Conclusion: Gazing with Soft Eyes: Envisioning a Responsive, Integrative Healthcare System

Integrative nursing offers a way to transform our beleaguered healthcare system, offering new solutions and paths to a system that is responsive, person-centered, relationship-based that is also affordable, and accessible. The principles of integrative nursing offer additional clarity about nursing’s role in the delivery of care across patient populations and clinical settings to promote health and wellbeing as well as serves as a call to action in the policy arena. Integrative nurses not only provide care that supports wholeness and healing but serve as activists that advocates for a hopeful and inclusive healthcare system.

Integrative Nursing Education

Integrative nursing provides an opportunity for the discipline to return to its roots, transforming curriculum and programmatic that reflects our beliefs and values while honoring current scope and standards of practice and clinical guidelines. The principles of integrative nursing calls us to consider our students as whole people who come into our academic settings with lives full of rich and varied experiences that provide both gifts and challenges as they complete their educational programs. They also call us to re-consider the nature of our classroom, how we create and nurture relationships with students, how we use teaching/learning and evaluation strategies to fit our outcomes, and how we instill the need to care for self while caring for others. This chapter is a call to action for educators across programs.

Integrative Nursing and the Environment

This chapter focuses on how the external environment impacts health and wellbeing. Through an integrative nursing perspective, healthy environments are a critical component of whole person health, and the role of the integrative nurse in furthering the health of individuals and communities is explored in depth. The evolving roles within an integrative nursing perspective are addressed, including integrative nursing leadership in advocating for creating healthier communities and impacting public health policy. The chapter looks to the legacy of nursing in environmental health and the importance in the modern world to address the global issues influencing health and disease. The goal of the chapter is to heighten awareness of the influence of the environment in human health and the role of integrative nursing leadership to implement strategies and influence policies that support community health and the wellbeing of all people, local to global.

Creating Optimal Healing Environments

An optimal healing environment is created through the deep and dynamic interplay between people, place, process and culture. Over 1,000 papers have been published linking the physical environment to outcomes related to patients and staff. Integrative nurses are well positioned to be leaders in the planning of healing spaces. This chapter defines “healing environment”; describes research on the impact of the designed environment; and discusses the effects of such factors as nature, daylight, positive distractions, aesthetics (including color), and an ambient environment on health and wellbeing. A case study of an optimal healing environment using North Hawaii Community Hospital is presented.

Whole-Systems Leadership and Healing

Social issues in education, housing, employment and the environment are linked and have a major impact on health comes. Effective leadership is collaborative and grounded in the shared values of people who work together to effect positive change. Whole-systems leadership builds capacity for adaptability, learning, and innovation. In displaying whole-system leadership, integrative nurses much engage in deep listening, have an awareness of the systems in which they are operating, have an awareness of self, seek diverse perspectives, suspend and embrace uncertainty when appropriate, and be ready take adaptive action. This chapter discusses whole-systems leadership in the context of integrative nursing and healing.

Nutrition and Integrative Nursing

This chapter focuses on creating an optimal healing environment for not only a patient’s inner physiology but also for one’s psychological relationship with food through an integrative nursing perspective on nutrition. The concept of creating precision nutrition is explored along with food story, food ethics, and sustainable nutrition practices. Emerging ideas are addressed such as viewing food as information for the body and the resulting impact on inflammation, the microbiome, distressing symptoms, and disease. The chapter further highlights the vital importance surrounding the use of food as medicine. The goal of the chapter is to review the philosophies upon which an integrative nursing perspective on nutrition is founded and to provide a framework for practical clinical application of sustainable nutrition recommendations with patients.

Facilitating Lifestyle Change and Health Coaching

This chapter focuses on the role of the health coach in supporting individuals in achieving meaningful, lasting behavior changes that promote optimal health and wellbeing throughout the lifespan. Variations in the types and definitions of coaching within the health and wellness industry are discussed, as well as key differences between health coaching and therapy and/or counseling. Key concepts of behavior change are reviewed and how the health coach can utilize powerful, learned techniques that assist individuals in recognizing personal habits that may be preventing them from achieving personal goals. Finally, this chapter discusses current trends in using health coaches in healthcare and offers simple coaching strategies that nurses can be use during every patient interaction.

Integrative Nursing and Care of the Human Spirit

Life’s big questions and the search for meaning underlie all spiritual issues in healthcare, and so, conscious or not, the issues are already there. Thus, while the symptom of “spiritual distress” can arise in the healthcare context, it is important to identify it as a subset of a much larger focus for integrative nurses, namely, tending the human spirit. This chapter explores an integrative nursing approach to spirituality: how the integrative nurse tends the human spirit and addresses the symptom of spiritual distress if and when it arises. Issues covered include the moral, human, legal and ethical, and evidence imperatives to engage in an integrative approach. Tools for an integrative nursing approach and a case example are presented.

Advancing Wellbeing in People, Organizations, and Communities

Wellbeing goes beyond the management of disease or illness; it is a larger concept that is characterized by a general contentment in life and the way things are. This chapter uses the framework of the University of Minnesota Wellbeing Model to explore the evidence-based factors that influence wellbeing, including health, relationships, security, purpose, environment, and community. Mindfulness, a way of being that provides another core component of wellbeing, is defined and its evidence based discussed. Exemplars of wellbeing at the individual, organizational, and society level are described. Some applications of similar models in towns such as Albert Lea, Minnesota, Austin, Texas, and Santa Monica, California, are discussed, as well as initiatives in Canada and the UK.

Concepts and Principles of Integrative Nursing

The discipline of nursing has always had a holistic ontology and epistemology that aligns with the unitary paradigm. Yet nursing practice has not always been consistent with these perspectives. This chapter describes concepts and principles of integrative nursing, which offer a way of being-knowing-doing that advances the health and wellbeing of persons, families, and communities through caring/healing relationships in a manner that honors historical roots and transforms nursing care delivery. Six principles provide a framework that can shape the way nurses use evidence to select therapeutic strategies from the full range of possible interventions to support whole person/whole systems healing.