If you have been around nursing or healthcare for any time, you have probably heard the word “holistic” more than a time or two. You may be in nursing school and wondering, “What is holistic care in nursing?” Perhaps you are already a nurse who wants to know how to improve your approach to holistic care. Either way, this article is for you.
As you read further, I will tell you about holistic care in nursing. You will learn what it is, why it is important, and find some examples of how to use holistic nursing care. Additionally, I will share some of the challenges you will face in holistic nursing and give you some tips on how to overcome them!
Holistic nursing is an approach to patient care that considers the patient as a whole being. Holistic care in nursing addresses all aspects of a patient’s being, including their emotional, mental, spiritual, social, and physical needs. The holistic approach to patient care considers that wellness comes from within and that all parts of a person’s being interact with and rely upon one another for wellness. Therefore, if one part of a person’s being is out of balance, it can affect all other aspects of their lives.
Holistic care in nursing is important for several reasons. Because holistic nursing recognizes the interconnectedness of a person’s social, emotional, spiritual, and physical well-being, this approach to nursing care allows us to consider the whole patient, instead of only their physical symptoms, illness, or disease. In addition to facilitating individualized patient care, improving patient outcomes, and promoting a comprehensive approach to care, the following are three main reasons why holistic care is important in nursing.
One of the most important things about holistic care in nursing is that it is focused not on one symptom or one disease but on the person as a whole, unique being. What this means is that, as nurses, we look beyond a test result on paper or a list of complaints. While those things are important, a holistic nursing approach allows us to see beyond the physical presentation and examine the social, economic, and spiritual factors that may impact a patient’s health. When we view our patients holistically, considering everything that makes them the unique individuals they are, it becomes easier to provide nursing care that is individualized for them.
I remember caring for a patient in a hospital who would not eat his meals unless his wife or another family was present. It was troubling because one of his diagnoses was poor nutritional status. After talking to his wife, I learned that the family always had meals together and she or her son always asked a prayer of thanksgiving before each meal. I visited with the patient and his family and asked if it would be okay if I sat with him during meals when his family was not available and offered to give thanks for the meals. He was so pleased and agreed. From that day, this patient had someone present with him for every meal. Because we addressed his emotional and spiritual connection with food, we were able to find a way to address his nutritional needs, and he began to gain strength and was soon discharged to home.
I have both a paternal and a maternal family history of Diabetes and cancer, which makes me keenly aware of the importance of doing what I can to take good care of my health. I have learned the hard way that the best way to take care of myself is to do what I can to prevent illnesses or diseases. That way, I do not have to worry about managing them after they occur.
Something I love about holistic nursing is that it is an approach to care that is focused on preventing illnesses and diseases as much as it is about finding cures for them. When we implement holistic nursing measures, we teach our patients ways of living healthy which can prevent some illnesses and diseases and promote better health and outcomes.
No matter how much we, as nurses, care for our patients, nothing does more for them than educating them about self-care. Holistic care in nursing places a special focus on self-care, realizing that when patients are involved in their care, it has a positive impact on their health outcomes. In fact, some research indicates that when patients implement self-management strategies, they achieve better disease management and control, and their quality of life improves. Because holistic nursing involves all aspects of patient care, promoting self-care is an essential part of this patient care concept.
To provide effective care, it is crucial that nurses learn to identify and embrace cultural diversity. Holistic nursing is an approach that takes into account all aspects of a patient’s individuality, including their cultural beliefs, values, and choices about their health. When we exercise cultural competence in nursing, we approach patient care with an outlook based not only on one's individual rights, responsibilities, wants, and needs but also on the beliefs that make up the core of one's being. By embracing cultural diversity, we create an atmosphere conducive to building strong nurse-patient relationships, which are also proven to be a contributing factor to positive patient outcomes.
Holistic care in nursing benefits more than just our patients and their loved ones. It is also beneficial to nurses providing care. Holistic nursing encourages us to integrate alternative and complementary approaches to care. As we consider the whole-patient approach, we acknowledge each aspect of our patients: mind, spirit, and body, which means we can provide more comprehensive care that is individualized to our patient’s specific needs.
Additionally, holistic nursing also recognizes the importance of self-care, and when we as nurses implement self-care, we can maintain our own wellness, which improves our ability to care for patients and to be a strong member of the healthcare team.
Holistic care in nursing involves integrating several aspects of care, each with a patient-centered approach. While there are different views of the principles behind holistic nursing, five core principles remain unchanged, and they are as follows.
The first principle of holistic care in nursing is the focus on philosophy, theories, and ethics as they pertain to patient care. This principle states that holistic nursing must align with the Holistic Nursing's philosophy, theories, and ethical code. As such, we must utilize American Holistic Nurse Association and American Nurses Association documents outlining a Code of Ethics and standards of practice. Additionally, for our care to be considered holistic care in nursing, we must articulate the foundations of holistic nursing, recognizing, and promoting the interconnectedness and energy of all things related to patient care.
The second holistic nursing principle recognizes that caring for patients goes beyond identifying and treating physical complaints or symptoms. This principle embraces the importance of utilizing the nursing process to identify needs and provide care that is patient-centered and focused on developing therapeutic nurse/patient relationships. The principle of a holistic caring process defines health as “an individually defined state or process in which an individual experiences a sense of well-being, harmony, and unity such that subjective experiences about health, health beliefs, and values are honored.” (American Holistic Nurses Association)
A key component to establishing solid relationships with patients and providing quality patient care is to learn to communicate. Holistic communication promotes a therapeutic healing environment and respects cultural diversity. When we apply this third principle of holistic care in nursing, we demonstrate a willingness to be open to the thoughts, feelings, and desires of our patients and to respect them despite our differences in beliefs or cultural backgrounds. In doing so, we create environments that are conducive to peace and healing, which is the focus of holistic nursing.
Another key principle of holistic nursing is education and research. One of the things I love about nursing is that it is a profession dedicated to lifelong learning. As nurses practicing holistic care, we must stay abreast of evidence-based practices and research methods and find ways to integrate them into whole-patient care. When implementing holistic care in nursing, we must attain knowledge that reflects current trends in holistic nursing and integrates verified sources of evidence into practice.
Something I strongly believe in is the importance of nurses practicing self-care. In my years of nursing, I learned that even the little things are big things when it comes to self-care. For example, wearing comfortable support shoes, getting a good night’s sleep and eating a well-balanced diet are all ways to practice self-care. As a nurse and health educator, I urge students and colleagues to prioritize their own well-being.
Self-care in nursing is especially important because, when we practice self-care, we not only ensure we are physically, mentally, and emotionally equipped to care for our patients. We also model the type of behavior that inspires our patients to care for themselves. Promoting patient independence is essential in nursing. Therefore, practicing self-reflection and self-care and leading by example is an excellent way to do so.
(The following are the 10 good examples of how nurses provide holistic care in their nursing practice.)
Wellness coaching is an integral part of holistic care in nursing. As a nurse, you can take a holistic approach to patient care, helping patients focus on their overall wellness. You will accomplish this by combining nursing knowledge and skills with lifestyle coaching methods. The objective of wellness coaching in holistic care is to help patients elevate or improve their physical, spiritual, and mental health. You can practice holistic nursing without being certified as a holistic nurse. However, if you are interested in becoming a holistic wellness coach, the American Holistic Nurses Credentialing Corporation offers several certifications, including Holistic Nurse and Nurse Coach certifications.
A common treatment modality that is used in holistic care in nursing is massage therapy. Massage therapy is considered a holistic nursing intervention because it affects more than one part of the patient’s well-being. For example, massage helps patients relax, which reduces stress and anxiety. It also helps relieve pain, promoting better rest and sleep. Additionally, massage therapy is an excellent way to promote a trusting relationship between patients and nurses, strengthening the nurse/patient bond, which is known to positively impact patient outcomes.
By the way, getting a massage is an excellent way to practice self-care. If you have never had a good massage from a licensed massage therapist, you do not know what you’re missing!
Although the use of aromatherapy is not taught in all nursing programs, its use is becoming more popular, especially as awareness of how its effects on the physical side of a person affect other aspects of their being. For instance, essential oils affect the part of the brain known as the hippocampus. The hippocampus helps consolidate information stored in short-term memory and move it to your long-term memory. It is also associated with mood enhancement and emotional responses.
As nurses, we realize mood and emotions can impact factors such as blood pressure and other stress-related factors. Because of this understanding, it is common for nurses to implement holistic approaches to care, such as using aromatherapy, to help alleviate some of the factors that contribute to physical illness.
Hydrotherapy is perhaps one of the oldest types of complementary therapy there is. Hydrotherapy is, as the name suggests, the use of water for health purposes. Nurses implement hydrotherapy by using either hot or cold water, sometimes with a specific amount of pressure or flow, to ease physical and mental health symptoms.
Hydrotherapy may be used to relieve symptoms related to temporary skin problems, such as skin ulcers or burns. It may be used to relieve swollen or aching muscles, arthritis, or other chronic pain symptoms. Hydrotherapy can be as simple as taking a warm bath at home or as sophisticated as using a physical therapy hydrotherapy tank.
Hydrotherapy is a favorite treatment option among nurses and patients as it offers many benefits, including reducing pain, improving mental health, and helping with relaxation. Also, aquatic exercise is a type of hydrotherapy often used for people with bone or joint issues, as it is an excellent way for people to exercise without causing too great stress on their joints.
Guided imagery is a type of focused meditation or relaxation technique that involves concentrating on a specific sound, object, or experience and visualizing something peaceful. Nurses often use the guided imagery technique when caring for patients with anxiety or mood disorders, as this method of holistic care in nursing is known to reduce anxiety and stress and their related symptoms and promote a relaxed mood.
Another common intervention associated with holistic care in nursing is teaching stress management. A few examples include mindfulness techniques, such as breathing exercises, journaling, yoga, Tai Chi, meditation, prayer, and progressive muscle relaxation. Because holistic nursing stresses the importance of self-care and whole-person wellness for both nurses and our patients, implementing stress management techniques in your personal life is equally as important as teaching your patients how to use them in theirs.
I am not the type of person to get easily frustrated, but one thing that does irritate me is when nurses or other healthcare professionals seem to de-personalize interactions with patients. Because holistic care in nursing is about embracing our patients as individuals with unique qualities, needs, and desires, it is important for us to make each encounter personal.
For example, practicing holistic care in nursing means that when you are with your patient, your attention should be focused solely on them. Get to know them as a person, not a room number or a diagnosis in a chart. Call them by name. Ask open-ended questions to encourage communication. Taking the time to make each patient encounter a personal experience for both you and your patient helps build stronger nurse/patient relationships and increases the likelihood of patient compliance with healthcare plans, improving their health outcomes.
When I first began my nursing career, I had a patient who was associated with a religion that I was not familiar with. As I got to know her, I quickly understood how important her religious beliefs were to her. I also learned she was worried that her care team did not know or wish to learn about her beliefs. I made it my mission to ask questions about what she believed and what healthcare interventions she felt comfortable with.
By showing an interest in my patient’s beliefs and working with her to respect her right to religious freedom, I was able to advocate for her with the interdisciplinary team. We took the information she shared with us and used that as a guide to develop the most appropriate care plans to meet her healthcare needs without infringing upon her beliefs.
You may find that collaborating with religious counselors or chaplains, trying to understand your patient's religious background and practices, or incorporating religious practices, such as prayers or rituals, help patients feel more at ease. The wonderful thing about respecting a person's religious beliefs and rights and working to accommodate them is that it can impact all areas of a patient's life. When patients feel they can receive care without compromising their religious beliefs, educating them, and getting them actively involved in their care becomes easier. As a result, patient outcomes improve dramatically!
Another important consideration when providing holistic care in nursing is how your patient’s nutritional status and needs factor into their care. Nurses of all degree levels learn about nutrition, and it is our responsibility to use what we know to try and make sure our patients’ nutritional needs are met.
Take me, for example. I have Type 2 Diabetes. Although the type of Diabetes I have does not mean I am insulin dependent, I do take medication to help maintain healthy blood sugar levels. Also, it is crucial that I adhere to a Diabetic diet. If I were not a nurse before being diagnosed, I may not have known the right questions to ask my healthcare provider.
It is in situations like this that we can take a holistic approach to care by advocating for our patients as educators. When you utilize your knowledge about disease processes and how diet affects them, you can teach your patients ways to minimize their risks. Not only are you helping manage disease processes, but you are helping them achieve a healthy nutritional status, which promotes better healing and faster recovery times.
One of the most important skills for nurses is to learn how to utilize therapeutic communication measures. Therapeutic communication is the process of using nonverbal and verbal communication to connect with your patients. This type of communication is a patient-centered technique that supports emotional care and concern. When you utilize therapeutic communication, you can establish rapport and trust with your patients, which makes them open to discussing important issues regarding their health and well-being. Holistic care in nursing is all about having a patient-centered care approach, and that begins with establishing effective, therapeutic communication.
As with any type of nursing intervention, you will face challenges when you begin to implement holistic care in nursing. Knowing what to expect and how to face the challenges will help you overcome them easier. Also, the more you practice a holistic approach to nursing, the more comfortable you will become with the techniques, and you will be able to implement them with greater ease.
One of the biggest challenges nurses face when implementing holistic care in nursing is the lack of education about the holistic care approach. Nurses and other healthcare providers are trained to identify symptoms and find the source of the problem so they can be treated. However, recognizing the interconnectedness of all aspects of the patient’s being or condition is often overlooked. If we do not educate ourselves and future nurses about the depths to which a holistic care approach must go, we cannot effectively implement holistic nursing care measures.
For example, suppose Mr. Smith presents to your clinic with a complaint of chronic headaches and insomnia. Upon your admission assessment, you discover his blood pressure is 180/100. The natural first assumption would be that Mr. Smith’s headaches are the result of elevated blood pressure, and you may also deduce that his sleeplessness is due to the pain he is experiencing from his headaches. Although your assumptions may be correct, holistic nursing goes a step further by considering all aspects of Mr. Smith’s life to find the primary source causing his headaches and lack of sleep.
Lack of education about holistic care is a challenge you can easily overcome. The best way to overcome this challenge is to apply everything you know about whole-patient care. By applying yourself and looking at every angle of the situation, you will learn to use your knowledge and skills with a holistic approach to care.
In the example above, you already know the physical symptoms Mr. Smith is reporting, which are headaches and insomnia. Your assessment indicates his blood pressure is elevated. The holistic nursing approach goes a step further to find out about other aspects of Mr. Smith's life that could be impacting his health. For example, is he stressed about work or finances? Is he experiencing family problems? What kind of diet is he consuming? Does he exercise? Any of these factors could affect his blood pressure, which could result in the physical symptoms he is experiencing. Taking all these factors into account is an example of holistic care in nursing.
Because holistic care in nursing emphasizes whole-person care, the social and psychological needs of your patients are just as important as their physical needs. Family or close friends often act as caregivers for patients and educating them about the holistic approach to care is important. However, it can be challenging for some caregivers to understand the importance of a whole-person approach to healthcare.
The first step in overcoming this challenge is to educate caregivers on the importance of their role in patient care. Caregivers are excellent sources of information and can provide valuable insight into your patient’s life and needs. Your patient’s caregiver is likely a source of emotional support, which is helpful, especially when patients may not understand what you are trying to tell them or if they feel apprehensive about a treatment plan. Working closely with caregivers and patients is a great way to implement holistic care in nursing.
Polypharmacy, which is the use of two or more medications to treat the same symptoms/disorder, can significantly impact holistic care in nursing. While there are times when polypharmacy may be beneficial, it can pose problems when the burden of monitoring several medications outweighs the benefits of using them or the risk of harm related to drug interactions is increased.
The best way to overcome the challenges to holistic nursing care associated with polypharmacy is to use a patient-centered approach when discussing care plan options and to conduct medication reviews and deprescribing programs. Addressing polypharmacy is a major responsibility of nurses, as our role is to ensure safe medication practices that promote better patient outcomes.
Socioeconomic factors impact every aspect of our lives, including access to safe housing, transportation, nutritious food, utilities, healthcare, and our approach to healthcare services. As nurses, it is important for us to identify and consider the impact of each of these factors on our patients. Unfortunately, without a proactive approach, overcoming socioeconomic barriers can be a challenge when it comes to implementing holistic care in nursing.
One example I remember well is when I was working as a home health nurse. One of my patients who was a diabetic had serious nerve issues in her feet related to the Diabetes. The neuropathy caused her to lose sensation in her feet, which meant she did not sense a change in extreme temperatures or feel pain in them. After two failed attempts at nurse visits, we asked the local sheriff's office to accompany me and one of our nursing assistants to her residence for a wellness check.
When we found her, we discovered her electricity and gas had been shut off due to non-payment. She was wrapped up in several blankets in an effort to stay warm. Although she survived and we were able to help her find housing at a local long-term care facility, she ended up having two of her toes amputated on one foot and lost her other foot due to the damage caused by exposure to the freezing temperatures, which was exacerbated by her untreated Diabetes.
Although all patient scenarios are not as dire as the patient I mentioned, socioeconomic barriers can still significantly impact the way we deliver holistic care in nursing. To overcome this type of barrier, it is essential that you consider all factors when planning your patient’s care. For example, does your patient have the income to buy nutritious foods? If not, what public assistance is available to help them? Do they live in stable housing with running water and electricity? If they do not, is living with a relative or friend an option?
You can play a vital role in combating socioeconomic challenges by engaging in open communication with your patients and their families/loved ones, collaborating with patients and your interdisciplinary team, and reaching out to access community resources that offer assistance to individuals in need.
A common practice in nursing today is to use a holistic approach to patient care, which often begs the question, exactly what is holistic care in nursing? In this article, I answered that question by sharing some insight into what holistic nursing is and how you can implement holistic techniques into your nursing practice.
Holistic care in nursing touches every aspect of patient care. This type of nursing transcends traditional healthcare measures and embraces the whole person, making patient-centered nursing the focus. As nurses, when we implement an approach that considers the interconnectedness of the body, mind, and spirit, we can create more individualized, compassionate care focused on our patient’s unique needs. Using a holistic approach to caring for our patients supports stronger nurse/patient relationships, promotes independence, and improves patient, nursing, and organizational outcomes.
1. “What Is Progressive Muscle Relation (PMR)” (medicalnewstoday.com)
2. “What Is Cultural Competence in Nursing? (with Examples, Importance, & Barriers)” (nursingprocess.org)
3. “Core Essentials for the Practice of Holistic Nursing” (ahncc.org)
4. “Self-Care for Nurses- 25 Proven Strategies to Take Better Care of Yourself” (nursingprocess.org)
5. American Holistic Nurses Credentialing Corporation (ahncc.org)
6. “What is Patient-Centered Care in Nursing? (with Examples, Key Principles, Importance, & Challenges)”
(nursingprocess.org)
Darby Faubion, RN, BSN, MBA
Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Her work history includes clinical experience in pediatrics, mental health, addiction and behavioral disorders, geriatrics, wound management, and communicable disease. Darby has worked in hospitals, long-term care facilities, and home health and hospice agencies. Darby also has experience as a nursing and allied health educator at both community college and university levels. Her love for nursing and nursing education led to her becoming a test-taking strategist and NCLEX prep coach.
