By Donna Audia, RN
Holistic nursing is defined as “all nursing practice that has healing the whole person as its goal” (American Holistic Nurses’ Association, 1998, Description of Holistic Nursing). Holistic nursing is a specialty practice that draws on nursing knowledge, theories, expertise and intuition to guide nurses in becoming therapeutic partners with people in their care. This practice recognizes the totality of the human being - the interconnectedness of body, mind, emotion, spirit, social/cultural, relationship, context, and environment.
Ten years ago I was given the project of providing trauma patients with an integrative approach to pain management. Working collaboratively with the University of Maryland School of Medicine’s Center for Integrative Medicine, I began a new path. It has been the most rewarding opportunity that I accepted. As a nurse, I focus on caring for the whole patient, mind-body-spirit. I learned multiple techniques to assist patients cope with their hospitalizations, pain, anxiety, insomnia, hopelessness, as well as suffering., I treasure watching as patients become people and write their own personal stories to their healing journeys.
I realized that my approach needed to include not only physical pain management but also the emotional and spiritual aspects of pain. No patient ever schedules admission to the trauma center or wants to have to go through the initiation process of admission. Patients arrive with broken limbs and the injuries that accompany horrific motor vehicle crashes. Severely injured, overwhelmed, and not to mention scared, many patients are not aware of what is going on around them due to the nature of the injury. Issues stemming from involvement of others, financial concerns and disabilities are all contributing factors to an individual’s pain score. The two most important priorities are to create a sense of safety for the patient, and, once the patient is aware, to empower patients to become active participants in their healing journeys.
The first step in providing integrative therapies for trauma patients involves educating the patients, families, and staff. Patients need to understand that the therapies are not contraindicated in their healing process. It is also important for them to understand that they are not choosing between western and eastern medicine practices. Families wanting the best for their loved ones can feel as they too have a role in their loved one’s healing process. Utilizing nurturing touch techniques, active listening, as well as journaling to release their feelings related to the hospitalization are foundations for our families.
Teaching families that self-care needs to become a priority because they will have an extended journey during the patient’s healing process.
Educating the staff in a tertiary care setting was a bit more challenging. Evidence based practice is expected. Reiki was not, and is still not, a practice that has the evidence to support the use. Although the practice has not received the research to support its use, in my experience it has been one of the most nurturing techniques that I have utilized in the hospital and one of the most requested therapies by the patients. The staff was very curious about how the treatments were performed and what the experience was like for the patients. I was able to treat staff members to allow them to experience the modalities. From housekeepers, unit secretaries, surgeons, anesthesiologists, nurses, and administrators, to respiratory therapists, physical therapists, and chaplains, I have treated the staff to dispel fears or concerns that they would have related to the treatments.
I have been fortunate to work in a setting that has allowed me to work within my scope of practice to provide relaxation techniques to patients to assist in their healing process. Many patients express that they experience a personal feeling of well-being post treatment.
About the Author: Donna Audia, RN
Donna Audia, an integrative therapy nurse and team lead for the Integrative Inpatient Care Team at the University of Maryland Medical Center, works to develop and implement integrative medicine care plans for patients and their families. Some of the therapies she uses to promote the healing process include Reiki, sound healing, music, art, acupressure, guided imagery, yoga, breath work, and journaling. She frequently lectures about her work with patients, speaking to professionals and students around the country as well as at the University of Maryland, Baltimore. In 2011, she was nominated as a Daily Record Health Care Hero. Her prior positions as a critical care nurse and her work as a pain service nurse enable her to share her experience and bring compassion to patients, families and staff within the University of Maryland Medical Center.
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