Where are all of the holistic nurses?

[PaleoNurse]

I would love for this holistic nursing forum to be more active! I am been so immersed in the holistic/integrative world for the last few years that it is odd to me when I read a lot of the posts in the general nursing forum. It reminds me of how grateful I am to have discovered alternative health.

If you are a holistic nurse, what brought you to the field? What does your current practice look like?

I became involved in holistic nursing and functional medicine almost 3 years ago. I was diagnosed with 3 autoimmune diseases and I was really struggling and very ill for a while. Then I discovered food as medicine and the transformation in my health was remarkable. I went back to school for additional certifications in holistic nutrition and herbalism and now I have a practice nutritional therapy and functional medicine practice.

I'd love to connect with other like-minded nurses!

[ixchel]

Ixchel,

Thank you for that. I have been out of high tech peds as well as vent trach nursing in the ICU for over a decade now. I started on a Seamons (I think that was the name) and ended with the Gerber (the one the size of a telephone book). It has come a long way since I started in it and since I left that field.

Very glad to help. :)

I work on a step down unit that typically has more cardiac and respiratory patients than anything else. I've been floated to our ICU and cared for chronic trach patients enough times to know that the copious secretions and horrible looking/sounding coughs are things that those trach patients are used to. Oh, man, and suctioning them? It just looks horrible! But they LIKE suctioning, and ask for more. *shudders* I hope I never need a trach.

On non-trach patients with cardiac and/or respiratory admissions, I approach anxiety as a symptom. Always. Awhile back, we had a patient with CHF and pulmonary HTN who quite suddenly became anxious and couldn't catch his breath. A code was called and when respiratory got there, she argued with the primary nurse saying the guy was fine and he just needed a better nurse. :\ ICU charge showed up and agreed he was fine, and started to dig in her heels when intubation was mentioned (as in, he'd be transferred to the unit). The MD trusted the nurses and was agreeable to transfer. Anyway, the last time we saw him, he was intubated, getting on the elevator to be transferred to a hospital with cardiothoracic surgery. (We don't open chests.) I'm not sure what they found, but he did have pulmonary HTN, which may have contributed to his issues. He actually died. He had the best chance he could, though, because a nurse followed her instincts when the patient became so anxious.

Another terrible story - had a guy come to the ED during night shift. He was hyperventilating, and since he steadied his breath during needle sticks, his nurses and MDs felt he was simply anxious. He came to one of my rooms mid-afternoon, still hyperventilating. RN bringing him to me said he was really anxious. She said very little else. We (CN and I) got him settled and did his assessment and history, while he was still hyperventilating literally the whole time. I sat with him, held his hand, talked to him softly trying to see if he could stop. He couldn't. I stopped asking open ended questions and asked yes or no ones instead. He couldn't catch his breath to say even yes or no responses. We called in respiratory and got an ABG. He was in horrific metabolic acidosis, and by his hyperventilation and CO2 level, his body was out of all ability to compensate. 7.1something pH, 5 CO2 (yes, I meant FIVE), and I can't remember his bicarb but that number was ridiculous as well. We dug through his chart to see what his respiratory status was for the last ABG and lung sounds, and literally none were done. NONE.

Anxiety is a symptom in my world, not a diagnosis. I hope your patient is well now!

[JustMeRN]

There are 2 discussions going on here. One on holistic nursing, one on alternative medicine. They are not the same thing. Op, which is it you want to discuss? Holistic nursing is something we are all taught to do. Look at the patient as a whole, treat the patient nor necessarily the disease. Alternative therapies are a whole other can of worms. I think you will find nurses who practice as holistic practitioners following evidence based practice will take offense at being lumped in with quacks like Gerson and his coffee enema / carrot juice "cure" for cancer (cured only because you end up dead, IMO). Alternative does not equal holistic. OP, which like minded people are you looking for?

[Steeleworks]

The Online Journal of Issues in Nursing said (Volume62001/No2May01) ....

"Precisely because holistic nursing recognizes the body-mind-spirit connection of persons, holistic nurses often practice complementary/alternative modalities. "

It went on to say that holistic nurses use 'complementary and alternative' as well as allopathic modalities. "Holistic nursing cannot and should not be defined as use of modalities defined as 'alternative'."

It also pointed out that while all nurses could be holistic, not all are. It is a specialty of nursing with practice standards and a certification.

[MunoRN, RN]

It's not a nursing "speciality", it's a core part of all nursing. There is unfortunately an element in nursing that doesn't recognize holistic care is a part of all nursing, which is the faux-speciality of "holistic nursing". I don't think it's possible to show respect for the profession of nursing and at the same time promote holistic care as something that should be a subgroup of nursing practice.

The previous example of intervening with a patient who is in respiratory distress due to an anxiety by using calming techniques is not something separate from standard nursing care, when appropriate that is the standard response by any nurse, not an alternative response that would come from a nurse who "specializes" in holistic care.

[Steeleworks]

A number of people smarter than me thought there was a need for a specialty. Then another number of people, also smarter than me and who are the governing body of nursing standards and practice agreed that there was a need. Thus we have a specialty.

It was said above,"When appropriate that is the standard response by any nurse."

While that is a nice thought and hopefully that would be the way it should be, it sadly is not.

Let me give an example from my past. Late in the night, taking blood sugars of two patients in the same room, their numbers are 45 and 43 respectively. Both feel fine and have no complaints. I assume that two numbers that close and that low is something wrong with the machine. Rather than checking the machine, I get another and repeat. The values are similar. I order stat blood draws to make sure. The numbers for both are off by only 1 or 2 again. I mix some orange juice, milk and sugar and give to each. This is a slow, medium and fast sugar that brings the sugar up fast and then holds it.

I got wrote up twice by one of my colleague for not giving IV push which was the protocol. The doctor came in the next day and thanked me for not giving the IV push and my manager said not to worry about the write ups. I was not worried as there was an empowerment policy that I used to justify my actions. Why would I want to put the patients at risk of an IV push when there was a safer alternative available.

Sadly, this is the norm in the hospitals where I have worked.

Or the nurse who draws up APAP for an aphasic patient with contracted hand pain. As a manager, I asked why. She said that was all that was ordered. I reminded her it was her job to question the orders when lacking or not appropriate. At the time, there were two double blind placebo studies that showed placebos worked better for arthritis pain. The question, if this was a common complaint as she said, which it was not documented, why wasn't something done about it in terms of solving the cause.

Calling the doc, he asked what I would recommend. Was he testing or curious, I did not know. I suggested siniment and baclofin. He thought it a good solution and it worked. Relieve the contracture and relieve the pain.

Sadly, this is not an isolated case. Maybe this is just in one hospital but these happened in facilities 2/12 hour apart. I kept seeing this over and over. What should be and what is, the are two different things. I respectfully disagree. Most nurses are not holistic. Most follow an allopathic model of nursing.

While a recent study found that 60% of schools are including the definition of holistic in their practice. If it always was a part of nursing practice, why is it only in 60 percent of schools.

While there is a shift toward this, the world nurses operate in is mostly allopathic.

And think about it, if someone breaks their leg, the doctor set it. Nurse helps. Job done. I have yet to find someone who got dietary exit teaching on how to heal in my part of the country, even in 2015.

I would be curious what others think?

[JustMeRN]

It is not an ANCC (Ana supported) recognized certification. That said, it is a certification created by its own professional organization. From the holistic nurse certificationFAQ page:

"Q1: What is Holistic Nursing practice?A: Holistic nursing practice is based on the nurses' ability to practice within the context of AHNA'sStandards of Practice, Code of Ethics and Nursing Theories consistent with Holistic Nursing Philosophy. Aholistic nurse and her/his client mutually plan goals that facilitate wellness, health, healing, and clientwell-being. Holistic Nurses practice in any place or space where they have a nurse-client relation. That is,they practice in community health, hospice, ICU, ER, hospitals, schools, etc. Although many HolisticNurses use modalities or alternative therapies in their practice, Holistic Nursing is not dependent onone's ability to use modalities or alternative therapies. Rather, holistic nursing is a way being not whatwe do. The best source of information about Holistic Nursing is provided in AHNA's book, HolisticNursing: The Scope and Standards for Practice. "

so, again, holistic does not equal alternative. Holistic is something that's taught to every nursing student. The degree to which we do or do not use it varies. Just like the degree we use other things we have learned. My question still stands for the OP. Are you looking for holistic nurses or practitioners of alternative therapies? They are not the same thing.

[JustMeRN]

A number of people smarter than me thought there was a need for a specialty. Then another number of people, also smarter than me and who are the governing body of nursing standards and practice agreed that there was a need. Thus we have a specialty.

It was said above,"When appropriate that is the standard response by any nurse."

While that is a nice thought and hopefully that would be the way it should be, it sadly is not.

Let me give an example from my past. Late in the night, taking blood sugars of two patients in the same room, their numbers are 45 and 43 respectively. Both feel fine and have no complaints. I assume that two numbers that close and that low is something wrong with the machine. Rather than checking the machine, I get another and repeat. The values are similar. I order stat blood draws to make sure. The numbers for both are off by only 1 or 2 again. I mix some orange juice, milk and sugar and give to each. This is a slow, medium and fast sugar that brings the sugar up fast and then holds it.

I got wrote up twice by one of my colleague for not giving IV push which was the protocol. The doctor came in the next day and thanked me for not giving the IV push and my manager said not to worry about the write ups. I was not worried as there was an empowerment policy that I used to justify my actions. Why would I want to put the patients at risk of an IV push when there was a safer alternative available.

Sadly, this is the norm in the hospitals where I have worked.

Or the nurse who draws up APAP for an aphasic patient with contracted hand pain. As a manager, I asked why. She said that was all that was ordered. I reminded her it was her job to question the orders when lacking or not appropriate. At the time, there were two double blind placebo studies that showed placebos worked better for arthritis pain. The question, if this was a common complaint as she said, which it was not documented, why wasn't something done about it in terms of solving the cause.

Calling the doc, he asked what I would recommend. Was he testing or curious, I did not know. I suggested siniment and baclofin. He thought it a good solution and it worked. Relieve the contracture and relieve the pain.

Sadly, this is not an isolated case. Maybe this is just in one hospital but these happened in facilities 2/12 hour apart. I kept seeing this over and over. What should be and what is, the are two different things. I respectfully disagree. Most nurses are not holistic. Most follow an allopathic model of nursing.

While a recent study found that 60% of schools are including the definition of holistic in their practice. If it always was a part of nursing practice, why is it only in 60 percent of schools.

While there is a shift toward this, the world nurses operate in is mostly allopathic.

And think about it, if someone breaks their leg, the doctor set it. Nurse helps. Job done. I have yet to find someone who got dietary exit teaching on how to heal in my part of the country, even in 2015.

I would be curious what others think?

none of what you are describing here fits the definition of holistic nursing, so I'm not even sure what your point is? What you are describing is either poor education, or young inexperienced nurses. And how long ago was this? In the last decade plus there has been a huge shift from the nurse being a follower of physicians orders (actively discouraged from questioning a physician or plan of care), to the nurse as an active participant of patient care, encouraged to question treatment plans and make reccomendations.

When you talk about things like dietary teaching for your leg fracture, honestly it's not feessable in the current healthcare landscape. There is not time or enough staff for in depth teaching in acute care or emergent care. The key in these situations in address the imminent problem (set the fracture), teach survival skills (crutch walking, weight bearing, cast care) and refer to outpatient care for the non urgent needs (dietary and exercise for your osteoporotic fracture patient). In this example a single nurse can not treat the patient holistically alone. You recognize the need, address it, refer to necessary supportive services and move on. The thing is, to me at least, this is simply good nursing care. Giving it a name or certification makes it sound like it is going above and beyond, when really it should be standard nursing practice.

[RNtoNPhopefully]

Hi! so great to see your post! I am a like minded nurse who has also found the power of food to manage my autoimmune disease! I have been an ICU for 15 years and have recently finished my MSN for family nurse practitioner. It is so great to see you on here. I am so passionate about functional medicine and the power of food as medicine. I am hoping to become certified in functional medicine and to start making a difference here in the Pittsburgh area. This area is in real need of alternatives! Take care :)

[ixchel]

A number of people smarter than me thought there was a need for a specialty. Then another number of people, also smarter than me and who are the governing body of nursing standards and practice agreed that there was a need. Thus we have a specialty.

It was said above,"When appropriate that is the standard response by any nurse."

While that is a nice thought and hopefully that would be the way it should be, it sadly is not.

Let me give an example from my past. Late in the night, taking blood sugars of two patients in the same room, their numbers are 45 and 43 respectively. Both feel fine and have no complaints. I assume that two numbers that close and that low is something wrong with the machine. Rather than checking the machine, I get another and repeat. The values are similar. I order stat blood draws to make sure. The numbers for both are off by only 1 or 2 again. I mix some orange juice, milk and sugar and give to each. This is a slow, medium and fast sugar that brings the sugar up fast and then holds it.

I got wrote up twice by one of my colleague for not giving IV push which was the protocol. The doctor came in the next day and thanked me for not giving the IV push and my manager said not to worry about the write ups. I was not worried as there was an empowerment policy that I used to justify my actions. Why would I want to put the patients at risk of an IV push when there was a safer alternative available.

Sadly, this is the norm in the hospitals where I have worked.

Or the nurse who draws up APAP for an aphasic patient with contracted hand pain. As a manager, I asked why. She said that was all that was ordered. I reminded her it was her job to question the orders when lacking or not appropriate. At the time, there were two double blind placebo studies that showed placebos worked better for arthritis pain. The question, if this was a common complaint as she said, which it was not documented, why wasn't something done about it in terms of solving the cause.

Calling the doc, he asked what I would recommend. Was he testing or curious, I did not know. I suggested siniment and baclofin. He thought it a good solution and it worked. Relieve the contracture and relieve the pain.

Sadly, this is not an isolated case. Maybe this is just in one hospital but these happened in facilities 2/12 hour apart. I kept seeing this over and over. What should be and what is, the are two different things. I respectfully disagree. Most nurses are not holistic. Most follow an allopathic model of nursing.

While a recent study found that 60% of schools are including the definition of holistic in their practice. If it always was a part of nursing practice, why is it only in 60 percent of schools.

While there is a shift toward this, the world nurses operate in is mostly allopathic.

And think about it, if someone breaks their leg, the doctor set it. Nurse helps. Job done. I have yet to find someone who got dietary exit teaching on how to heal in my part of the country, even in 2015.

I would be curious what others think?

I'm not understanding how your approach in these scenarios was "holistic" (as in, the "specialty", not its actual definition). Your responses in these situations were responses any nurse might have, except the lab drawing to confirm the low BG. Why? That delays intervention.

[MommaJewelz]

I am in that discouraged place right now. I live in a smaller town, and we do have a complimentary medicine practice but nothing else that I know of. I work at a hospital because it's close to where I live, but I struggle with how things are run every time I work. I see the same routine thing going on...the same sick people time and again.

I get frustrated that nutrition is never really talked about in the healthcare setting, and so many are on drugs unnecessarily. I believe food is medicine. If the body is supported by nutrient rich foods without pesticides, it will thrive. So many people have cured themselves of (or brought under control) IBS, allergies, RA, and much more. I think the hospital food is terrible and don't get me started on that sludge they call 2cal. I'm just so frustrated with the whole system. I don't fit there, and I find that many nurses think conventionaly and don't seem to understand. They consider holistic to be quack stuff. They don't get it because their eyes are not opened to the possibility of something better.

Yes! Nutrition is everything! So you guys are way ahead of me. I'm just beginning to realize I need to get out of the hospital and into holistic health. Not sure I have access to anything in my town - we're pretty small but we have our own hospital...

I'm looking into getting my cert. as well as a yoga cert. and go from there. I'm thinking about heading into assisted living, nurses, etc. for stress-reduction. I like EO, traditional chinese medicine, yoga, qi gong/tai qi and herbalist is intriguing. All I know for sure is I need out of the hospital and something more preventive and holistic!

[trindawolfe]

Oh my goodness, I feel your pain!!! I'm not "against" conventional medicine as it clearly has a purpose and a place, but I'm frustrated that holistic and conventional can't seem to coexist. I'm an LPN and have worked ambulatory care for 8 years. I want to help patients, I want to educate them, but I feel like my hands are tied, and I'm not allowed to say anything that wouldn't be scripted by the doctor. I see no reason why the knowledge we have as nurses can't be used alongside a holistic approach to help improve lifestyle. If you come up with anything that has been helpful let me know! There are no holistic practices where I live, and I'm pretty sure even if there were, they wouldn't accept my conventional credentials:/

[trindawolfe]

What is this "Functional Medicine" you speak of?