Johnson, Lori, MSN, RN

Stein, Claudia, BA, BSN, RN

English

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UC San DiegoSummer 2014 - UC San Diego Health Journal of Nursing: The Unique Power of NursingTitleHolistic Nursing: Journey from Florence Nightingale to a Specialty CertificationPermalinkhttps://escholarship.org/uc/item/4zn5w28dJournalUC San Diego Health Journal of Nursing, 7(1)AuthorsJohnson, Lori, MSN, RNStein, Claudia, BA, BSN, RNPublication Date2014-07-01 Peer reviewedeScholarship.org Powered by the California Digital LibraryUniversity of California4 UCSD Journal of Nursing | Summer 2014By Lori Johnson RN, MSN, OCN and Claudia Stein, BA, BSN, RNHolistic Nursing:  Journey From Florence Nightingale  to a Specialty CertificationA sk any nurse if the discipline of nursing is holistic and chances are they are likely to answer, “Yes, of course! We’re all about the mind-body-spirit connection.” Most, if not all, academic nursing programs introduce this concept early on; but it is not always evident in practice. The holistic approach to patient care often crumbles under the ever-increasing pressures of medically-oriented healthcare systems. More patients, higher acuities, fewer resources- these factors and more can make it difficult to find the time and/or the energy to do more than implement medical treatments and tend to the patient’s physical needs. It is tempting to think that these barriers to holistic nursing are a new development related to advances in technology and a struggling economy, but when we read Florence Nightingale’s Notes on Nursing we find that the challenge of providing nursing care within a medical model is long standing. Nursing “has been [up to this point] limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet- all at the least expense of vital power to the patient” (Nightingale, 1860).So how exactly is holistic nursing any different from nursing in general? The American Nurses Association (ANA) has defined criteria for specialty designations. The criteria met by holistic nursing include a specific body of knowledge, evidence-based research, sophisticated skills, defined standards of practice, a diversity of modalities from a broad range of health practices, and a philosophy of living and being that is grounded in caring, relationship, and interconnectedness. Holistic nursing was officially recognized as a specialty by the ANA in 2006 (http://www.ahna.org/About-Us/ANA-Specialty-Recognition). The foundation for holistic nursing practice is encompassed in the American Holistic Nurses Association (AHNA) Scope and Lori Johnson, RN, MSN, OCN is the current Chair of the UCSD Holistic Integrative Nursing Committee, which she founded in May of 2012. Lori has been with UC San Diego Health System since 1996, and has been a nurse since 1998 when she graduated from San Diego State University’s BSN program. She obtained her MSN in Nursing Education in 2012. He professional focus is on patient and family-centered whole person care and student-centered education. Lori is trained in Healing Touch Level 1, and is scheduled to obtain certification in holistic nursing in OctoberStandards of Practice, which “describe the responsibilities for which its practitioners are accountable…reflect the values and priorities of the profession…provide direction for professional nursing practice and a framework for evaluation of this practice” (Dossey & Keegan, 2009, p.50). In addition to the scope and standards, holistic nursing is founded in five core values: 1) philosophy, UCSD Holistic Integrative Nursing Committee Mission Statement The UC San Diego Health System Holistic Integrative Nursing Committee recognizes the privilege of being involved in the lives of the people we serve. Our mission is to promote exceptional care of patients, families, the community, and each other through a philosophy that has the whole person at its core; and to advance Holistic Nursing practice that utilizes evidence-based integrative modalities that are attentive to the physical, emotional, mental, and spiritual aspects of well-being. This mission will be achieved through a variety of interprofessional clinical, educational, and research activities, with the goal of integrating the conscious person-centered clinical practice of holistic healthcare throughout the San Diego Health System.5Claudia Stein, BA, BSN, RN is the current Co-Chair of the UCSD Holistic Integrative Nursing Committee. She has been a Clinical Nurse III in the Electrophysiology Lab since 2005. Claudia joined UCSD as a nurse in the Cardiac catheterization Lab in 2004. She earned a Bachelor of Arts in Health and Physical Fitness Management in 1990 and a Bachelor of Science in Nursing in 1996 from Marymount University of Virginia. She is a member of the American Holistic Nurses Association (AHNA). Her professional interests include integrative healthcare and energy healing. Claudia has completed Reiki 2nd degree and Healing Touch Level 3.theory, and ethics; 2) holistic caring process; 3) holistic communication, therapeutic environment, and cultural diversity; 4) holistic education and research; and 5) holistic nurse self-care (Dossey & Keegan, 2009).Holistic nurses can be found in all areas of UC San Diego Health System, from the Neonatal Intensive Care Unit to Behavioral Health to the Emergency Department. Nurses have career paths that lead to so many healthcare settings that some nurses find themselves without a certification available for their specialty. The good news about holistic nursing is that a nurse from any specialty can become Board Certified in holistic nursing. It follows that a Board Certified Holistic Nurse can change specialties throughout their career and always have the professional certification that will enhance their career and marketability. Like other specialty certification processes, becoming a Board Certified Holistic Nurse is a significant commitment of time, as well as a financial investment. Board certification is obtained through the American Holistic Nursing Credentialing Corporation (AHNCC), a separate entity from the American Holistic Nurses Association (AHNA). To be eligible to sit for the exam applicants must first have completed 48 contact hours in Holistic Nursing. This requirement is a significant accomplishment in itself, and serves to establish a minimum level of competency in Holistic Nursing. Secondly, applicants must complete a Self Reflective Assessment; this is a collection of short essays, the topics of which are selected from a list on the AHNCC website. Only after these have been accomplished will the applicant be eligible to take the Certification Exam. Many Holistic Nurses are also certified in one or more complementary modalities such as Reiki, Healing Touch, reflexology, aromatherapy, massage, imagery, and biofeedback. Training in these modalities is frequently approved for continuing education hours by state Boards of Registered Nursing and the contact hours gained are applicable toward the Holistic Nursing Board Certification Application. Any nurse who has been considering pursuing specialty certification, will want to consider Holistic Nursing Specialty Certification. It is an investment in skills that, offer a wealth of opportunity to branch out into other areas of the nursing profession while retaining specialty certification.REFERENCESAmerican Nurses Association (ANA), Nursing Scope and Standards of Practice, 2nd ed. (Silver Spring, MD: NurseBooks.org, 2010).American Holistic Nurses Association (AHNA), Holistic Nursing: Scope and Standards of Practice (Silver Spring, MD: NurseBooks.org, 2007).American Holistic Nurses Credentialing Corporation (AHNCC), Certification Process. Retrieved from http://www.ahncc.org/certificationprocess:html. Dossey, B. M., & Keegan, L., (2009). Holistic nursing: A handbook for practice (5th ed.). Sudbury, MA: Jones and Bartlett Publishers.Florence Nightingale, F., (1860). Notes on nursing: What it is, and what it is not. New York, NY: D. Appleton and Company.The AHNCC administers three versions of certification exams, determined by the level of formal nursing education received from an accredited school. • Nurses with a diploma or Associate Degree in Nursing (ADN) sit for the Holistic Nurse Board Certified (HN-BC) exam.• Nurses with a Bachelor of Science degree in Nursing (BSN) sit for the Holistic Baccalaureate Nurse, Board Certified (HBN-BC) exam.• Nurses with a Master of Science degree in Nursing (MSN) sit for the Advanced Holistic Nurse Board Certified (AHN-BC) exam. 6 UCSD Journal of Nursing | Summer 2014Development and implementation of a Healing Touch training program. To date, four Healing Touch classes have been held, training a total of 41 people- 38 nurses, one child life specialist, one patient experience representative, and the spouse of one nurse.IRB-approved patient survey examining patient knowledge of, and interest in, integrative modalities.HINC has formed a partnership with the UC San Diego Center for Integrative Medicine (CIM), and with the Moores Patient & Family Support Services. Through these partnerships, they are working to bring a holistic approach to the care of patients, caregivers, and staff.On March 9th, 2014 HINC brought Karen Drucker, inspirational speaker and songwriter, to Moores Cancer Center for a spiritual self-care event. The event was sponsored by HINC in partnership with UCSD Chaplain Services and the Moores Cancer Center Departments of Patient and Family Support Services and Cancer Prevention and Control; and the event was well attended by patients, families, and staff.Future Direction:A second IRB-approved study is in development to evaluate the potential benefits of daily self-Reiki on nursing workplace stress.The existing Healing Touch Nursing Protocol is blossoming into a cohesive energy therapy program. Look for information in the coming months on how you can refer a patient for treatment.Integrative modalities for bedside use are being developed through the partnership between HINC and CIM.A holistic nursing curriculum is in development to serve UCSD and San Diego community nurses. This curriculum will consist of four-hour classes on a number of topics, and will serve to prepare nurses for holistic practice and to sit for certification exams in holistic nursing. Structural Empowerment• SE1EO: Clinical nurses are involved in interprofessional decision-making groups at the organizational level. •  HINC-CIM Energy Therapy Steering Group  •  HINC-CIM partnership re. inpatient services• SE4EO: Nurses participate in professional development activities designed to improve their knowledge, skills, and/or practices in the workplace. Professional development activities are designed to improve the professional practice of nursing or patient outcomes, or both. May include interprofessional activities •  Healing Touch Training Program  •  Holistic Nursing Curriculum    [slated for 2014-15]• SE10EO: Nurses participate in the assessment and prioritization of the healthcare needs of the community. •  2013 IRB-approved patient survey    [Dee Parks RN]Exemplary Practice• EP4: Nurses create partnerships with patients and families to establish goals and plans for delivery of patient-centered care. •  Patient scheduled for HIPEC procedure   in August 2013, contacted Patient   Experience office requesting Healing Touch   (HT). HINC coordinated HT RNs to provide   treatments every day during    hospitalization,and all HT RNs provided   distance HT during surgery. HIPEC patients   go from OR to ICU for 4-5 days, then to 2E   for additional several days. This patient   went from OR directly to 2E, and was   discharged with length of stay less than 5   days. •  When HINC is contacted with requests,   arrangements are made for a plan of care   that is individualized to the patient.• EP 12: Nurses assume leadership roles in collaborative interprofessional activities to improve the quality of care •  HINC brought the drafted energy therapy   policy to Lori Montross PhD, Director of   Inpatient Integrative Medicine with a proposal   to form the Energy Therapy Steering Group   in partnership with CIM. The steering group   is co-chaired by Lori Johnson, Chair of   HINC and Dr. MontrossNew Knowledge• NKIEO: The organization supports the advancement of nursing research. •  2013 IRB-approved patient survey conducted   in Peri-Anesthesia by Dee Parks RN •  2014 IRB-approved therapeutic study   examining the impact of self-Reiki on   workplace stress and well-being of staff   nurses. This study is currently in   development, being designed and   conducted by Dee Parks RN and Anita   Darcey RN, and supported by Judy Davidson   DNP and Lori Johnson RN MSN OCN.Magnet Correlations for HINC ActivitiesThe UC San Diego Holistic Integrative Nursing Committee (HINC) celebrated its second birthday in May 2014. Membership includes nurses across sites and specialties, as well as professionals from nutrition services, physical therapy, child life specialist, and psychology. Meetings are held the fourth Tuesday from 12 noon to 1:00pm, and are video-conferenced to facilitate attendance in Hillcrest and La Jolla. The following describe HINC accomplishments and future direction:UCSD Holistic Integrative Nursing Committee 2014 Update

Holistic Nursing: Journey from Florence Nightingale to a Specialty Certification

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Holistic Nursing: Journey from Florence Nightingale to a Specialty Certification

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