Academic journal article Creative Nursing

The Promise of Integrative Nursing

Academic journal article Creative Nursing

The Promise of Integrative Nursing

Article excerpt

The U.S. health care system requires transformative changes that reduce risk and improve overall well-being while increasing access, quality, safety, and affordability. Integrative nursing can serve as a road map to care that is culturally safe, personalized, and meaningful. Using exemplar case studies, we explore both opportunities and challenges to care that advances the health and well-being of persons, families, and communities through caring/healing relationships.

Keywords: integrative nursing; health care transformation; relationship-centered care; patient-centered care; whole person; whole systems

Although the political and ideological debates about health care delivery continue, patients, providers, and payers all agree that the U.S. health care system requires transformative changes that reduce risk and improve overall well-being while increasing access, quality, safety, and affordability (Institute of Medicine [IOM], 2001, 2011, 2013). Relationship-centered care that is culturally safe, personalized, and meaningful is an ideal we all seek.

Integrative nursing provides a way for nurses to honor the traditions of our profession while embracing novel evidence-informed solutions that address these calls for health care reform. Defined as a "way of being-knowing-doing that advances the health and wellbeing of persons, families, and communities through caring/healing relationships," integrative nursing should not be conceptualized as a "theory" (Koithan, 2014, p. 4). Rather, integrative nursing is a very practical guide that can be used to shape practice, define a nursing research agenda, and work interprofessionally with colleagues across a wide variety of traditional and nontraditional health care disciplines. The principles of integrative nursing suggest how to operationalize our beliefs and values, various nursing theoretical frameworks, and social mandates in various practice settings to improve the well-being of patients. Thus, integrative nursing serves as a road map for nursing practice so that we can choose wisely among various interventions in support of whole person/whole systems health.

In the intricacies of expert integrative nursing, we find both opportunities and challenges. As the largest of the health care disciplines, nursing is well positioned to lead global integrative health initiatives. However, we are often reluctant to step to the forefront in the delivery of integrative care, claiming that institutional policies, workload, and contemporary nursing roles prohibit full implementation of these practice principles. Let's take a look at the promise of integrative nursing to explore what this way of being-knowing-doing might hold-for our patients, ourselves, and our beleaguered health care system.

THE PROMISE OF WHOLE PERSON, PATIENT-CENTERED CARE

When we practice nursing from a whole person/whole systems perspective, we acknowledge that recipients of care, whether individuals or groups, live within a particular context (social, relational, temporal, cultural) that is emergent or ever-changing. What works for one person does not necessarily work for another. The interventions that are used to promote health in one community may not be valid in another. Furthermore, strategies and plans that were once viable may no longer be relevant or appropriate as time moves forward.

In adopting this principle, our care becomes individualized, tailored, and meaningful. We do not recommend therapies, whether biomedical, mind-body, or manipulative, that a person cannot afford or access. We do not ask the impossible of our clients or their families. We consider the full ramifications of our interventions on the ecological (environmental) and social (communities and organizations) systems within which we exist. As such, our practice becomes sustainable and moral, one that is mindful and respectful of the complexities of life.

When guided by the principle that people have an innate capacity for health and well-being, nursing's role becomes supportive rather than directive. …

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