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Concept Analysis
Introduction
Nobody would argue that a current state of nursing is dynamically developing as long as a wide range of new techniques, models, and approaches emerge on a regular basis. Nursing is one of the most scientifically driven fields of human activity, which justifies a constant change of trends in this sphere. However, some fundamental concepts exist, one of them being a holistic nursing. The concept is quite widespread nowadays; therefore, it is worth giving an account. Holistic nursing is a peculiar nursing concept from the perspective of flexibility, integration, and cross-disciplinary basis. One may consider it one of the most sophisticated approaches in the contemporary nursing. Overall complexity, innovativeness, and popularity within the healthcare community make holistic nursing a cutting-edge concept; therefore, the following paper focuses on its analysis.
To be more specific,the paper discusses and describes the concept of holistic nursing. Initially, the study covers a brief history and background of holistic nursing and defines the concept as a nursery approach primarily oriented towards healing a patient. Furthermore, the paper reveals the most applicable disciplines and related attributes of the concept to depict its empirical perspective. The related attributes include health care and nursing processes, diagnosis, assessment, and evaluation. The study also pays a major attention to the conditions and outcomes of the concept, hence outlining two main methodologies. The first one is a linear methodology as it depends heavily upon statistics and scientific methods for therapeutic management. The second methodology is circular since it implies a complex appliance of attributes and procedures for addressing multiple health problems. Subsequently, the paper provides a model case study that describes a practical use of the concept. Conversely, a contrary case depicts the circumstances, under which holistic approach is not applicable. Further, the paper gives an account of the antecedents and consequences of the concept’s appliance. Eventually, the study also describes particular empirical metrics, such as integrity, flexibility, innovation, and compliance with current standards and guidelines, which assists in measuring the effectiveness of the concept.
Short Summary
Presentation of Concept
The concept of holistic nursing dates back to the practice of Florence Nightingale. Since 1970, the concept was recognized as an independent nursery practice because it suggested an entirely new approach. The latter rested on the recognition of the human being totality. The concept considers the wholeness of the human being as a complex of mutual relationships between body, mind, feelings, spirit, socio-cultural considerations, and the environment. Consequently, the factors mentioned above should be taken into consideration while applying nursing management. These and other instruments such as linking cognitive and physiological processes, research methods, and focusing on the patient care required a nursing community to create the American Holistic Nurses Association (AHNA) in 1980. The foundation of AHNA intensified the development of practice so that the holistic nursing received a status of nursing specialty practice.
Numerous healthcare organizations utilize the best practices of holistic nursing to enhance their healthcare environment and design new cutting-edge models of care delivery. One of the current trends is a common striving for the adoption of integrative health programs, as diversified approaches to treatment and care are flexible and effective for both patients and healthcare managers. Recently, the government paid much attention to the concept since its fundamental ideas comply with the statutes of the Affordable Care Act. This policy requires a patient-driven health care process; thus, the holistic nursing is the most appropriate practice for the policy’s implementation.
Definition
According to the Holistic Nursing Association, the holistic nursing is "all nursing practice that has healing the whole person as its goal". Similarly, one may define the concept as a nursing philosophy based on the philosophy of living, caring, relationships, and mutual connection. Holistic nurses differentiate and adopt various approaches and modalities of holistic treatment in their clinical practice on a regular basis. Holistic nursing also presupposes such traits as integrity, responsibility, spirituality, and empathy. Therefore, this concept is relatively complicated, as it requires a nurse to consider multiple factors simultaneously.
In fact, holistic nursing is a special nursing practice that is particularly oriented towards nursing knowledge, theories, experience, and intuition. It aims at guiding nurses in partnership with their patients regarding the daily therapeutic environment and care. Holistic nurses incorporate complementary and alternative modalities (CAM) for the treatment of physiological, psychological, and spiritual needs of patients. However, holistic practice does not deny traditional approaches to clinical management and therapy because they serve as the basic empirical material for the integrative broadening scope of nursing. In addition, holistic nursing strives for gaining the highest healing potential from accessing the treatment of various aspects of human health.
Appliance of Disciplines
Speaking about disciplines applicable to the concept of holistic nursing, the primary reference should be made to AHNA standards for holistic nursing practice. They provide more insight into the concept’s scope, requirements for professional performance, principles, values, responsibility, educational background, and comprehension of CAM instruments. Hence, one can conclude that ethics and philosophy are the primary consideration of holistic standardization since the concept recognizes therapeutic and clinical management of a patient as an open live system. As a result, the discipline of the empirical caring process is crucial, even though it presupposes the basic knowledge of nursing care. Considerations regarding communicative skills, assessment of the therapeutic environment, and adjustment to a cultural diversity are also pivotal. Therefore, it is expected that this knowledge should be integrated into the concept in terms of evidence-based disciplines.
Eventually, there is a need for the detection of connections on the statistic level for a successful patient’s treatment and enrichment of nursing expertise knowledge. Consequently, research-based discipline has to be applied. Furthermore, it is becoming increasingly apparent that holistic nursing may include disciplines that are far beyond the terms of nursing practice. One may argue that such tendency worsens the concept’s scope. However, it is certainly not true as it involves numerous perspectives to make the best judgment of patients’ state and the most effective ways of their treatment.
Attributes of the Concept
Among a wide variety of techniques and instruments, one can outline the following attributes of holistic nursing. The first attribute worth indicating is the holistic caring process. This circular caring process includes such steps as assessment, detection of needs, planning outcomes, development of a therapeutic care plan, implementation, and evaluation. Another attribute of holistic nursing is nursing diagnosis commonly defined as a clinical judgment about patients from the perspective of their health state. This concept helps to distinguish possible ways of nursery intervention and treatment. Consequently, the nursing process is one more attribute that creates the environment for the fulfillment of purposes of nursing, namely assessment, diagnosis, planning, intervention, evaluation, among others.
As an independent attribute, one should also introduce a relationship-based practice. In general, the concept implies that a nurse should be a factual therapeutic agent. Therefore, the relationship-based practice suggests the appliance of care and nursing processes in terms of close interaction and personal encounter with the patient as long as such relationships render a direct reflection from the side of the patient. In other words, patients become witnesses of their treatment because a nurse shares all information regarding the succession of the treatment. Thus, building close and cooperative relationships are essential for the concept, especially in regards to the purpose of healing the patient as a personality.
Model Case
To contextualize the findings of holistic nursing, the following model case demonstrates a practical appliance of the concept. James Hurst, a 56-years old man, who has just retired from the manufacturing plant, experienced a cardiac arrest two weeks ago. Now, he has recovered after the strike, but his overall state leaves much to be desired. With regard to the fact that he lives alone, his psychological state also requires major improvements. Therefore, the appliance of holistic nursing is the most appropriate choice in the following situation. A nurse assigned to Mr. Hurst conducted an overall assessment of the patient’s state via recording his statistics regarding heart rate, body temperature, pulse, weight, and others. Subsequently, the nurse talked to Mr. Hurts and conducted an interview that demonstrated his psychological stability.
Based on the assessment results, the nurse developed a systematic plan, which included complex treatment of the cardiac arrest causes and elimination of consequences after the psychological trauma. Moreover, the nurse conducted additional evaluations during the process of treatment, as the objectives of treatment course were changing in accordance with the improvement of Mr. Hurst’s state. Furthermore, the nurse was paying a significant attention to the patient’s loneliness because the creation of informal communication intensified a willingness of James Hurst to follow the treatment instructions.
Contrary Case
The model case has made apparent the fact that holistic nursing is applied to clinical cases that presuppose a prolonged treatment and do not require immediate reaction to the patient’s state. Thus, the factual event of a cardiac arrest of James Hurst can present a contrary case. In this particular case, none of the linear approaches should be applied because the nurse is supposed to act immediately without the consideration of the patient’s personality. It can be explained by the terms of emergency, as the primary focus of the nurse should be directed towards preventive measures; otherwise, the patient might just die. Hence, it is not recommendable to use holistic nursing in situations of emergency because the consideration of personality at this moment may play a tragic role. The nurse is expected to deliver the primary care without respect to the psychological state, feelings, and the anxieties of the patient. Generally, the main purpose of preventive reaction is saving the patient’s life and adjustment of his processes to the further clinical care and therapeutic management.
Antecedents and Consequences
Speaking about the conditions, under which holistic nursing is implemented, there is a need to describe the linear methodology. Linear holistic nursing presupposes a step-by-step implementation of a favorable environment. It is a scientific depiction of the nursing process and statistical approach to data collection. This procedure is an initial phase of linear holistic practice as it creates the basis for the further assessment, clinical judgment, planning, care process, and evaluation. In general, the linear methodology mainly rests on scientific knowledge, statistic evidence, and gradual integration of attributes and perspectives. Hence, linear methodology results in addressing an exact aspect of a patient’s health.
Conversely, a circular methodology suggests a complex appliance of all procedures and activities to address problems of multiple patients. The main objective of the circular methodology is a personal encounter with patients for a better evaluation of their state and progress. One may argue that this methodology is ineffective and complicated, but a major flexibility compensates overall sophistication. A nurse can compare witnessing and interview results with related statistical data because the circular method is empirically driven. Therefore, the circular methodology is usually applied for a purpose of addressing entire complex of health problems. Unlike the linear methodology, the circular holistic nursing requires a dynamic nursing process.
Empirical Metrics
The appliance of holistic nursing presupposes its practical evaluation; thus, empirical metrics is required. First, there is a need to verify the basic guidelines regarding the care process. In case they are absent or vague, a nurse has to redesign the scope of the concept; otherwise, it will be dramatically inefficient. In the same vein, nurses need to check the integrity of their holistic performance. In other words, every single activity should be easily combined with other procedures as long as complex addressing of the problems is one of the concept’s objectives. Besides, the knowledge should be up-to-date, as the compliance with scientific trends is a pivotal metric of holistic nursing. To return to the subject of integrity, holistic nursing should comply with traditional guidelines of the caring process. Hence, the related policies and standards of care should approve the relevance of methods and techniques. Eventually, flexibility is one of the most important metrics since any CAM model is supposed to be easily altered in case a patient refuses to follow a particular pattern of therapy. This metric presupposes a heavy reliance on a nurse’s intuition that can be cultivated, especially for such sort of cases.
