Creating inroads for integrative health care.

Scores of individuals pursue careers in nursing because they yearn to work in a compassionate manner, but current nursing positions are often perceived as stressful and the environments uncaring. In some work places, the nurses’ quality of living and practice perspectives are often overlooked or not considered important. As a result, large numbers of nurses are attracted to holistic modalities, but these nurses must be creative when integrating healing techniques into practices within and outside the mainstream workplace. Typical holistic nursing practices include such modalities as aromatherapy, herbal medicine, energy work, meditation, guided imagery, massage, and craniosacral therapy, to name just a few. Holistic nursing uses the science of conventional nursing education and theory as a framework for complementary and alternative medicine (CAM) healing modalities. Because the practice of nursing is regulated by each state, the ability of nurses to bring CAM modalities into a nursing framework depends upon how each state defines CAM and integrates it into the profession. Nurses wanting to work outside the current traditional healthcare system while maintaining a nursing license must contact their state’s board of nursing and ask for a contact person who can help with the legalities of setting up an alternative nursing practice (Amdall Thompson, 2003). As CAM modalities are documented according to theory and with the standard taxonomies, they are then acknowledged in peer-reviewed journals and slowly brought into the domain of mainstream nursing activities. For instance, Margaret Neuman’s theory of health as expanding consciousness provides the nurse with a conceptual framework for applying modalities based on recognizing patterns of archetypal expression in such insightproducing therapies as astrology, Tarot counseling, guided imagery, and dream interpretation. Neuman’s theory explains how client insights lead to an expanded awareness that is a necessary component of growth and development (Neuman, 1999). This supports what health psychology researchers like Jeanne Achterberg (1985) and others have told us for over 30 years: Careful attention to the development of the mind and spirit is needed for optimal psychological and physical healing to occur. Documentation of nursing care using CAM modalities makes it clear that the care is practiced within the scope of our profession. Using taxonomies such as North American Nursing Diagnosis Association (NANDA) Classification of Nursing Diagnoses makes a statement of client problems and nursing concerns as well as opportunities to promote wellness. By using these classification systems, nurses are accomplishing three important things: (1) identifying work as within the scope of professional nursing, (2) appropriately documenting care, and (3) adding to a body of knowledge for nurses to use about specific interventions (Cavan Frisch, 2001). Pioneering holistic nurses explore and introduce complementary and alternative therapeutic modalities to nursing in language that can be understood. Although we have a long way to go before integrating holistic nursing practices within institutional workplaces, nurses can be proud of what we are accomplishing within the respected framework of the nursing profession.