Should Every Hospital Have a Holistic Department
Controversies In Holistic Nursing
By Karilee Halo Shames, PhD, RN, HNC
Should Every Hospital Have a Holistic Department?
As consumers demand more holistic and complementary care, nurses might consider the responsiveness of health care institutions to these demands. Why have many facilities not adopted a holistic model?
Many administrators cannot imagine a cost-effective holistic department. They are concerned about the additional cost of staff education and equipment not currently utilized in standard medical practice. They are anxious about changing caregivers’ roles and the increased liability for providing treatment modalities that require further research to demonstrate efficacy. They are reluctant to fund research in holistic modalities, lest they be viewed as less "scientific."
Another overriding issue for hospitals in creating a holistic unit is the possible conflict in nurses’ attitudes. Presently, many nurses seem willing to disregard their own health needs. This longstanding pattern has allowed nurses to remain hospital employees. Adopting a holistic framework and creating holistic departments involving various types of health professionals could lead to the evolution of a new role for nursing, with direct reimbursement for nursing care.
Is nursing care inherently holistic? According to Barbara Hancock, a number of theorists, including Henderson, Leininger, Nightingale, Peplau, Roy, and Watson portray nursing as a holistic art.1 Still, there may be concerns on the part of administrators and physicians related to moving nurses away from their present roles and into new, more independent ones. Physicians also may be hesitant to work with alternative practitioners.
In addition to all these challenges, space and reimbursement are enormous problems in most facilities.
Despite these fears and possible concerns, many would agree that in today’s chaotic and fragmented system, a holistic department could mark the beginning of a healthy integrative process. Nurses skilled in caring for the whole person can begin to meet the growing demands for holistic care. As others witness the efficacy and restorative powers of the holistic model, they may be drawn to practice in a similar, life-affirming fashion.
According to Bellack and O’Neil, nursing can assure its leadership role by responding to the needs of the profession as it will be practiced in the new century.2 Their report emphasized that curricula must be redesigned to ensure students acquire broad general competencies.
The recommendations included the following: "Require interdisciplinary competence in all health professionals. In the old cost plus’ reimbursement system of health care, the separation of the professions into distinct and inviolable patterns of practice may have made sense. The challenge now is to integrate services in an efficient and effective way to meet patient care outcomes, price, and satisfaction needs of individuals and health systems.... Many of these changes are already making themselves evident in active experiments to redesign health care."
Consider some of these existing "experiments." The Planetree Model provides a unit within a traditional hospital structure where patients can receive massage, imagery, energy healing, and other options that are considered "complementary," in addition to standard medical treatment. Patients may select from a variety of resources that include videotapes, computerized programs, and music therapies. Today, there are numerous Planetree-affiliated units in major U.S. hospitals.
Along a similar vein, the Imperial Point Medical Center in Ft. Lauderdale, Florida, has converted an entire wing into a home-like environment. The center offers community and staff complementary therapies, including massage, energy healing, yoga, tai chi, movement, chi gung, meditation, and a number of other specialty classes. "We don’t do any third-party billing; therefore, we make 100 cents on the dollar, paid at the time of service," says Brenda Astor, Healing Arts Director. "Very few hospital departments can claim this."
Should every hospital provide holistic therapies or holistic nurses?
Although there may be growing pains involved in implementing this change, I believe it will be worth the effort. Ideally, each nurse will be exposed to the benefits of holistic practice, and will come to understand how self-nourishment results in a deeper connection with those in one’s care. The mutuality in nursing will become more evident as nurses awaken to their power as healers and feel better about their work, health, and lives.
At that point, hospitals may no longer need to have separate wings for holistic care. Rather, hospitals will become integrated and holistic principals will be woven into the framework of the institution, underlying the leadership and management of the entire medical system and allowing nurses to practice in a richer and fuller manner, more fully connected to ourselves and each other. As we move into a new model, there will likely be further integration of these tools and practices; eventually, all care will be provided from a holistic perspective, eliminating the need for a holistic department.
Nurses are in an obvious leadership position. We can restore our deepest connections and maintain a sense of health and wellness that will resonate with our patients, reminding them of the joys of health and well-being.
We should begin with our own self-healing endeavors; our modeling will begin the process. As time passes, we will be moving further from the hospitals into the communities, where we can keep our finger on the pulse of the public and inspire health-promoting lifestyles. Hospitals then will be utilized most appropriately, as Florence Nightingale urged, for the care of the sick.
References
1. Hancock B. Are nursing theories holistic? Nursing Standards 2000;14:12.
2. Bellack JP, O’Neil EH. Recreating nursing practice for a new century: Recommendations and implications of the PEW Health Professions Commission’s final report. Nursing Health Care Perspectives 2000;21:14-21.
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