The holistic approach can support a nurse to provide better care for a patient by understanding a patient’s, lifestyle, background, social class, culture, religious/spiritual values and social support and use this information to support recovery and sustained health. This level of engagement will allow the nurse to develop a trust relationship with the patient, allowing a therapeutic relationship to take place. Sherwood (1997, p.40) suggests that therapeutic relationships have an impact on healing patterns that make patients feel better. Sussex and Scourfield (2004, p.306) suggests that not only to people have needs they have ideas about their needs and these cover many areas of their lives. Therefore the therapeutic relationship will encourage the patient to be involved with their own care, recovery and can empower them to self advocate with involvement.
The white paper, valuing people 2001 suggests that as health care providers we should promote choice, independence, rights and inclusion for people with learning disabilities and the underpinning ethos is person centred and holistic care. In 1998 the Department of Health introduced the standard two: person centred care guidance directing the NHS and social care services treat older people as individuals and enable them to make choices about their own care. This would include takings into consideration the individual needs of a person and not just comparative needs or needs relating to illness. The importance of holism is being incorporated in to many care based initiatives to create a more patient focused service. valuingpeople.gov.uk/dynamic/valuingpeople4.jsp
When all the perspectives on holistic care are collated, it is possible to see that treating a patient holistically is not only important, but it is paramount from the period of admission, during assessment, care planning and discharge. It should be incorporated in all levels of nursing intervention as it is considered a macro approach by looking at the bigger picture as apposed to the micro problem or health problem. Pearson & Vaughan (1994, p.97) supports the view that holistic care treats the whole person and promoting holistic care as assessment and care planning which occur as an integral part of the relationship can be tailored to individual need.
The need for a holistic approach is also reflected in legislations and regulations and these statues require compliance. For example the Human Rights 1998 states that people have the right not to be discriminated against, right to respect for private and family life, freedom of thought, conscience and religion. By considering these rights it could be argued that we would be taking a holistic approach rather than treating patients as a condition; as apposed to an individual. In 2007 and the Mental Health Act was amended to remedy human right incompatibilities and the code practice changed to include recognition for diversity and sets a more holistic approach to patients care. Therefore importance of treating people holistically applies to all patients including marginalised groups.
The holistic approach embraces equality diversity and rights avoiding litigation and oppressive care practice. By looking at the person as an individual and engaging with the person we are working ethically, within legal frame works and codes of practice. We are putting the patient at the centre of all decisions made and supporting inclusion and involvement.
In conclusion there are many aspects of patient care and the holistic approach is about taking a more rounded view of a person their life and their lifestyle. It is more ethical is more likely to maintain or encourage a positive self concept/image or a balanced equilibrium. We have established that there are many elements and factors make up a person’s identity and we should consider these factors to ensure a patient maintains a sense of self and does not become diminished as a result of treatment or care provided. We need to comply with law and codes of practice to ensure that we keep patients and our selves safe. The holistic approach is one that should start at the point of contact to discharge. It is important when identifying need within multi agency working frame works and planning patient care. It helps to maintain independence and can in some cases have an impact on recovery. The holistic approach requires nurses to be more diverse, innovate and analytical, demanding a host of new skills that are required to undertake the role. Many nurses have evolved from working with medical facts and processes to working outside the box and co-coordinating care for individuals with complex needs. The holistic approach underpins how we practice and treat our patients.
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References:
Brown, J & Libberton, P. (2007) Principles of Professional Studies in Nursing. London: Palgrave Macmillan.
Dryden, W. (1995) Individual Therapy. Milton Keynes: Open university Press.
Pearson, A & Vaughan, B. (1994) Nursing Models for Practice. Oxford: Heinemann.
Sherwood, G.D, (1997) Meta-synthesis of qualitive analysis of caring; defining a theraoutic model of nursing. Advanced Practice Nurse, 3(1), 32-42.
Stevenson, C. Grieves .M & Stein-Parbom. J. (2004) Patient and person; empowering interpersonal relationships in nursing. Sydney: Elsevier Churchill livingstonte.
Sussex, F & Scourfield, P. (2004) Social Care. Oxford: Hinemann.
Weller, B.F. (2004) Nurses Dictionary. 23rd ed. London: Elsevier Limited
valuingpeople.gov.uk/dynamic/valuingpeople4.jsp (Accessed 30/4/2010)
(Accessed 30/4/2010)