By Quilvio Rodriguez DNP, PMHNP-BC, MSN, HNB-BC, BSN, RN
I would like to take this time to reflect on ways that I incorporate my holistic nursing awareness and knowledge gained from Pacific College of Health and Science’s RN-BSN Holistic Nursing program into my current practice. Currently, I am a psychiatric nurse practitioner at a public hospital in New York City working in the outpatient adult behavioral health department. The profession is unique in that we can both diagnose and treat mental illness through either psychotherapy or medication management, and, in some cases, applying both. Therefore, we function as psychiatrists and psychologists, being trained in both disciplines. My secret weapons are use of holistic modalities coupled with my background in complementary and alternative therapies.
Incorporating Holistic Nursing in Psychiatric Practice
As holistic nurses, we are aware of the complexity and uniqueness of each person’s healing journey. We help navigate treatments and are privileged to be a pitstop on their journey as we facilitate healing for our clients, all while striving to create meaningful connections through our use of presence, intention, and openness. Coming from this perspective, I sought an area of healthcare where I could go beyond the “pill as cure” treatment delivery medical paradigm. Although medications have their place in healing, they are not the only route for recovery. I am fortunate to work in a field where patients are open to my questions about finding meaning in their experience with illness/trauma, or how do you feel you can get out of your present challenge, or what is your reason for living- to be. I am pretty sure if I worked in medical-surgical or, the emergency department, these questions may get not more than a smirk or prompt dismissal from patients.
Exploring Theoretical Perspectives in Nursing
I am privileged to guide practice under the theoretical perspectives of 2 nursing theorists, including Margret Newman’s Health as Expanding Consciousness and Florence Nightingale’s Environmental Theory, and even some other non-nurse theorists, such as David Bohm’s Implicate and Explicate Order. Newman’s belief that one can continue to heal in the presence of illness is paramount in my treatment of chronic conditions like schizophrenia and bipolar disorder. Using her theory, I also attempt to help clients uncover their patterns of behavior over time. I ask questions like “Does this event remind you of something we spoke about in a previous session?”, “Does your current partner treat you the way someone in your family has treated you?”, or “Who is this person and are there any possible connections here?”. Pattern identification can be challenging yet rewarding in that it helps clients understand their lived experiences, allowing them to take ownership and find meaning in these events.
Utilizing Bohm’s Concept in Patient Care
Bohm’s concept of implicate and explicate order reminds us that each moment illustrates one version of how we have explicated/demonstrated ourselves in the holographic universe. He reminds us that the choice is always in our grasp. How we wish to be in the present moment- I dare ask how will you explicate tomorrow- what version of yourself will be revealed? Practicing under this theory, I am reminded that change is always possible, growth is always possible, and most importantly we are all made of the same stuff. The “same dough” as Professor Carla Mariano taught me. What we do with the dough, how we shape our mold it is up to us, but all of the essential ingredients are the same. We can share with humanity this knowledge regardless of our perceived differences in appearance, age, gender, ethnicity, or other qualities, as we all came from the same implicate order-base ingredients.
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Creating a Therapeutic Environment in Clinical Settings
Under Nightingale’s guidance, I have attempted to provide a comfortable environment in my tiny office, where stories are shared with me. In my windowless office you will find a giant print of a nature photograph. The photograph illustrates a path in a forest for people to walk through and there is gentle sunlight coming through the branches of dense foliage and trees. I imagine it to be a metaphor for a journey to recovery or healing. Amidst the overcrowding of plants, grass, and trees there is still a path (a way out) and warm sunlight (hope). I do not think my patients may see it this way, but that is the impression it left on me when I chose to get it for the office. There are also two orchid plants next to my computer, a Tibetan sound bowl I use for guided meditations and breathing exercise for anxiety, a tissue box with sustainable napkins made from discarded bamboo and tree bark, and some chairs that are not very comfortable, but are provided by the facility. I have yet to gain the courage to bring my tarot deck into the treatment plan (then I will truly be judged for my “peculiar ways” by colleagues). I believe there is a place for tarot in psychiatry as the images can promote openness and sharing of distant memories from clients. There is growing evidence in this field and I hope I can conduct my own research study one day.
Above is the photograph in my office. I continue to try to find ways to incorporate holism into my practice and have only shared a handful of ways I am able to bring these concepts into my practice. As an instructor of NR 300, I always look forward to reading how current students bridge the gap from theory to practice. Have a great rest of your semester!
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