While the essence of nursing has long been whole-person, body, mind, and spirit, and whole-system focused, In reality, the contemporary practice of nursing in many settings around the globe has become increasingly fragmented and destabilized. Nursing shortages in many parts of the world are significant, and hierarchies and bureaucracies often remove nurses from the point of care, be that the bedside, home, or clinic, replacing them with less-skilled workers and filling their time with documentation and other administrative tasks. Technology, while life-saving, also has the potential of creating distance between the nurse and the patient, particularly when the nurse attends more to the machine than the patient. These factors can contribute to a lack of meaning and connection that contributes to job dissatisfaction among nurses. Patients tell the story from a different point of view. Many experience a long parade of care providers who are too busy to actually care, or they encounter different nurses on every shift day after day, making it very difficult to establish a relationship that builds trust and confidence. In many settings, care has become so fragmented that care coordinators or care managers are required just to maintain some semblance of order. Stress in the healthcare environment also takes its toll on nurses. Burnout is a term used to describe workers reaction to chronic stress, and is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Burnout among nurses is high. It's estimated to be between 30-40 percent. It varies with different practice settings. Nursing requires the delivery of humane, empathetic, culturally sensitive, proficient, and moral care, while working in environments that often have limited resources. Nurses have increasing responsibilities. When nurses experience burnout, it impacts their personal wellbeing as well as the quality and efficacy of patient care. Nurses experiencing ongoing stress are more likely to eat poorly, smoke cigarettes, and abuse alcohol and drugs. Lack of self-care is a pervasive issue that adversely impacts personal health and wellbeing, patient care, and the organization as a whole. Are you experiencing stress or burnout in your work setting? Do you have strategies for managing stress and caring for yourself? Take a look at this week's resources if you are in need of help. At a time when the need for nursing globally is so great, and healthcare systems are fragmented and resources constrained, patients are demanding care that is more holistic and attentive to the whole person. Nurses are yearning to provide care that is aligned with the values that led them into the profession originally. Integrative Nursing is a framework for practice that is aligned with many nursing theories that get to the heart of what nursing is; the essence, or the core of nursing. While you were in school, you may have been introduced to important nursing theorists such as Martha Rogers, Margaret Newman, Dorothea Orem, or Jean Watson, or approaches such as relationship-based care. Each of these theorists have written about their ideas and concepts that focus on the ways that nurses interact with patients in their environment. While theory development is very important in the development of nursing science, nurses in practice often view theory as being abstract, and unrelated to their day-to-day practice. The principles of Integrative Nursing capture these commonalities among nursing theories, and as such, complement both historical and contemporary nursing theories. Integrative Nursing is not a theory, but the principles do provide a pathway for bridging the gap between theory and practice. Each principle has behavioral indicators that provide clarity and specificity as to what Integrative Nursing looks like in practice. Integrative Nursing also addresses the crisis of stress and burnout within the nursing profession through emphasizing the importance of self-care within its principles. Throughout this course, you will be introduced to the principles and practices of Integrative Nursing, and learn how to apply Integrative Nursing in your own practice. For now, here is a quick overview of the six Integrative Nursing principles. Human beings are whole systems inseparable from their environments. Human beings have the innate capacity for health and wellbeing across all dimensions: body, mind, and spirit. Nature has healing and restorative properties that contribute to health and wellbeing. Integrative Nursing is patient-centered and relationship-based. Integrative Nursing is informed by evidence and uses the full range of therapeutic modalities, moving from least intensive/ invasive to more depending on need. Integrative Nursing focuses on the health and wellbeing of caregivers as well as those they serve. In sum, we define Integrative Nursing as a way of being, doing, knowing that advances the health and wellbeing of people, families, and communities through caring and healing relationships. Integrative Nursing is not synonymous with holistic nursing, nor is it the same as complementary therapies. Though Integrative Nursing is holistic, whole person focused, and it does encompass the use of complimentary or integrative therapies and healing practices. Dr. Jean Watson discusses her theory of caring science, which is closely aligned to Integrative Nursing in the next video. After that, we will take a much deeper dive into the core concepts of Integrative Nursing.
