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    Holistic Nursing: Scope and Standards of Practice, 3rd Edition
    Holistic Nursing: Scope and Standards of Practice, 3rd Edition
    Holistic Nursing: Scope and Standards of Practice, 3rd Edition
    Ebook493 pages4 hours

    Holistic Nursing: Scope and Standards of Practice, 3rd Edition

    By American Nurses Association and American Holistic Nurses Association

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    About this ebook

    The premier resource for today’s holistic nurses, Holistic Nursing: Scope and Standards of Practice, 3rd Edition is informed by the advances in health care and professional nursing today. This new edition of the publication contains information on core role accountabilities, role qualifications, ethics in holistic nursing, along with trends, issues and opportunities that every holistic nurse must know.

    Holistic Nursing: Scope and Standards of Practice, 3rd Edition covers the full extent of holistic nursing practice needs in any setting or role and at any level of influence and authority. This specialty’s core accountabilities illustrate that depth and breadth of practice:

    Safety, quality, and risk management
    Patient and population health advocacy
    Clinical care delivery and optimal patient outcomes
    Healthy work environments
    Strategic, financial, and human resource management
    Legal and regulatory compliance
    Networking, partnering, and collaborating
    Accountability/advocacy for their employees
    The publication also addresses 17 updated national standards, which offer a framework for evaluating practice outcomes and goals, as well as for what is expected of all gerontology nurses, and its scope of practice specifies the who, what, where, when, why, and how of their practice. This new book is a must-have for the aspiring or practicing holistic nurse, or any registered nurse.
    LanguageEnglish
    PublisherNursesbooks
    Release dateJul 7, 2019
    ISBN9781947800410
    Holistic Nursing: Scope and Standards of Practice, 3rd Edition
    Author

    American Nurses Association

    The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4 million registered nurses. ANA is at the forefront of improving the quality of health care for all. Founded in 1896, and with members in all 50 states and U.S. territories, ANA is the strongest voice for the profession

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      Holistic Nursing - American Nurses Association

      This ANA publication reflects the thinking of the holistic specialty nurses on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of rheumatology nursing, while Holistic Nursing: Scope and Standards of Practice, Third Edition, guides nurses in the application of their professional knowledge, skills, and abilities.

      American Nurses Association

      8515 Georgia Avenue, Suite 400

      Silver Spring, MD 20910-3492

      1-800-274-4ANA

      http://www.Nursingworld.org

      American Holistic Nurses Association

      2900 S.W. Plass Court

      Topeka, KS 66611-1980

      https://www.ahna.org/

      Cataloging-in-Publication Data on file at Library of Congress.

      Copyright ©2019 American Nurses Association and American Holistic Nurses Association.

      All rights reserved. Reproduction or transmission in any form is not permitted without written permission of the American Nurses Association (ANA). This publication may not be translated without written permission of ANA. For inquiries, or to report unauthorized use, email copyright@ana.org.

      ISBN-

      Print: 978-1-947800-39-7

      ePDF: 978-1-947800-40-3

      EPUB: 978-1-947800-41-0

      Kindle: 978-1-947800-42-7

      SAN: 851-3481 First published: 06-2019

      Contributors

      Introduction

      Function of the Scope of Practice Statement of Holistic Nursing

      Function of the Standards of Holistic Nursing

      Function of Competencies Accompanying Standards of Holistic Nursing

      Development of the Holistic Nursing Standards of Practice: Basic and Advanced

      Summary

      Holistic Nursing Scope of Practice

      Definition and Overview of Holistic Nursing

      Evolution of Holistic Nursing

      Current State and Trends of Holistic Nursing

      Healthcare in the United States

      Trends in Healthcare

      Philosophical Principles of Holistic Nursing

      Person

      Healing/Health

      Practice

      Environment

      Nursing Roles

      Self-Reflection, Self-Development, and Self-Care

      Integrating the Art and Science of Holistic Nursing: Core Values

      Core Value 1. Holistic Philosophies, Theories, and Ethics

      Core Value 2. Holistic Nurse Self-Reflection, Self-Development, and Self-Care

      Core Value 3. Holistic Caring Process

      Core Value 4. Holistic Communication, Therapeutic Relationship, Healing Environments, and Cultural Care

      Core Value 5. Holistic Education and Research

      Settings for Holistic Nursing Practice

      Educational Preparation for Holistic Nursing Practice

      Basic Practice Level

      Advanced Practice Level

      Continuing Education for Basic and Advanced Practice Levels

      Certification in Holistic Nursing

      Commitment to the Nursing Profession

      Care of Older Adults in Holistic Nursing

      Issues in Holistic Nursing

      Education

      Research

      Clinical Practice

      Policy

      Standards of Holistic Nursing Practice

      Overarching Philosophical Principles of Holistic Nursing

      Standards of Practice for Holistic Nursing

      Standard 1. Assessment

      Standard 2. Diagnosis

      Standard 3. Outcome Identification

      Standard 4. Planning

      Standard 5. Implementation

      Standard 5A. Coordination of Care

      Standard 5B. Health Teaching and Health Promotion

      Standard 6. Evaluation

      Standards of Professional Performance

      Standard 7. Ethics

      Standard 8. Culturally Congruent Practice

      Standard 9. Communication

      Standard 10. Collaboration

      Standard 11. Leadership

      Standard 12. Education

      Standard 13. Evidence-Based Practice and Research

      Standard 14. Quality of Practice

      Standard 15. Professional Practice Evaluation

      Standard 16. Resource Utilization

      Standard 17. Environmental Health

      Glossary

      References and Bibliography

      Appendix A. Holistic Nursing: Scope and Standards of Practice, Second Edition (2013)

      Appendix B. American Holistic Nurses Association (AHNA) Position Statement on Holistic Nursing Ethics

      Appendix C. Position on the Role of Nurses in the Practice of Complementary and Integrative Health Approaches (CIHA) June 2016

      Index

      Workgroup

      Nancy Laplante, PhD, RN, AHN-BC, Chairperson

      Rebecca Cohen, RN, MS, EdD, MPA, HNB-BC

      Colleen Delaney, PhD, RN, AHN-BC

      Susan Dyess, PhD, RN, AHN-BC, NE-BC, HWNC-BC

      Barry S. Gallison, DNP, MS, APRN-BC, NEA-BC, CPHQ, AHN-BC

      Martha Libster, PhD, MSN, APRN-CNS, APHN-BC

      Carla Mariano, EdD, RN, AHN-BC, FAAIM

      Deborah Shields, PhD, RN, CCRN, QTTT, AHN-BC

      The work of many provided the foundation for Holistic Nursing: Scope and Standards of Practice (2013) and its evolution into this, the third edition (2017). These are cited in Appendix A and throughout the document. The task force members are grateful for these contributions, including those of Carla Mariano, EdD, RN, AHN-BC, FAAIM, for the first edition (2007) and the second edition (2013). Without this previous work, our latest edition would not be possible.

      There were numerous individuals and AHNA committees who provided documents and input along the way. In particular, these task forces and review committees contributed the following documents:

      Holistic Nursing: Scope and Standards of Practice (2007, 2013)

      Standards of Holistic Nursing Practice (2005)

      Standards of Advanced Holistic Practice for Graduate-Prepared Nurses (2005)

      American Holistic Nurses Credentialing Corporation (AHNCC) Core Essentials for the Practice of Basic Holistic Nursing (2012)

      American Holistic Nurses Credentialing Corporation (AHNCC) Core Essentials for the Practice of Advanced Holistic Nursing (2012)

      AHNA Position Statements and White Papers

      AHNA Research Committee, Annotated Bibliographies (2016)

      Other key contributors: Leadership Councils, Board of Directors and Staff of the American Holistic Nurses Association (AHNA), Charlotte McGuire, and the founding members of the AHNA. Also, the numerous holistic nurses throughout the years who have contributed to the body of holistic nursing knowledge and advancement of the specialty of holistic nursing in practice, research, education, certification, administration, advocacy, and healthcare

      American Nurses Association Staff

      Carol J. Bickford, PhD, RN-BC, CPHIMS, FHIMSS, FAAN—Content editor

      Joi Morris, BS, CAP-OM—Project coordinator

      Lisa M. Myers, Esq.—Legal counsel

      Liz Stokes, JD, RN—Ethics consultant

      Erin E. Walpole, BA, PMP—Project editor

      ANA Committee on Nursing Practice Standards

      Danette Culver, MSN, APRN, ACNS-BC, CCRN

      Patricia Bowe, DNP, MS, RN, Co-Chair

      Renee Gecsedi, MS, RN

      Kirk Koyama, MSN, RN, CNS, PHN, Co-Chair

      Tonette McAndrew, MPA, BSN, RN

      Mona Pearl Treyball, PhD, RN, CNS, CCRN-K, FAAN

      Verna Sitzer, PhD, RN, CNS

      Stacy McCall, MSN, RN, IBCLC

      Ruth Odochilfediora, MSN-ED, RN, Alternate

      Jordan Wilson, BSN, RN, Alternate

      About the American Holistic Nurses Association

      The American Holistic Nurses Association (AHNA) is a nonprofit specialty nursing organization that is open to nurses and other individuals interested in holistically oriented healthcare practices throughout the United States and the world. AHNA is the definitive voice for holistic nursing and supports the education of nurses, allied health practitioners, and the general public on health-related issues and the concepts of holism: a state of harmony among body, mind, emotions, and spirit within an ever-changing environment.

      About the American Nurses Association

      The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 3.6 million registered nurses through its constituent/state nurses’ associations and its organizational affiliates. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public.

      The nursing profession and healthcare arena continue to evolve and expand. The purpose of this document is to articulate the scope and standards of the specialty practice of holistic nursing and to inform holistic nurses, the nursing profession, other healthcare providers and disciplines, employers, third-party payers, legislators, and the public about the unique scope of knowledge and the standards of practice and professional performance of a holistic nurse.

      Holistic Nursing: Scope and Standards of Practice, 3rd Edition (2018), is a foundational document for holistic nursing practice, theory, research, education, advocacy, and certification, and serves as a valuable resource for all levels of holistic nursing education (undergraduate, graduate, and continuing education).

      Function of the Scope of Practice Statement of Holistic Nursing

      The scope of practice statement describes the who, what, where, when, why, and how of the practice of holistic nursing. The answers to these questions provide a picture of the dynamic and complex practice of holistic nursing, its evolving boundaries, and its members.

      Nursing: Scope and Standards of Practice, 3rd Edition (ANA, 2015b) applies to all professional registered nurses engaged in practice, regardless of specialty, practice setting, or educational preparation. With the Code of Ethics for Nurses With Interpretative Statements (ANA, 2015a) and Nursing’s Social Policy Statement: The Essence of the Profession (ANA, 2010), it forms the foundation of practice for all registered nurses. The scope of holistic nursing practice is specific to this specialty, but it builds on the scope of practice expected of all registered nurses.

      Function of the Standards of Holistic Nursing

      The Scope of Practice Statement is accompanied by the Standards of Professional Nursing Practice. The standards are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. The standards published herein may serve as evidence of the standard of care, with the understanding that application of the standards depends on context. The standards are subject to change with the dynamics of the nursing profession, as new patterns of professional practice are developed and accepted by the nursing profession and the public. In addition, specific conditions and clinical circumstances may also affect the application of the standards at a given time (ANA, 2015b, p. 3). Specifically, a professional organization has a responsibility to its members and to the public it serves to develop scope and standards of practice for its profession (ANA, 2015b, p. 1). The standards of holistic nursing practice are specific to this specialty but build on the standards of practice expected of all registered nurses.

      Function of Competencies Accompanying Standards of Holistic Nursing

      A competency is [a]n expected level of performance that integrates knowledge, skills, abilities, and judgment (ANA, 2015b, p. 44). The competencies that accompany each standard in this book are evidence of compliance with the corresponding standard. The list of competencies is not exhaustive and may depend on circumstances or context.

      Development of the Holistic Nursing Standards of Practice: Basic and Advanced

      The American Holistic Nurses Association (AHNA) first developed Standards of Holistic Nursing Practice in 1990. In 2006, holistic nursing was officially recognized by the American Nurses Association (ANA) as a distinct specialty within nursing. The first edition of Holistic Nursing: Scope and Standards of Practice was jointly published by the AHNA and ANA in 2007; the 2nd edition was published in 2013. [See Appendix A. Holistic Nursing Scope and Standards of Practice, 2nd edition (2013)].

      Summary

      Holistic Nursing: Scope and Standards of Practice, 3rd Edition (2018), reflects a consensus of the most current thinking in the specialty and provides a blueprint for holistic nursing philosophy, theory, principles, education, research, and practices. It incorporates the fundamental philosophical beliefs, theories, and practices as well as new developments and advancements in the field of holistic nursing. It is a foundational resource for holistic nursing and a key resource for certification in holistic nursing. The Standards guide clinicians, educators, researchers, nurse leaders, and administrators in professional activities, knowledge, and performance that are relevant to basic and advanced practice, education, research, and advocacy in holistic nursing. This document, used in conjunction with Nursing’s Social Policy Statement: The Essence of the Profession (ANA, 2010), Nursing: Scope and Standards of Practice, 3rd Edition (ANA, 2015b), Code of Ethics for Nurses With Interpretive Statements (ANA, 2015a), and the laws, statutes, and regulations related to nursing practice for the nurse’s state, commonwealth, or territory, delineates the professional responsibilities of a holistic nurse.

      Definition and Overview of Holistic Nursing

      Holistic nursing is defined as all nursing practice that has healing the whole person as its goal (AHNA, 1998).

      Holistic nursing focuses on protecting, promoting, and optimizing health and wellness; assisting healing; preventing illness and injury; alleviating suffering; supporting people to find peace, comfort, harmony, and balance through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, groups, communities, populations, and the planet.

      Holistic nursing embraces all nursing that has the enhancement of healing the whole person from birth to death—and all age groups from infant to elder—as its goal. This means viewing the whole person and his/her needs in their integrated entirety.

      Holistic nursing care is person and relationship centered, and healing rather than disease and cure oriented. Holistic nursing is prospective, focusing on:

      Comprehensive health promotion to enhance wellness and well-being;

      Proactive interventions that address risks, antecedents, and mediators of illness and disease; and

      Opportunities for transformation, growth, and finding meaning that exist in each individual’s experience of health challenges.

      The phenomena of concern to holistic nursing include, but are not limited to:

      The caring–healing relationship;

      The subjective experience of and meanings ascribed to health, wellness, well-being, healing, birth, growth and development, illness, and dying;

      Cultural values, beliefs, and folk and indigenous practices of health, wellness, well-being, healing, illness, and death;

      Physical, mental, emotional, and spiritual comfort, discomfort, and pain;

      Spirituality in nursing care;

      Energy and consciousness;

      Reflective practice;

      The use and evaluation of complementary and integrative health approaches (CIHA) in nursing practice;

      Comprehensive health promotion, disease prevention, and well-being;

      Self-reflection, self-care, and self-development processes;

      Empowerment, decision-making, and the ability to make informed choices;

      Social and economic policies and their effects on the health of individuals, families, and communities;

      Diverse and alternative healthcare systems and their relationships to access and quality of healthcare;

      Healing environments; and

      The environment, ecosystem, and the prevention of disease.

      The holistic nurse is an instrument of healing and a facilitator of growth, development, and the healing process. Holistic nurses honor the individual’s subjective experience about health, health beliefs, and values. To allow nurses to become therapeutic partners with individuals, families, communities, and populations, holistic nursing practice draws on nursing knowledge, theories, research, expertise, intuition, and creativity, incorporating the roles of clinician, educator, consultant, coach, partner, role model, and advocate.

      Holistic nursing emphasizes practices of self-reflection, self-care, self-development, intentionality, presence, mindfulness, and the therapeutic use of self as pivotal for the facilitation of growth, development, healing, and patterning wellness in others. The holistic nurse recognizes and integrates body, mind, emotion, spirit, energetic, cultural, environment principles and approaches in daily life and clinical practice; creates a caring healing space within herself/himself that allows the nurse to be an instrument of healing; shares authenticity of unconditional presence that helps to remove the barriers to the healing process; facilitates another person’s growth (body–mind–emotion–spirit–energetic–cultural–environment connections); assists with maintaining wellness; and facilitates well-being, recovery from and/or living with illness, or transition to peaceful death.

      Philosophically, holistic nursing is a worldview—a way of being in the world, not merely the use of modalities. Holistic nurses incorporate complementary and integrative health approaches (CIHA) into clinical practice to treat people’s physiological, psychological, and spiritual needs. Doing so does not negate the validity of conventional healthcare therapies, but rather serves to complement, broaden, and enrich the scope of nursing practice.

      The scope of holistic nursing practice is differentiated from that of faith community nursing (FCN) in that the focus of holistic nursing is the interconnectedness of body, mind, emotion, spirit, social/cultural, relationships, context, environment, and energy, while the focus of FCN is the intentional care of the spirit as well as the promotion of whole-person health and the prevention or minimization of illness within the context of a faith community and the wider community (American Nurses Association and Health Ministries Association, Inc., 2017; p. 1).

      Evolution of Holistic Nursing

      Ancient cultures have defined holism within the healing arts in terms of the balance of forces in nature also referred to as the elements: fire, air, water, earth, and ether. These elements are foundational in the healing arts practiced today by traditional and indigenous peoples around the globe.

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