Standards of Practice
The Canadian Holistic Nurses Association has formulated Standards of Practice for holistic nursing. They are available for your reading and printing below in both pdf and a Word format.
Canadian Holistic Nursing
Practice Standards
Approved by CHNA May 16, 2006
INTRODUCTION
The Nursing Practice Standards for the Canadian Holistic Nurses Association:
1. delineate the uniqueness and scope of holistic nursing practice for all settings where holistic nursing is practiced;
2. facilitate evaluation of holistic nursing practice;
3. enable the client to judge the adequacy of holistic nursing care;
4. provide a foundation for the further refinement and specificity of the standards;
5. reflect the evolution of a nursing conceptual framework based on unitary human
science, human-environmental essence field theory and energy-based nursing
practice;
6. facilitate articulation of holistic nursing practice and its methods to clients and
health professionals.
These standards are based on the assumption that nurses are practising within the Scope
of Practice, Nursing Practice Standards and Code of Ethics, as defined by the Canadian
Nurses Association and the province or territories in which nurses are registered to practice.
PHILOSOPHY
We believe that each person is a whole, unitary human being, and a unitary human
essence field in continuous mutual process with the environmental essence field
( Leddy, 2003 ). Each human being has the capacity for abstraction and imagery,
language and thought, sensation and emotion ( Rogers, 1970 & 1987) and to participate
knowingly in the process of change ( Rogers, 1987). Each person has the spiritual
ability to develop relatedness with self, others, nature and a higher power.
We believe:
human beings have potentials for healing and well being
human beings use their capacity to participate knowingly in change, to make health
related choices, and to advocate for fulfillment of these choices.
human beings have unique human essence field characteristics and pattern
manifestations that arise from their mutual human-environmental essence field process.
desired health outcomes are client-generated and considered in the context of
continually emerging health patterning goals affirmed by each human being.
desired client health outcomes are achieved when the health care, social and political
systems support nursing practice.
that all unitary energy-based modalities used with human beings should be researched
and or evidenced based including evaluation.
holistic nursing is an area of specialization.
holistic nurses practice in collaboration with other health professionals
that a nursing conceptual framework based on unitary human science, human-
environmental essence field theory and energy-based nursing practice is the
foundation for holistic nursing practice.
GLOSSARY OF TERMS
Client People and their environment are the central focus for holistic nursing.
A client may be an individual, family, group or community.
Nursing Defines the scope of practice and functions of nurses.
Goal Defines what holistic nursing will accomplish.
Health Is “ a process of actualizing potentials for well being and (healing)
by knowing participation in change” (Barrett 1990: 33).
Nursing Any setting where holistic nurses and clients knowingly choose
Practice to participate in change with the intention of assisting clients
Context to move toward their desired health patterns.
Essence Field A unitary perspective of energy assumes that everything in our
world is comprised of a universal essence. “ Universal essence is
comprised of matter, which is the potential for structure and identity;
information, which is the potential for coordination and pattern; and
energy, which is the potential for process, movement, and change.”
(Leddy,2003: 21). The fundamental unit of living and non-living
systems is a field ( Rogers, 1980) of universal essence… “ Human
and environmental essence fields are open, participating in a continuous
mutual process” (Leddy, 2003:22).
Health Assisting clients with their knowing participation in change through
Patterning the use of a unitary human science based nursing process including
ethical and legal parameters as established by provincial or territorial
nursing associations.
Pattern are the characteristics, experience, perceptions and expressions revealed
Manifestations in the client’s verbal and human-environmental essence field information
that inform the client and nurse about the client’s presenting field
patterns, major life themes and issues
Standards Are formal statements established to measure extent, value and quality.
CONCEPTUAL FRAMEWORK
CLIENT
The client of Holistic Nursing is any person who experiences difficulties living and
dying, who desires assistance in actualizing potentials for healing and well being through knowing participation in change. The client is viewed as a whole, unitary human being, and a unitary human
essence field in continuous mutual process with his or her environmental essence field. Clients
are health seekers concerned with the quality of their lives, searching for meaning and purpose
in life and ways to make changes.
HEALTH
Health is a value that is defined by individuals and cultures for themselves. Health is viewed as
“a process of actualizing potentials for ( healing) and well being by knowing participation in change”
( Barrett,1990:33). People participate in the life process by choosing and executing behaviors that
lead to fulfillment of their personal potential, meaning and purpose in life and well being. Well
being is a subjective perception of wholeness, harmony, balance and vitality of the human-
environmental essence fields.
NURSING
Nursing is a human science and an art. Nursing uses a unique body of knowledge of people
and their world to describe the boundaries in which the Registered Nurse practices. “The art of
nursing is the creative use of the science of nursing for human betterment and well being”
( Rogers, 1990: 6). The values that capture the art of nursing are “compassion” ( Rogers, 1988)
and “ unconditional love” ( Rogers, 1992). Nursing is based on a code of ethics. Professional
nursing practice is based on provincial / territorial and national standards of practice for
clinicians, educators, researchers and administrators.
Holistic nursing practice adds to general nursing practice a specialized and expanding body of
knowledge of whole, unitary human beings who are also unitary human essence fields in
continuous mutual process with his or her environmental essence field. In holistic nursing
practice, the nurse who is integral with the clients’ environmental field , intentionally
participates with the client to promote his or her well being and betterment. Effective and
knowing participation in change emerges from a clear identification and utilization of the
client’s strengths, assets, abilities and the client’s expressed desire to change. Nurses act as
advocates to protect or facilitate fulfillment of the clients’ health related choices provided
that they do not endanger others. Quality holistic nursing practice is demonstrated through
evidenced- based decision making and practice modalities that facilitate fulfillment of the
clients’ health patterning goals and desired health outcomes.
GOAL
The goal of holistic nursing care is to promote the betterment and well being of the client
by mutually participating with the client in changing health dynamics and direction of
change as defined by the client to:
1. strengthen the coherence and integrity of the human-environment essence field
2. stimulate mind / body / spirit healing.
3. facilitate life style changes and optimal quality of life.
4. facilitate awareness of feelings, thoughts, and attitudes related to perceived difficulties
with living and or dying.
5. enhance meaning and purpose in life and relatedness with self, others, nature , and / or
a higher power.
6. facilitate empowerment through the health patterning process.
7. facilitate self determination and advocacy of client generated health related choices that
do not endanger others.
NURSING PRACTICE CONTEXT
The context for holistic nursing practice is any setting where holistic nurses and clients
knowingly choose to participate in change with the intention of assisting clients to move
toward their desired health patterns. The holistic nurse and the client are human-
environmental essence fields in simultaneous, mutual process. The holistic nurse brings
intentionality, as a helping, healing professional with knowledge of a nursing conceptual
framework based on unitary human science, and commitment to serve the well being
betterment of the client. The client brings perceptions, thoughts, and feelings related to
his, or her experiences of self, others, nature and a higher power; perceptions of life experiences difficulties, desired health changes and actions toward change.
HEALTH PATTERNING PRACTICE METHODThe health patterning practice method assists clients with their knowing participation in change through the use of a nursing conceptual framework based on unitary human science,human- environment essence field theory and unitary energy-based modalities.According to Barrett ( 1990: 33) “Health patterning enhances clients’ capacity to transform themselves in creative mutual process with their environments”. In the “ pattern manifestation knowing process the nurse is continually apprehending ( the clients’) human-environmental (essence) field” ( Barrett, 1998:136). The second process of the health patterning practice method is “ voluntary mutual patterning which is defined as the continuous process whereby the nurse assists clients to freely choose with awareness ways of participating in their well-being” ( Barrett, 1998:136). This continuous “ process is comprised of sharing knowledge gained from the pattern manifestation knowing process (PMKP) both from the clients’ perspective and the nurse’s perspective, collective reflecting on the meaning of the pattern knowledge for the client’s health goals, and formulating intervention strategies and ( exploring unitary energy-based modalities) that reflect the nature of change desired by the client” (Cowling, 1990: 60).
A holistic nurse, using the health patterning practice method, will:
1. prior to the client nurse mutual process, prepare self by grounding and centering.
and make a specific intent to assist the client with their knowing participation in
change.
2. initiate the PMKP that may include acquiring information and knowledge related
to the client’s perceived life patterning difficulty and health events; lifestyle
parameters of health such as nutrition, work, leisure; sleep / wake cycles;
interpersonal networks; daily schedule and established routines; choices made
and how patterns evolved; recurring health issues; space-time shifts; health care
access and use; experience with health care providers; and changes desired or expected.
3. use a pendulum and hand scan to apprehend the human-environment essence field and
other health assessment tools or techniques to identify emerging patterns and their
manifestations. Discusses the findings / manifestations with the client to facilitate further
awareness and / or meaningful connections.
4. validate the pattern information , emerging patterns and their manifestations with the
client.
5. initiate the Voluntary Mutual Patterning Process (VMPP) to involve the client in knowing
participation in change by setting mutually determined client intentions and health outcomes,
exploring non-invasive modalities and strategies that reflect the nature of change desired
by the client and that are appropriate for healthful patterning change.
6. initiate an evaluation process that: documents health patterning changes related to each
client intention, facilitates the making of informed decisions about the effectiveness of
a modality, strategy, lifestyle change or other behavior or event in creating change.
STANDARD STATEMENTS
1. Professional Responsibility
The holistic nurse is personally responsible and accountable for ensuring that their holistic nursing practice and conduct meet the standards of the profession and the legislative
requirements in the province or territory in which the holistic nurse is registered to practice.
Indicators
1.1 The holistic registered nurse is accountable at all times for their own actions.
1.2 The holistic registered nurse follows current legislation, standards and policies relevant
to the practice of nursing
1.3 The holistic registered nurse questions policies and procedures inconsistent with
therapeutic client outcomes, best practices and safety standards.
1.4 The holistic registered nurse practises competently.
1.5 The holistic registered nurse engages in and supports others in maintaining continuing
competence.
1.6 The holistic registered nurse regularly assesses their practice and takes the necessary
steps to improve personal competence.
2. Knowledge-Based Practice
The holistic nurse continually strives to acquire knowledge and skills consistent with a
nursing conceptual framework based on unitary human science, human-essence field
theory and energy-based nursing practice.
Indicators
2.1 The holistic nurse supports decisions with evidence-based rationale.
2.2 The holistic nurse acquires knowledge of holistic nursing through formal and informal continuing education opportunities in the work setting.
2.3 The holistic nurse acquires knowledge and practice with unitary energy-based modalities and strategies to promote human-environment integrity and wellness.
2.4 The holistic nurse documents timely, accurate reports of the health patterning practice method with each client.
2.5 The holistic nurse demonstrates critical thinking in all aspects of the health patterning practice method with each client.
2.6 The holistic nurse uses appropriate information and unitary energy-based modalities , strategies and resources that enhance the client moving toward their desired health patterns.
2.7 The holistic nurse supports, facilitates or participates in research relevant to holistic
nursing.
3. Health Patterning Practice Method
The holistic nurse consistently provides person-environment care that facilitates the client’s
knowing participation in change and movement toward desired health patterns and well being.
Indicators
3.1 The holistic nurse practices with honesty, integrity and respect and complies with the Canadian Nurses Association Code of Ethics for Registered Nurses (2002)
.
3.2 The holistic nurse prepares self through centering and grounding exercises that create
ability to be fully present with the client in meaningful dialogue.
3.3 The holistic nurse enhances awareness of thoughts, feelings and attitudes in relation to
difficulties and strengths of living and dying.
3.4 The holistic nurse promotes awareness of human life patterns that facilitate well being
and those patterns that create difficulties.
3.5 The holistic nurse validates and facilitates desired client intentions and outcomes.
3.6 The holistic nurse provides health education and access to health care information.
3.7 The holistic nurse facilitates access to the health care system and health care providers.
3.8 The holistic nurse enhances the clients’ sense of feeling empowered.
3.9 The holistic nurse provides information and experience with unitary energy-based modalities
3.10 The holistic nurse facilitates the enhancement of meaning and purpose in life and
relatedness with self, others, nature and a higher power.
4. Client Self – Determination
The holistic nurse provides care that facilitates client self-determination.
Indicators
4.1 The holistic nurse advocates for client generated choices that do not endanger others.
4.2 The holistic nurse promotes the clients’ right to autonomy, respect, dignity and privacy.
4.3 The holistic nurse facilitates the clients’ awareness of the connection between social
context and their health experience.
4.4 The holistic nurse facilitates the clients’ desire to be an active partner in community
health care planning and decision making.
5. Service to the Public
The holistic nurse provides nursing service in collaboration with the client, significant others and other health professionals.
5.1 The holistic nurse recommends, to the client, referrals to other health professionals.
.
5.2 The holistic nurse communicates client information with the clients’ consent
to other health professionals
5.3 The holistic nurse explains holistic nursing practice and its methods to clients and
others.
References
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Nursing Science Quarterly, 1, 50-51.
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Visions of Rogers’ science –based nursing (pp. 31-44). New York: National League for
Nursing.
Barrett, E.A.M. (1998). A Rogerian practice methodology for health patterning. Nursing
Science Quarterly, 11,4, 136-138.
Cowling, W.R. (1990). A template of unitary pattern-based practice. In E.A.M. Barrett
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League for Nursing.
Leddy, S.K. (2003). A unitary energy-based nursing practice theory: Theory and
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