Holistic nursing praxis: interview with Valerie Lincoln, PHD, RN, AHN-BC.
|Publication:||Name: Visions: The Journal of Rogerian Nursing Science Publisher: Society of Rogerian Scholars Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2009 Society of Rogerian Scholars ISSN: 1072-4532|
|Issue:||Date: Jan, 2009|
|Product:||Product Code: 8043110 Nurses, Registered NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners|
As Clinical Lead of Integrative Services at Woodwinds Hospital, Dr.
Val Lincoln has successfully led the integration of holistic nursing
practice in this 86 bed community-based hospital in Woodbury, Minnesota,
a suburb of the Twin Cities.
What prepared you to integrate a Holistic Nursing Model in an acute care environment?
For nearly all of my 35 years of nursing practice, I have been involved in acute care inpatient nursing. In the mid eighties and early nineties, I discovered the works of Rogers, Newman, Watson, Parse and other nursing scholars. Then I received an unsolicited copy of the Journal of Holistic Nursing. In it was a copy of the Position Statement on Social Justice and Nursing and the Environment. I joined the Society of Rogerian Scholars, Inc. and became a life long learner of Rogerian Nursing Science.
I found that my evolution as a nursing leader within the context of High Risk Obstetrics and Neonatal Intensive Care became a strong foundation as I explored the newest sub-specialty in Holistic Nursing. I eventually became one of the first certified nurses in Holistic Nursing in the country and an instructor in the Certification Program. In that capacity, I was further drawn to nursing theory and the deep work of Rogerian Nursing Science. Eventually, I completed my doctoral dissertation on the concept of ecospirituality based upon a Rogerian philosophy and cosmology.
I am passionate about contributing to the promotion of a healing environment and the practice of holistic nursing especially in an acute care hospital environment. Too many nurses have left this often chaotic demanding work environment and too many of us will need the best that high technology and high touch can provide. It was an opportunity of a life time to weave the tapestry together of holistic nursing, healing environment and holistic nursing theory and practice.
What were some of the first steps, strategies and tactics that you employed?
The first step was the articulation of a clear vision supported by guiding principles. Secondly, nurses were carefully selected who had both strong clinical skills as well as an openness to practice nursing from a holistic perspective. Each RN completed the American Holistic Nurses' Association (AHNA) assessment tool to help us understand their learning needs. Staff then attended several inservices on a variety of holistic topics. In the first year, we altered this topic based educational process and developed an integrated tapestry of a two day Holistic Nursing class. The foundation of these educational seminars are solidly built on Rogerian ontological postulates and principles.
After a year, we facilitated a survey of all RN's to identify the barriers to their practice. From that assessment we formulated a Holistic Nursing Practice Council (HPC) with the express intent to identify strategies and tactics to integrate a holistic nursing model based on holistic theory and evidence based care. We established an overarching goal of "Caring Well for Self and Soul" as our template under which we create all continuing education activities. The specific educational activities are living examples of the breadth of understanding of Rogerian Science. For example the postulate of "energy" is manifest in the clinical use of energy based healing arts therapies. The postulate of "interconnection" is manifest in a seminar of therapeutic use of intention and intuition.
Two manifestations of this knowing is evident in both our Pause for Prayer Initiative and the Prayer Shawl Initiative: From our Hearts, thru our Hands. When a patient, family member, volunteer or staff has been identified, we can initiate a Pause for Prayer "code". We have very minimal overhead paging. When we hear the "gentle chimes" on the overhead, our communal group acknowledges this by taking the moment to get grounded, set the intention for strength and comfort, take a deep cleansing breath and send out a ripple of compassion. For those on a beeper, no matter what building they are in, they can also choose to participate. The Prayer Shawl Initiative is a monthly group of individuals who subscribe to "setting an intention of peace, comfort and healing" while they create shawls to be given to staff, volunteers, patients and their families in need.
What does your curriculum present that is in alignment with Rogerian Science?
I try to lead from the consciousness of how to be a bridge from the academic to the practical. In that journey, I attempt to "bridge the language barriers" often associated with Rogerian philosophy from the colloquial perspective. I use easy to relate daily examples to make the concepts accessible to the entire spectrum of our nurses. To many, nursing theory is a new concept.
To younger professionals they "had a little of it, but never practiced in a hospital" with a strong theoretical foundation in their professional practice model.
I briefly review holistic principles incorporating language that is familiar to the staff given our holistic nursing model (HNM) of care. The first presentation "Pillars" briefly reviews: quantum science, interconnection, pandimensionality, energy fields, integrality, pattern, process, co-evolution, and relationship. Given my personal passion, the curriculum is grounded in Rogerian Science. Additionally I review the contributions of other nursing scholars such as Newman, Watson, and Nightingale under the rubric of Nursing Theory, Research and Ways of Knowing.
The Woodwinds' HNM is in alignment with the ideas about praxis as submitted by Butcher (2006). Praxis is a unitary pattern-based practice of a nexus of Rogerian cosmology, philosophy, and science to inform nursing practice and research (Butcher, 2006). Further, praxis involves recognizing that persons are irreducible energy fields and focuses on enabling clients to create a new and alternate reality based on making new choices and actions (Butcher, 2006). The Woodwinds' HNM praxis emanates from the inter-relationship of practice, research, and education.
What Healing Art Therapies do your holistic nurses employ?
The nurses employ a wide variety of mutual patterning therapies in our Holistic Nursing Praxis. Butcher (2006) reviewed many holistic, non-invasive modalities. The Healing Art Therapies that are incorporated into care at Woodwinds includes: energy based healing techniques such as Healing Touch, Therapeutic Touch, Reiki and acupressure, the use of essential oils, guided imagery, healing music and massage. I introduce the staff to a simple mnemonic of the FOUR A's: "Awareness, Access, Appreciation and Action". The infinite, integral nature and co-extensive nature of a nursing assessment begins first with embracing the consciousness of deep awareness, following the development of skills in energy assessment and appreciation utilizing multi-sentient skills. This is followed by the action a nurse takes to accurately use this information to coparticipate with the patient in their healing process.
[FIGURE 1 OMITTED]
This is closely linked to what I call the "ABC's of Woodwinds". We focus first on healing ourselves due to our deep understanding of mutual patterning and process. We first must become Aware before we can Attend to our own healing. This is followed by Balance and Being. Before we can access a place of being, we must seek and allow more balance in our own self. This is followed by Compassion & Consciousness. Our goal is to allow the flow of compassion. This dynamic, innovative pattern of embracing a consciousness of service allows the mutual process of unfolding potential; in self, for other and for the cosmos. This nursing model has contributed immensely to RN staff professional satisfaction and engagement. We have one of the highest RN engagement scores in the country according to Gallup.
Butcher, H. K. (2006). Unitary pattern-based praxis: A nexus of Rogerian cosmology, philosophy, and science. Visions, 14 (2), 8-33.
VAL LINCOLN, PHD, RN, AHN-BC
Clinical Lead--Integrative Services
Woodwinds Campus, HealthEast Care System
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