Expand your knowledge of holistic nursing by reading the answers to commonly asked questions.

What is holistic nursing?

Holistic nursing is generally defined as all nursing practice that has healing the whole person as its goal. A holistic nurse is a licensed nurse who takes a “mind-body-spirit-emotion-environment” approach to the practice of traditional nursing. Holistic nursing is based on a philosophy of living and being that is grounded in caring, relationship, and interconnectedness. A holistic nurse recognizes and integrates the principles and modalities of holistic healing into daily life and clinical practice. Holistic nursing encourages nurses to integrate self-care, self-responsibility, spirituality, and reflection in their lives.

What is the history of holistic nursing?

Present-day holistic nursing is based on the work of Florence Nightingale. It was not until the mid-20th century that nursing began to emerge as a profession and became linked to developments in western medicine. Since 1970, many nurse scholars have described nursing as being concerned with the whole person. Dossey developed a theory of nursing that includes an integral worldview that builds upon a solid holistic, integrated, and multidimensional theoretical nursing foundation. Unlike previous theories of nursing, this theory serves to explain the function of the inner world of the nurse as a vital component of nursing practice.

These and other influences, such as research linking the mind and body and an emphasis on patient-centered care, have affected the development of holistic nursing. The American Holistic Nurses Association (AHNA) was founded in 1980 to serve as a voice for holistic nurses and to promote the education of nurses and others in the philosophy, practice, and research of holistic caring and healing. The American Holistic Nurses Certification Corporation (AHNCC) was founded in 1997 to credential holistic nurses. AHNCC has a collaborative relationship with AHNA to advance the role of holistic nursing and to provide educational opportunities in holistic nursing.

Is holistic nursing a specialty practice?

The American Nurses Association (ANA) officially recognized holistic nursing as a specialty area of nursing practice in 2006. Specialty status provides holistic nurses with a foundation for practice. It provides a clear depiction of who we are to the rest of the world of nursing, other healthcare professionals, and the public.

What are standards and scope of practice for holistic nursing practice?

The AHNA and the ANA co-published Holistic Nursing Scope & Standards of Practice. The standards are aligned with the definition, values, assumptions, and other standards of nursing as outlined by the ANA.

Standards of Practice reveals the unique intricacies of the specialty’s scope of practice, and describes the standards of practice and professional performance of holistic nursing. It defines holistic nursing, provides an overview and history of holistic nursing, and describes the following regarding holistic nursing: principles, core values, responsibilities, educational preparation (basic, advanced, and continuing education), certification, information about complementary/alternative modalities (CAM), and position statements.

Standards of Practice also shines a light on the philosophy, values, knowledge, and skills on which holistic care, health, and healing are based, and shows the relationship of CAM to the standards. Five core values integrate the art and science of nursing and capture the essence of holistic nursing:

• Holistic philosophy, theories, and ethics
• Holistic caring process
• Holistic communication, therapeutic environment, and cultural diversity
• Holistic education and research
• Holistic self-care.

Do the Standards apply to all nurses in all settings?

Unlike many other specialty areas, holistic nursing is practiced in all settings with individuals, families, communities, and populations throughout the lifespan. Holistic nursing is not specific to a particular patient/client group, disease, setting, or population. Holistic nurses practice in a myriad of roles.

No matter where holistic nursing is practiced, nurses must continually develop knowledge and skills in all aspects of their practice because holistic nursing is a way of thinking, reflecting, practicing, and of life. As a way of life personally and professionally, self-care becomes and is incorporated into one’s existence.

As with some other nursing specialty standards, Standards of Practice provides a blueprint for a nursing curriculum or continuing education programs, validates research and garners funds for research, enables recognition by state boards of nursing, describes to others what they can expect from holistic nurses, and assists the professional practice to better regulate itself.

How is holistic nursing moving into the forefront of health care?

Many developments in nursing and health care have contributed to bringing holistic nursing forward. Increasingly, hospitals and other healthcare settings are creating delivery models that include integrative health. Integrative health merges traditional western and CAM approaches with interventions to facilitate maximum curing and healing. In 2010, the Samueli Institute released Wellness Initiative for the Nation, which included a focus on integrative health care promotion and delivery. Holistic nursing has flourished within these integrative care systems.

Students are seeking programs that focus on holistic nursing and integrative health. In 2008, the revised The Essentials of Baccalaureate Education for Professional Nursing Practice, from the American Association of Colleges of Nursing, incorporated terminology that referred to “holistic, patient-centered care” and the expectation that nurses understand complementary and alternative modalities.

The Patient Protection and Affordable Health Care Act of 2010 defines how health care will be delivered for the foreseeable future. Patient-centered care will achieve considerable attention, and patients will become key players in determining which health care outcomes are valued. With an emphasis on effectiveness, coordination of services, and preventive care, a strong foundation in lifestyle change and holistic care strategies are required. In this new climate of healthcare delivery, nurse coaches who practice from a holistic framework are partnering with patients to achieve health and wellness goals.

What lies ahead for holistic nursing?

Holistic nursing will continue to evolve as nurses incorporate holistic principles and practices into their personal and professional lives, and as the needs of patients and society evolve. Yet, no matter the setting or the time, holistic nursing will retain its focus on healing the whole person—the very foundation of holistic nursing.

Nina A. Klebanoff is the retired RN to BSN program director and an assistant professor at the College of Nursing & Health Sciences in Northern New Mexico College, Espanola, New Mexico. Darlene Hess is self-employed and based in Los Ranchos, New Mexico.

Selected references

American Association of Colleges of Nursing. The Essentials of Baccalaureate Education for Professional Nursing Practice. Washington, DC: American Association of Colleges of Nursing; 2008.

American Holistic Nurses Association/American Nurses Association. Holistic Nursing: Scope and Standards of Practice. Silver Spring, MD: Nursesbooks.org; 2007.

Dossey BM. Nursing: integral, integrative, and holistic—local to global. In: Dossey BM, Keegan L, eds. Holistic Nursing: A Handbook for Practice. 6th ed. Sudbury, MA: Jones & Bartlett; 2013:3-57.

Dossey BM, Luck, S, Schaub BG, et al. Nurse coaching. In: Dossey BM, Keegan L, eds. Holistic Nursing: A Handbook for Practice. 6th ed. Sudbury, MA: Jones & Bartlett; 2013:189-204.

Hess D. Defining holistic nurse coaching. AHNA Beginnings. 2011;31(1):16-9.