Gazing With Soft Eyes: Envisioning a Responsive, Integrative Healthcare System

I f there is something that every sector of our global society can agree on, it is the need for a transformed healthcare system. have all issued calls for sweeping changes that address access, quality, safety, patient/family-cen-teredness, prevention and community-based intervention , and affordability. 1-3 Interestingly, consumers and providers alike long for relationship-centered care that is culturally safe, personalized, and meaningful in a system where the delivery of care is supported by our administrative requirements and financing. Recommendations abound, and the points of agreement seem to recede into the swirl of political and ideological controversy. As I ponder possible ways forward for our health-care system, I am immediately struck by the potential wisdom that can be found in the metaphor of hard and soft eyes (terms that those of us who ride horses understand). Hard eyes are sharply focused, seeing very clearly but with limited range and almost oblivious to surroundings. Someone riding with hard eyes can almost run another rider over before realizing that the other rider is there. The rider with hard eyes studies the arena, takes in the boundaries and markers of the space, plots her course, and moves ahead—often straight ahead—without understanding the nuanced context within which she is operating. When riding with soft eyes, you see not only what is immediately ahead but also everything else in the environment. Riding with soft eyes improves your balance, provides connection to both horse and other riders, and helps prevent collisions. Soft eyes expand your vision and your awareness, providing all the data necessary to assess possibilities, weigh alternatives , identify priorities, and then correct your course. Riding with soft eyes doesn't necessarily mean taking your eyes off the destination; rather, it means that you may be more easily able to identify the path to the goal. 4 The wisdom of integrative nursing provides a way to turn soft eyes toward our healthcare system, offering new solutions and paths to our shared goals. In the intricacies of expert integrative nursing , defined as " a way of being-knowing-doing that advances the body-mind-spirit wellbeing of those entrusted to nurses through caring/healing relationships , " we find a profession that historically has used a " soft eyes " approach to patient care. 5 Let's look for just a moment at the full meaning and consequences of this approach when used to inform healthcare transformation. Practicing nursing from a whole-person/whole-systems perspective …