to-human caring interactions in nursing cannot be understood using a positivistic, deterministic and materialistic mindset.
The Watson theory has eleven assumptions related to Human Care values in Nursing, which explain how nursing is connected to care. The assumptions include: Care and love are the most universal and most mysterious of cosmic forces comprising the primal and universal psychic energy; people tend not to behave well towards each other despite knowing the essence of loving and caring ways; nursing is a caring profession and its ability to sustain its caring ideal will affect human development of civilizationcivilization and determine nursing contribution to the society; our will to care and love others should be based on how we treat ourselves with gentleness and dignity; nursing has always held a human-care and caring stance to people with ill health; caring is the essence of nursing and the central focus of the nursing practice; human care at both the individual and group level is receiving less emphasis in the health care delivery system; the role of human care is being threatened by increased is of technology ad bureaucracy submerging the values of caring in nursing; preservation and advancement of human care is significant for nursing today and in the future; human care be effectively demonstrated and practiced interpersonally due to the intersubjective nature of humans; and nursingâ€™s social, moral and scientific contributions to humankind lie in its commitment to human care ideals in theory, practice and research.
Watson also derived ten carrative factors to enable people to understand the science of caring. These factors are linked to basic human needs, human relationships and health maintenance involving interpersonal aspects of caring. The factors are; the formation of a humanistic-altruistic system of values; the instillation of faith-hope; the cultivation of sensitivity to one’s self and others; the development of a helping-trust relationship; the promotion and acceptance of the expression of positive and negative feelings; the systematic use of the scientific problem-solving method for decision making; the promotion of interpersonal teaching-learning; the provision of the supportive, protective and corrective mental, physical, socio-cultural and spiritual environment; assistance with the gratification of human need and the allowance for existential-phenomenological forces. These carative factors become actualized as the nurse continues to practice them.
The Watson theory involves three areas, and its goals are related to mental and spiritual growth. Nursing should be practised within the context of human science, and art is one of the areas covered in theory. The other major areas are the mutual person of the nurse and patient with the connection of the mind, body and soul and the moral ideal of human care relationship in nursing. The human care relationship in nursing includes transpersonal caring, actual caring occasions and phenomenal field.
Discussion on the Alignment of Caring Theory with the Core Values of Holistic Nursing Practice
The Watson caring theory uses interventions related to the human care processes, which require intention drive, a relationship and actions. The Watson caring theory demonstrates philosophy, theory, and ethics in holistic nursing. The Watson caring theory emphasizes the spiritual and philosophical basis of caring. It uses scientific-problem solving methods for decision-making and promotes interpersonal teaching and learning. The Watson caring theory understands the multiple dimensions of a patient with caring as the core of the nursing practice. It promotes the expression of positive and negative feelings and provides a supportive, protective, socio-cultural, and spiritual environment. Watson’s caring theory allows human care to be demonstrated interpersonally, teaching people to identify themselves with others, therefore, is in line with the core value of holistic nursing care, Holistic communication, therapeutic environment and cultural diversity. One of the assumptions in the Watson caring theory emphasizes the need to treat oneself with gentleness and dignity before taking care of others. Watson’s caring theory also assumes that nursing’s social, moral and scientific contributions to humankind and society lie in its commitment to human care ideals, theory, practice and research. It stresses the need for the nurse’s continuous gaining of skills and knowledge. The theory promotes holistic education and research by promoting interpersonal teaching and learning.
Holistic caring Reflective Story
In my clinical rotations, I interact with many patients. In my surgical rotation, I interacted with a patient admitted to the wards due to a fall injury. The patient was of African-American origin and expressed the inability to meet his financial needs fully. He always read the Bible in the morning and evening and asked questions about alternative care for his wounds. I was not only expected to be involved in the technical care of the patient, such as administering medications and dressing the wound but also get involved in the spiritual care and emotional well-being of the patient.
I should have focused more on his spiritual and financial well-being in my patient care. The lack of finances made him worry so much about the cost of care, causing anxiety-induced insomnia. I should have involved the social worker and advised him on the importance of using medical insurance. Understanding his cultural and spiritual background and how they affect their care is essential. Understanding the multidimensional state of the patients would have increased patient satisfaction and the outcome of his care.
Holistic nursing includes all practices that provide healing to a personâ€™s mind, body and soul. Care should be based on understanding the patient’s physical, psychological, emotional and spiritual dimensions. Caring in nursing aims to provide emotional comfort to the patient by including attentive listening, nonjudgemental acceptance, sensitivity and honesty. Caring is the core domain of caring theories. The Watson caring theory defines caring as the moral ideal of nursing and emphasizes the spiritual and philosophical basis of caring. The study of holistic nursing practice has broadened my perception of patient care. I can comprehend the complex nature of patient care. It has also challenged me to improve my nursing skill and knowledge and increase my collaboration with my colleagues.
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