The goal of holistic nursing is healing the whole person. This is accomplished by recognizing and integrating into patient care the well established principles of body-mind-emotion-spirit-energy-environment factors that affect both a patient’s potential for optimal healing and a nurse’s own well being. For the nurse personally this engagement creates an internal caring, healing space that allows her or him to act as an instrument of healing, sharing the authenticity of an unconditional presence that helps to remove the barriers to a patient’s healing process. It is an approach that facilitates the nurse’s own growth and assists with patient recovery from illness, injury or medical procedures and the transition to peaceful death.
Holistic nurses can and do practice within any scope of practice defined by the American Nurses Association (ANA). They may be part of surgical, neonatal, ER, ICU, or other healthcare teams, and they will be part of holistic and integrative health care practices. Holistic nurses are licensed and available in every state.
Holistic nursing is based on the philosophy of “holism” in health care is a philosophy that evolved from the experiences of Florence Nightingale, the Englishwoman who famously cared for soldiers during the Crimean War. She then established the world’s first nursing school in London in 1860. She believed in care that focused on unity, wellness, and the inter-relationship of human beings, events and environments: thus holistic care. Holistic nursing evolved as a movement in the US in the 1970’s, led by Charlotte (Charlie) McGuire, RN, MA, HPN. In 1980 with 75 others she founded the American Holistic Nursing Association (AHNA).
Holistic Nurses in the US today: More than 12,000
|Examples of Use||Education and Certification|
|In US health||References|
Examples of Use
Holistic nurses support patients who are being treated in fully conventional ways, and within any setting where healing occurs, including those were patients are served by integrative practitioners. Holistic nursing can enhance the healing process within any nursing care environment.
Whole-person healing is supported by nurses with a caring framework that addresses all aspects of the patient’s health: body, mind, spirit, emotions, bioenergetics, social/cultural, environment, and relationships. The nurse promotes attaining a patient’s best health and wellness during any kind of clinical experience through:
- His or her own authentic presence
- A holistic assessment of the patient
- Creating therapeutic partnerships with patients
- Empowering patients to live in ways that are supportive of health and wellness, including use of appropriate integrative as well as conventional modalities.
Nursing and Complementary and Alternative Medicine (CAM) and Integrative Health Practices
By their training and inherent approaches to healing, holistic nurses are ideal collaborators with patients and their CAM and integrative health providers. They are particularly well prepared to help patients:
- Identify the need for integrative interventions
- Assist clients in locating providers
- Through education, counseling, coaching, and other forms of assistance facilitate the use of these interventions
- Coordinate the use of integrative therapies among various health care providers who might be involved in clients’ care
- Evaluate the effectiveness of clients’ total care, conventional and integrative.
NOTE: Practicing within a holistic nursing framework does not imply competency in specific holistic or integrative treatment practices. A nurse can and many do expand their healthcare skills by completing the education and training required to work within the scope of practice for specific disciplines: for instance, as a licensed massage therapist (LMT).
Conditions Treated by Holistic Nurses
Wherever patients are receiving care, holistic nurses will apply the basic precepts of their training and healing philosophy:
- Supporting self-care
- Enabling self-reflection
- Adjusting care based on cultural and spiritual preferences
Understanding that illness in any part of the body can affect the whole means that therapies and treatments can reach just as far into the patient’s systems. This multi-dimensional quality of healing is why holistic nurses assess and address the whole state of a person who is seeking resolution of an issue or health condition: mind, body, spirit, and environmental factors can all affect how healing takes place.
This comprehensive view allows the holistic nurse to create with the patient a therapeutic partnership that creates the best healing environment possible.
Safe practice is a core component of holistic nursing practice, which is appropriate for all health care consumers, as it works within a structure that identifies patterns, challenges, needs and health crises. As such it can meet the needs of the consumer without any contraindications.
Education, Training, Certification and Licensure
Holistic nurses build on and expand their basic nursing education to develop competence in the practice of holistic nursing. This is accomplished through academic and continuing education courses and programs that are focused on: 1) the principles, core values, and competencies of holistic nursing and 2) understanding and practice of various evidence-based integrative modalities.
In the United States 12 schools of nursing embody the tenets and philosophy of holism and are endorsed by the American Holistic Nursing Certification Corp. (AHNCC):
Capital University Dept. of Nursing
Dominican University of California
School of Arts and Science
San Rafael, CA
Eastern University School of Nursing
St. Davids, PA
Florida Atlantic University School of Nursing
Boca Raton, FL
Metropolitan State University School of Nursing
St. Paul, MN
New York University School of Nursing
New York, NY
University of Texas at Brownsville
Texas Southmost College
University of Texas Medical Branch at Galveston
School of Nursing
University of Colorado at Colorado Springs
Colorado Springs, CO
Western Michigan University
Bronson School of Nursing
West Virginia University
School of Nursing
Xavier University School of Nursing
Scope of Practice and Licensing
Nurses are licensed and their scopes of practice are regulated according to the state licensing boards and nurse practice acts where they work. A holistic nurse certification is awarded after successful completions of examinations that demonstrate competencies in specialized nursing practice that encompass holism. Holistic nurses may be required to attain additional certification in the practice of particular integrative modalities if they choose to specialize in those disciplines.
The scope of practice for holistic nursing is defined by the AHNA and the ANA and is published in: “Holistic Nursing: Scope and Standards of Practice,” the second edition of which was published in 2013.
In a handful of states the Board of Nursing has adopted a position statement or has addressed specific modalities being performed by the licensed nurse in specific (non-English) language, but there are limited restrictions on the practice of holistic nursing with patients.
Holistic Nursing in US Health and Wellness
In Veterans Healthcare
The Veterans Health Administration’s Office of Patient Centered Care (OPCC) was established in 2011 to advance treatment and healing towards wellness, health coaching and self-care. As of 2011 125 VHA clinical facilities were providing some form of complementary or integrative therapy, including mediation and acupuncture. Holistic nurses are playing important roles supporting this expansion of care.
VHA nurse researchers at the San Diego VA Medical Center are supporting the rapid deployment of integrative therapies in the VA network by conducting research on mind-body-spiritual interventions such as mantra repetition for veterans suffering from mental illness.
At the VA Medical Center in Northport, N.Y., advanced board-certified holistic RN and staff nurse Richelle Rapaport with other AHNA members was awarded a $380,000 grant to extend training for VA clinical staff in mind-body modalities for mental health recovery. The year-long program focused on clinical meditation and guided imagery, addiction and pain management, three levels of Reiki, essential oils for aromatherapy, Tai Chi Easy sessions, reflexology, restorative yoga and relaxation.
In a Rural Regional Hospital
At the Integrative Health Care Department at Mission Hospital in Asheville, NC holistic nurses are helping the institution build a reputation as a leader in integrative healthcare, by bringing training and experience to both patients and staff.
Organized around the holistic nursing principle of co-creating therapeutic partnerships, department programs include research, education, clinical services, and community partnerships that carefully integrate complimentary and traditional medical practice.
- Staff nurses participate in a 24-hour continuing education course that emphasizes the practice and core values of holistic nursing established by the AHNA and ANA.
- Participants in a Healing Touch Program receive an in-depth understanding of and practice energy work and other holistic treatments that apply scientifically supported techniques to complement conventional medical therapies.
- A Pet Therapy Care Team currently consists of 99 dogs and 120 volunteers who bring the healing power of pets to anyone experiencing loneliness, isolation or other emotional challenges.
- Holistic therapies also include aromatherapy, guided imagery and mind/body therapies.
A hospital’s rapid response to patient distress in the form of a Code Blue may be familiar to TV viewers. But what happens when a hospital staff itself comes under extreme emotional duress? In the healthcare system of the Cleveland Clinic an interdisciplinary team of holistically trained nurses and chaplains delivers a Holistic Rapid Response known as Code Lavender. The most extensive reported Code Lavender involved the entire staff at the system’s Hillcrest Hospital in Mayfield Heights in 2012 when it became the center of the medical response to the Chardon High School shootings. Many of the hospital staff had children in the school, some of whom were victims of the tragedy. More than 500 employees at Hillcrest were supported by the Code Lavender team during a 72-hour period.
In Cancer Treatment
At CTCA’s Midwestern Regional Medical Center in Zion, Illinois, a comprehensive holistic mission is embraced: “To be the home of integrative and compassionate cancer care and to never stop searching for and providing powerful and integrative therapies to heal the whole person, improve quality of life, and restore hope.”
A survey published in Healthgrades in 2014 bears out the impact of this approach to care supported by holistic nursing: In 2013 holistic nurses outperformed the national average in all ten measures recorded by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Notably:
“87% of patients gave the Midwestern Center an overall rating or a 9 or 10 (10 being the highest) compared to 69% for all reporting hospitals in the United States.”
References for Holistic Nursing
AHNA is the specialty professional organization representing holistic nurses. Established in 1980, AHNA’s membership is 4,500, including professionals from 14 countries. 146 local chapters are located across the United States. AHNA’s foundational professional work includes:
- Developing and promoting the adoption of the Scope and Standards of holistic nursing practice by the American Nurses Association in 2005 and the release of the 2nd edition in 2013
- Establishing a Holistic Nursing certification examination beginning in 1997
- Publishing the “Holistic Nursing Handbook for Practice” beginning in 1988.
For more about Holistic Nursing
See: What is Holistic Nursing at the AHNA web site.
State-based regulatory information
Dossey, B. M. & Keegan, L. (2013) Holistic Nursing: A handbook for practice. Burlington, MA: Jones & Bartlett Learning.
Kreitzer, M. J. & Koithan, M. (2013). Integrative Nursing New York, NY: Oxford Press.
Thornton, L. (2013). Whole Person Caring: An interprofessional model for healing and wellness. Indianapolis, IN: Sigma Theta Tau International.