Holistic Nursing, as opposed to... (II)

[MunoRN, RN]

'Holistic' Nursing is a term that seems redundant to me, sort of like saying 'invasive open heart surgery' or 'technical engineering' or 'basic fundamentals'. I had always thought that considering all aspects of the patient; physical (all systems), emotional, social, economic, etc was a basic concept of Nursing in general, but I'm discovering maybe I was wrong. Maybe it's just where I went to school and the area I live (which is sort of crunchy) that believes holistic care is part of nursing by it's basic definition. But I had a family member the other day who made me question that. After I turned on the radio in his room overnight to try and get him to settle down, the patient's daughter said "Oh, so you're a holistic nurse, that's great, are you certified?" My first thought was "certififed at what? Certified to turn on a radio?"

So I looked into it and I'm ashamed to admit I had no idea Holistic Nursing was considered a subset of Nursing, or that there was a "Holistic Nurses Association". This makes no sense to me. Is there an "Assessment Nurses Association"? Of course there isn't, assessment is an integral part of Nursing care, just as viewing the patient as a complex, interconnected group of factors that determine their overall health is an integral part of Nursing care. Pretty much every theory, tool, and philosophy we use in nursing is to help us see patients holistically, from Maslow to Orem to Nightengale. One review of all nursing theories summed up nursing with this: "Nursing is concerned with the whole person", i.e. Nursing is holistic.

My first thought was that this was all due to a malaprop, or as Mr. Montoya put it:

The term Holistic has been misused by the general public as a euphemism for homeopathic, naturopathic, complimentary medicine, integrated medicine, etc. which is completely false. Tehre are always going to be those who have an inaccurate understanding of vocabulary, but it would seem a recognized Nursing Professional group should at least be able to get it right, particularly concern a concept so central to Nursing. Naturopaths, homeopaths, etc tend to be ardent supporters of viewing patients holistically, but they are not the same thing. I personally believe both naturopathy and homeopathy are not completely without merit, but many people, both care providers and patients, are turned off by many less than scientific or traditional treatment modalities, yet by lumping holistic care with every disreputable treatment there is, we are turning both caregivers and patients away from the idea of holistic care. I would have been relieved if this was all just based on a poor understanding of the English language, but looking at Holistic Nursing resources I realized it really is about what seems to be a bad understanding of what Nursing is, at least based on my Nursing education and experience. From one site for instance: “Holistic nursing entails any nursing care that has treating the whole person as its goal, Holism looks at all aspects of the person—physical, spiritual, emotional, social and the patient’s family and overall environment. You aren’t just treating the appendix, but treating everything in the patient’s life that appendicitis might impact. It is a gentler way to treat a patient.”

That pretty much sums up what I was taught Nursing is, not just nursing for those who choose to specialize in "holistic nursing". So my question is, is this really not a part of Nursing in general? While there are specialty areas in nursing such as wound care or diabetes education, this is not one of this, this is a basic core component of ALL nursing just like the Nursing process or being caring, lets not bastardize it.

[queenjulie, RN]

I completely agree. Although I am a big proponent of using nutrition, acupuncture, and other alternative treatments instead of pharmacology, using the word "holistic" as a name for that makes no sense. As you said, nursing IS holistic, because nurses, as a rule, see treating the entire patient--even, sometimes, their family!--as a part of their job, not just treating a disease process. I think "holistic nursing" as a specialty should be renamed something like "alternative medicine nursing," "nonpharmacological nursing," or something similar.

[BetsyRN1]

As a Holistic RN, I'd have to disagree. I went back to get certified in holistic nursing after completing a 2 year course with hands on clinical work. Nursing here in the U.S is not holistic, unlike in the east, which is why I left the hospital. I felt like all we did was push medication. That's definitely not holistic! Holistic by definition means 'treating the body as a whole'. When a patient in the hospital complains of a headache, lets say, we give them pain medication. That simply eliminates the pain...it doesn't look into the cause(s) of the pain. The holistic approach would be to find out what's going on in the body that's triggering this headache, and to treat it without drugs, using acupressure, reiki, essential oils, etc. Unfortunately this does not happen in the hospital setting.

[Not_A_Hat_Person, RN]

Would it not be holistic to treat a headache with accupressure, essential oils, and pain medication? Are drugs and alternative treatments automatically incompatible?