Global Activism, Advocacy, and Transformation

In almost every nation, the severe and chronic global nursing shortage continues to threaten the health and well-being of people across the globe. Florence Nightingale’s legacy of activism is closely aligned with integrative nursing and the United Nations Millennium Goals. Together, they lay out a bold agenda that calls nurses to a way of being-doing-knowing that embraces activism, advocacy and transformation. As 21st century Nightingales, our own deep personal and professional integrative nursing mission can continually transform our own lives, thus allowing each of us to become effective catalysts for human health and to sustain our change agency for global transformation.

Integrative Nursing in Sweden

In Sweden concepts of holistic care are well integrated in nursing curricula and health care legislation, but terms such as integrative nursing and integrative medicine is unfamiliar. A major challenge in Sweden is to inform and reform stakeholders in healthcare to acknowledge the benefits and value of evidence generated in (pragmatic-real world research) complex systems research since often integrative nursing methods are complex interventions where it is hard to rely on evidence of specific effects from individual elements of interventions. Experience based programs (on evidence informed integrative nursing practices) may be a key to create awareness among university staff, students, and future healthcare professionals of the qualities of integrative practices to promote and maintain health.

Integrative Nursing in Iceland

Icelandic entry level nurses remain one of the best educated in the world and appear to have a positive attitude regarding integrative approaches as do many of their patients. A more organized effort is needed in Icelandic health care facilities and by Icelandic nurses and educators to develop and promote integrative nursing in Iceland. There is a unique opportunity for further growth in integrative nursing in Iceland due to the excellent educational background of nurses in Iceland, its unique proximity to various natural resources and a broad cultural acceptance of integrative modalities in Iceland.

Continuing Professional Development for Integrative Nursing

Nursing professional development (NPD) is a career-long continuum of formal and informal educational activities informed by wide-ranging sources of clinical, practice, scientific and theoretical evidence. An environmental scan indicates a plethora of professional development opportunities in integrative nursing with offerings across multiple learning platforms (symposia and conferences, residential intensives, online asynchronous sessions, asynchronous media-supported classes and agency-supported in-service sessions) and multiple venues. Several professional organizations, universities, and private companies offer opportunities to develop knowledge, skills, and abilities that prepare nurses to competently care for self and patients.

Integrative Nursing in the Community

This chapter discusses integrative community health nursing, providing a model to guide practitioners as they address the physical, psychosocial and spiritual needs of individuals, families, communities and society overall. Community health nurses are in a prime position to comprehensively assess needs of community members, and integrate beneficial and culturally based healing interventions. At all levels of care, integrative community health nurses establish strong caring relationships, recognize the importance of cultural beliefs and values, and incorporate therapies to nurture the body-mind-spirit, resulting in whole person/system healing. Exemplars of integrative nursing are presented to illustrate creative possibilities for community health and wellness.

Integrative Nursing Management of Depressed Mood

Integrative mental health nursing is founded on the principles of whole person, relationship-based care provided within the personal, lived context, and the use of the best range of evidence-informed interventions to support the individual’s mental health and healing. Using a case study, this chapter describes the integrative mental health nursing approach for the holistic assessment of mood and the collaborative approaches developed by the psychiatric/mental health nurse practitioner and client to reduce her mood symptoms and promote mental health.

Facilitating Lifestyle Choice and Change

Creating optimal well being is a multifaceted, complex process. It involves many biological, psychological, physical, behavioral, emotional as well as neurobiological factors which all interact and effect the choices we make and changes that we are able to implement. Research has begun to connect with the decision making process to better understand how our decisions and choices are made. This research coupled with research and evidence based models provides integrative nurses and patients with validated tools to optimize change and wellness.

Creating Optimal Healing Environments

Creating an optimal healing environment requires attentiveness to the built environment as well as care processes, culture, and competencies of care providers and leadership. There are over 1,000 studies that link the physical environment to outcomes such as health care quality, patient safety, reduction of stress and improvements in patient safety. Key design elements highlighted include access to nature, access to daylight, positive distractions, and the ambient environment.

Building an Integrative Health Program

In response to the changing healthcare environment, clinical care transformation can support the strategic goals of organizations. The creation of relevant and successful model(s) begins with a thorough assessment including the voices of all stakeholders. Program design is an iterative process that includes proto-typing, ongoing education and program evaluation. To ensure sustainability, patient outcome measures and employee feedback are an integral part of the new clinical care model.

The Integrated Nurse

The nurse and the healer are one and the same in the integrated, holistic nurse. Yet many of us have forgotten our heritage as healers as we have become immersed in the sick-cure paradigm that continues to dominate healthcare. This chapter explores the opportunity for integrative nurses to reclaim their roots as healers in the lineage of Nightingale, becoming instruments of healing in service to life. The way of the healer is explored as a potential spiritual path for nurses who wish to follow Nightingale in awakening the diving spirit of love within.