Holistic Health and Spirituality

In this article we will explore the fairly new Whole Person Caring Model (WPCM) and review relevant published literature. Originally searching The Cumulative Index of Nursing and Allied Health Literature (CINAHL), out of 673 articles that came up while searching in terms wholistic health, holistic, nursing models, three articles were directly relevant to the framework of Whole Person Caring Model.  Medline, ProQuest and Google Scholar were also explored for direct framework articles, yielding no results. After contacting the author Thornton by email, she sent a few more relevant articles and directed me to her Web site, providing additional information on the WPCM she wrote.  Thornton speaks to the model’s efficacy in helping hospitals decrease costs and improve patient satisfaction and included additional articles that speaks about two of the key concepts the model provides and how they were implemented (Personal Communication, Lucia Thornton, May 1, 2011). The Whole Person Caring Model (WPCM) incorporates physical, mental, emotional and spiritual aspects of patients and nurses life to improve one’s health (Thornton, 2010).

Review and Synthesis of Literature Related to Whole Person Care Model

The Whole Person Caring Model is born from experience and derived from nursing, physics and system analysis theories. It provides a framework for organizations to create a healing and nurturing environment for consumers (patients) and healthcare personnel (nurses). WPCM is easy to understand and interdisciplinary, having a practical application, that embraces our infinite and spiritual nature (Thornton, 2005). WPCM is considered a behavioral model for creating healing and transformational relationships (Donadio, 2005). WPCM is also an award -winning model that provides a common framework so various disciplines and cultural backgrounds are effectively able to work together to provide quality and compassionate care services. Thornton (2010) states the WPCM defines who we are from a more expansive and holistic perspective.  The model transcends the current paradigm and acknowledges the energetic and spiritual nature of our existence.  This viewpoint helps us perceive the inherent unity of life by moving beyond our cultural, religious, social and economic differences. The WPCM is based on nursing theorists Jean Watson, Martha Rogers and Florence Nightengale. Thornton, Gold and Watkins (2002) define person as “an energy field that is infinite and spiritual in essence and in continual mutual process with the environment. Each person manifests unique physical, mental, emotional and social-relational patterns that are interrelated, inseparable, and continually evolving.” Environment is defined as “An energy field beyond and inclusive of the person. Because person and environment are in a state of constant mutual process, there is no distinction from an energetic perspective” (Thornton et al., 2002). Health is defined as “The subjective experience of well-being” (Thornton, 2005). Thornton (2005) defines Whole Person Caring Model as “the delivery of care and services to promote well-being. Whole-person caring is based on the concepts of sacredness of being; therapeutic partnering: self-care and self-healing; optimal whole-person nourishment; transformational health care leadership; and caring as sacred practice” (Thornton, 2005). Spiritual is defined as:

The spiritual dimension is a unifying field that integrates the physical, mental, emotional, and social/relational aspects of being. The spiritual dimension is the essence of self and also transcends the self. It is our closest, most direct experience of the universal life force. (Thornton et al., 2002)

Tjale and Bruce (2007) conducted a qualitative, interpretive, explorative and contextual research design study to gain understanding and meaning of holistic nursing. A series of searches of the EBSCO Host, CINAHL, OVID, MEDLINE, Pubmed, PsycINFO, Medline and Sociological databases were completed to conduct an analysis of the concept and meaning of holistic nursing care.  The following search criteria and search terms were used: “holistic nursing care and definition, holistic care and

holism, holistic nursing care and health, holistic nursing care and child, holistic nursing care and paediatrics, holistic nursing care and pediatrics, holistic care and complimentary medicine”(pg 45). Seventy-seven articles on holistic nursing care were analyzed and labeled according to criteria.  Rodgers' evolutionary method was utilized to conduct the concept analysis and the objectives of this study were set in two phases:

1. Phase one was conducted to analyze the concept of holistic nursing care and obtain viewpoints of holistic nursing care from paediatric nurses working in academic hospitals.

2. Phase two the identified the characteristics and dimensions and characteristics of holistic nursing care to develop a framework of holistic nursing care for paediatric nurses working in academic hospitals and to validate and refine the framework for paediatric nursing. 

Varying qualitative and quantitative studies indicate the most prominent findings were the similarity of definitions and descriptors of holistic nursing care observed from many disciplines. Attributes of holistic nursing care yielded two dimensions: whole person and mind-body-spirit dimension. The indicated descriptors of whole-person include physical, mental, emotional and spirit. Spirituality is the predominant antecedent. Holistic nursing care is described to be the recognition of an individual as a spiritual being with a mind-body-spirit dimension. Spirituality is a present force pervading all human experience and existence. Complimentary alternative medicine (CAM) was identified as a surrogate term. The connection of CAM with holistic nursing care is the focus of therapeutic interventions that are directed to the mind-body-spirit dimension and are designed to meet the needs of the whole-person (Tjale & Bruce, 2007). Clark (2008) informs us that we are now the only country in the world that does not prepare and require a nurse, to quote the International Council of Nurses’ policy, “the capacity and authority to practice competently primary, secondary, and tertiary care in all settings and fields of nursing.” Clark (2008) notes that nursing education tends to favour a hospital-based, task-oriented training curriculum leaving specialty and community based education out. Clark (2008), states that many nurses who claim to offer holistic care, really don’t have a full understanding of holistic care and makes an observation that nurses are unable to meet the mental health needs of adult patients, people with mental illness are nursed by nurses who are unable to meet their physical health needs, and children are taken care of by nurses who know little about child development. 

Finfgeld-Connett (2008) conducted a meta-syntheses qualitative study from articles developed between 1993 and 2007 for the convergence of three nursing concepts: art of nursing, presence and caring. Results led to development of a theoretical framework of nursing practice to illustrate the areas of convergence among the concepts: art of nursing, presence and caring. Nursing involves an intimate relationship-centered partnership between the patient and nurse. A value system of holistic beneficence and patient empowerment are based on specific nursing actions are derived from multiple forms of personal and professional knowledge. Nursing actions are promoted by a conducive work environment and result in enhanced well-being among patients and nurses. Continued research and work is recommended to expand the proposed framework, especially due to the wide variety of nurse–patient relationships that exist. The art of nursing, presence and caring take place within an atmosphere of interpersonal sensitivity and intimacy, which is characterized by open and honest interactions.

Personal insights are disclosed in verbal and non-verbal ways, and the nurse unobtrusively grasps the patient’s needs and responds in a kind and compassionate way. Empathy is expressed through words and actions, and a supportive nurse–patient partnership is cultivated.  Additionally, the art of nursing, presence and caring take place within an atmosphere of interpersonal sensitivity and intimacy, characterized by open and honest interactions. Nurses then unobtrusively grasp the patient’s needs and respond in a kind and compassionate way, while a supportive nurse–patient partnership is cultivated (Finfgeld-Connett, 2008). 

Gold (2003) emphasizes that caring simply comes from our hearts and nurses need to speak and listen from their hearts. The Whole Person Care Model considers caring for people as sacred work. There are many differences between the biomedical model and the Whole Person Care Model. As the biomedical model has an organized structure depicted as a pyramid with the most valuable people on the top, the WPCM requires therapeutic partnering which all parties are respectful and non-hierarchical. To aid in nurse and patient satisfaction the interdisciplinary model encourages mentoring programs and does not tolerate negativity as this is a reflection of the care the patient receives. The model encourages an atmosphere of cooperation, unity, cohesiveness, continuity of care, productivity and creative synergy in the workplace to provide patients with optimal care and nurses with job satisfaction. It encourages that self-care is an absolute crucial element in employee satisfaction and subsequently organizational health and wellbeing (Gold, 2003). 

Review of Literature related to Holistic Nursing and Nurse/Patient Satisfaction 

The WPCM pilot study, funded by Union Hospital enrolled 50 patients from the Cardiac Rehabilitation Department at Union Hospital in Lynn, Massachusetts, which is part of the North Shore Medical Center and a member of the Partners HealthCare System, founded by Massachusetts General Hospital and Brigham and Women's Hospital, both teaching hospitals of Harvard Medical School. Study population included a heart transplant recipient, patients with varying levels of heart disease, patients with multiple pathologies and patients who were obese, alcoholic and addictive. The patients were initially evaluated using SE-36, a quality of life validated survey instrument widely used to measure quality of life, as well as the Clinical Data Collection Inventory (CDCI), a non-validated internal instrument. Patients were contacted by letter, those agreeing to participate completed SF-36 and CDCI questionnaires and met with a whole health educator for a series of 6 one-on-one sessions. Six months later they completed the SE-36 and CDCI again to reevaluate treatment. Pilot studies were compared to historical data. The historical data included cardiac rehab patients without receiving WPCM. These patients completed baseline and follow-up (6 months) SF-36 and CDCI questionnaires as well. 

Six certified whole health educators and six New England School of Whole Health Education (NESWHE) interns participated. The principal investigator for the pilot study is a cardiologist and Medical Director of the Department of Cardiac Rehabilitation at Union Hospital.  The investigational review board at Union Hospital approved the study. The focus and intention is to bring the nurse and physician toward in-the-moment, compassionate, relationship-centered care regardless of the amount of time spent with the patient and becomes the foundation for all future interactions.  This study is not considered a controlled study and was not powered to reach statistical significance. According to Pelzang (2010) healthcare is rapidly changing to provide Patient Center Care (PCC), which is treating our patients as unique individuals. This standard of practice demonstrates respect for the patient, as a person and taking into consideration the patient’s circumstances and point of view in the decision-making process regarding their healthcare. PCC needs a clear definition and methods of measurement, as implementation has been hampered due to lack of understanding the core elements of PCC by nurses and healthcare providers. The underlying philosophy of PCC is to understand the patient as a person rather than as a cluster of diseases.  PCC is considered to come from a systems model and a process model. The basic aspect of PCC is to respect, care and consider the patient as a whole. Pelzang (2010) found during his literature review that PCC indicates improved continuity of care and integration of nurses and health professionals collaborating on behalf of their patients, increasingly providing autonomy to patients, empowering staff members to plan and execute their work in ways that are most responsive to the patient needs, wants and preferences. Providing patients with abundant opportunities to be informed and involved in care decision-making. Furthermore, PCC is considered to deliver more holistic care; facilitates a team approach, shifts emphasis to total body care; enhances communication skills between relatives, patients and healthcare providers, as well as between family members. The outcome of PCC for the patient includes: satisfaction with care, involvement with care, improved health, feeling of well-being and creating a therapeutic culture.

Miller et al. (2008) conducted a Qualitative study and collected data in 2006 using non-participant observation, shadowing and semi-structured interviews with nursing, medical and allied professionals in the internal medicine wards of three urban hospitals in Canada. The findings of the study indicate nurses’ collaborations with other professionals are influenced by emotional work considerations. The establishment and maintenance of a nursing esprit decorps corridor conflicts with physicians, and the failure of the interdisciplinary team to acknowledge the importance of nursing’s core caring values are important factors underpinning nurses’ interprofessional disengagement. The conclusion is that longstanding emotion work issues must be addressed before nurses will engage collaboratively. We suggest improving nursing collaboration through the refining of holistic nursing information, and reflections on practice by all interprofessional team members.

Agrimson and Taft (2009) states the term spiritual crisis has been used ambiguously in the literature, resulting in lack of clarity. A holistic approach includes spirituality in nursing care of the whole person. Articles with search terms spiritual crisis, spiritual emergency, spirituality and life crisis between 1998 and 2007 were retrieved for analysis. Using Walker and Avant’s method of concept analysis, a definition of spiritual crisis was identified. Spiritual crisis is often described as a unique form of grieving or loss, with a profound questioning of lack of meaning in life, in which person or community reaches a turning point, that leads to a significant change in the way life is viewed. Possible reasons for this include loss of important relationships and sudden acute illness. The results of the study indicate people that are experiencing terminal illness, depression, or grieving may be at special risk for a spiritual crisis. The literature suggests that an interdisciplinary approach, nurses’ self-exploration of their own spirituality, and the ability to refrain from defining spirituality by religious affiliation will help improve nursing practice and patient centered care.

Summary

Whole Person Caring Model, holistic nursing and spirituality are intertwined. Articles articulating that mind, body and spirit makes up the patient as a whole and all aspects need to be treated for holistic health care practices.

Conclusions

• Further research using the WPCM is indicated

• WPCM comes from nursing theorist Florence Nightengale, Martha Rogers and Jean Watson

• WPCM indicates each person is a unique individual with physical, mental, emotional and social-relational aspects  

• Interdisciplinary approach to nursing care is indicated having nurses first exploring their own spirituality

• The term spiritual crisis is a unique form of grieving or loss questioning of the meaning in life that leads to a significant change in the way life is viewed

• Most nurses do not have a clear understanding of holistic care 

• Incorporating a patients’ spirituality is lacking in most nursing practices

• Holistic health is considered somewhat synonymous with spirituality 

• The studies show a correlation between holistic care and service indicating a positive professional and scholarly perspective 

References

Agrimson, L.B., & Taft, L.B. (2009). Spiritual crisis: A concept analysis.  Journal of Advanced Nursing, 65(2), 454-61.

Clark, J. (2008). Protectionist nurses stand in the way of truly holistic patient care. Nursing Standard, 22(29), 26. 

Donadio, G. (2005). Improving healthcare delivery with the transformational whole person care model. Holistic Nursing Practice, 19(2), 74-77.

Finfgeld-Connett, D. (2008). Qualitative convergence of three nursing concepts: Art of nursing, presence and caring. Journal of Advanced Nursing, 63(5), 527–534.

Gold, J. (2003). Therapuetic partnering and caring as a sacred practice. Bridges ISSSEEM Magazine, 14(2), 8-17.

Miller, K., Reeves, S., Zwarenstein, M., Beales, J.D., Kenaszchuk, C., & Conn, L.G.  (2008). Nursing emotion work and interprofessional collaboration in general internal medicine wards: a qualitative study. Journal of Advanced Nursing, 64(4), 332-343.

Pelzang, R. (2010). Time to learn: understanding patient-centered care.  British Journal of Nursing, 19(14), 912-917.

Thornton, L. (2005). The model of the whole person caring, creating and sustaining a healing environment. Holistic Nursing Practice, 19(3), 106-115.

Thornton, L. (2010). Creating Healing Environments for individual, communities and organizations. Retrieved from http://www.luciathornton.com

Thornton, L., Gold, J., & Watkins, M. (2002). The art and science of whole-person caring: an interdisciplinary model for health care practice. International Journal for Human Caring, 6 (2). 38-47.

Tjale, A.A., Bruce, J. (2007). A concept analysis of holistic nursing care in paediatric nursing. Curationis, 30(4): 45-52.

Maslow Hierarchy of Needs and Behavior Change

    Abraham Maslow is a well know Psychologist, many nursing schools base their teachings on Maslow's hierarchy of needs. Which in general terms appear to be simplistically laid out. But when looking deeper into Maslow's work, it is not simplistic at all. Maslow outlined principles of self-actualization theory, he emphasizes encouraging our inner nature, and when we deny or suppress expressions of our inner nature is when one experiences illness.

    During my recent research, there are so many aspects to his work.  The depth and realizations of who we are, illness, health, wholism, psychology, spiritual issues and behavior change are a few. He speaks of "deficiency needs" and if they are not met we do not function well. This carry's into all levels within the hierarchy. Obviously for example, if someone is starving, they must meet that deficiency need to maintain health, otherwise illness or death will result. Now looking at it more complex, apply defiency needs to all levels, safety, belonging and self-esteem needs. Maslow states we still must meet these deficiency needs to maintain health and avoid illness - for example, psychopathology may occur if any of those are deficiency needs are not met. Very insightful.
   
    More interesting I am intrigues with behavior change and the drive behind successful change. There are so many contributing factors when dealing with change that we will address in another blog, but Maslow hits this one on the head as well. Looking at it on such a deep innate level, making it easy to understand and difficult to deal with. He goes on to say that INSIDE US ARE TWO SET OF FORCES:

1. ONE THAT CLINGS TO SAFETY AND DEFENSIVENESS OUT OF FEAR
2. ONE THAT URGES US TOWRD WHOLENESS AND FULL EXPRESSION OF OR TRUE SELVES.

    Again looking at expressing our true nature, if we deny that and cling to safety and defensiveness out of fear - illness will result. Look at your own lives for a second and think of one example or behavior that you can identify you function thru fear and defensiveness, because it may be all you know, it is the safe thing to do you think. But then look and see if there is success in that aspect or situation in your life.

    So let the fear and clinging to safety go and see how you can feel your own true expression of your inner self. I am not saying this is easy, It is the opposite of easy, but what it takes to make positive changes in your life!!!  Good luck

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Hierarchy of Needs

Self-Actualization
Esteem Needs
Belonging Needs
Safety Needs
Physiology Needs

Please visit www.chandraklaiber.com for more information.

Arlowski, M. (2009). Wellness Coaching for a Lasting Lifestyle Change. Duluth, Minnesota: 

          Whole Person Associates.

 

Whole-Person Caring Model

Whole-Person Caring Model (WPCM) 

Uniqueness of WPCM

•  Interdisciplinary 

•  Easy to Understand 

•  Practical Application 

•  Re-defines who we are 

•  Embrace our infinite and spiritual nature 

(Thornton, 2005)

Framed around Nurse Theorists 

Florence Nightingale – “ We are the reflection of the divine, with

physical, metaphysical and intellectual attributes” 

(Thornton, 2005).

Martha Rogers describes each person as: “ irreducible, indivisible, pandimensional energy field that is open and infinite in nature, and inseparable from the environment” (Thornton, 2005).

Jean Watson’s contemporary theory states, “ We are sacred

beings (and) we must regard ourselves and others with

deepest respect, dignity, mystery, and awe” (Thornton, 2005).

Model of Whole-Person Caring theory & framework is derived

•  Nursing Theory 

•  Physics Theory 

•  Systems Theory

(Thornton, Gold, & Watkins, 2002)

Key Concepts of the WPCM 

•  Sacredness of being

•  Therapeutic partnering 

•  Self-care and self-healing 

•  Optimal whole-person nourishment

•  Self-care and self-healing 

•  Optimal whole-person nourishment 

•  Transformational healthcare leadership, and 

•  Caring as a sacred practice 

(Thornton, 2005)

WPCM Definitions 

•  Person

•  Environment 

•  Health 

•  Whole-Person caring 

•  Spiritual

Person

Thornton et al. (2002) defines a person as:

“The art and science of whole-person caring defines person as an energy field that is infinite and spiritual in essence and in continual mutual process with the environment. Each person manifests unique physical, mental, emotional and social-relational patterns that are interrelated, inseparable, and continually evolving”.

Environment & Health 

“An energy field beyond and inclusive of the person. Because person and environment are in a state of constant mutual process, there is no distinction from an energetic perspective” (Thornton et al., 2002).

Health 

“The subjective experience of well-being” (Thornton, 2005).

Whole Person Caring 

“The delivery of care and services to promote well-being. Whole-person caring is based on the concepts of sacredness of being; therapeutic partnering: self-care and self-healing; optimal whole-person nourishment; transformational health care leadership; and caring as sacred practice” (Thornton, 2005).

Spirit 

“The spiritual dimension is a unifying field that integrates the physical, mental, emotional, and social/relational aspects of being. The spiritual dimension is the essence of self and also transcends the self. It is our closest, most direct experience of the universal life force” (Thornton et al., 2002).

Concept of Whole-Person 

•Self – Realization

•Emotional 

•Physical 

•Social/Relational 

•Mental

•Spiritual Energy Field 

•(Field of Love) 

(Thornton, 2005)

Development of WPCM 

The Model of Whole-Person Caring was created while Three

Rivers Community Hospital was developing a curriculum with the purpose to create a healing and nurturing environment for both patients and employees (Thornton, 2005).

The New England School of Whole Health Education conducted

A 2-year pilot study, and a behavioral model for creating healing for patients as well as for practitioners and others in the work environment (Donadio, 2005).

Proven Effectiveness 

At Three Rivers Community Hospital, Oregon, the theoretical

WPCM has resulted in quantifiable and sustainable results in the areas of:

•  Increased patient satisfaction 

•  Increased employee satisfaction 

•  Decrease nursing turnover, below the National average 

•  Increased integration of organizational values by employees 

•  Enhanced healing environment 

(Thornton, 2005)

The New England School of Whole-Health Education illustrated its congruency and demonstrated the transformational effects of whole-health education in an educational setting during a 2-year pilot study in 1997 (Donadio, 2005).

Leadership within WPCM 

•  Assess organization’s ideology and culture 

•  Elicit support of key people 

•  Customize strategies for implementation 

•  Involve everyone 

•  Honor and recognize exemplary people 

•  Initiate programs for personal growth and transformation 

•  Incorporate whole-person caring concepts in performance

criteria

References

Donadio, G. (2005). Improving Healthcare Delivery with the

Transformational Whole Person Care Model. Holistic Nursing Practice 19(2) 74-77.

Thornton, L. (2005). The model of whole-person caring: Creating and

      sustaining a healing environment. Holistic Nursing Practice 19 (3),

      106-115.

Thornton, L., Gold, J., & Watkins, M. (2002). The art and science of 

     whole-person caring: an interdisciplinary model for health care

     practice. International Journal for Human Caring 6 (2). 38

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Nurse Theorist Quote's

"We are a reflection of the divine, with physical, metaphysical, and intellectual "We are a reflection of the divine, with physical, metaphysical, and intellectual attributes."   - Florence Nightingale

“The process and outcome whereby thinking and feeling people, as individuals or in groups, use conscious awareness and choice to create human and environmental integration.” Callista Roy

Martha Rogers describes each person as,

“ Irreducible, indivisible, pandimensional energy field that is open and infinite in nature, and inseparable from the environment.”

Jean Watson’s contemporary theory states, 

“ We are sacred beings (and) we must regard ourselves and others with deepest respect, dignity, mystery, and awe”.

Stress Affirmations

 By: Chandra Klaiber, RN

 Use these powerful words to

 transform you life thru your

 intentional thoughts.

       

Mindful Affirmations

Love Corner Blog

Quotes on Love 

By: Chandra Klaiber, RN

Quote By: Merle Shain

"Many of us spend our lives saying we would give anything for love, while we're often really pushing it away."

Quote By: Marianne Williamson

"Love is what we were born with. Fear is what we learned here."

Quote By: Anonymous

"You can close your eyes to the things you do not want to see, but you cannot close your heart tot he things you do not want to feel."

Quote By: Houssaye

"Tell me whom you love and I will tell you who you are."

Quote By: Oprah Winfrey

"Lots of people want to ride with you in the limo, but what you want is someone who will take the bus with you when the limo breaks down."

Quote By: Jalal ad-din Rumi

"Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it."

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Affirmation Corner

Enjoy this wonderful, upbeat affirmation corner. Look daily for new positive affirmations. You can think them in your head, say them aloud, write them down, even write them and hang around to see them to remind you to think them. These can reprogram your mind and improve your health and happiness.

By: Chandra Klaiber

        Here are some simple basic positive affirmations to start. These are fundamental and can be used all day everyday throughout our lives. These very powerful thoughts will produce change in your life. You can make your own affirmations and customize them for your specific issues you would like to work on. Continue to watch for many many more enlightening thoughts. This is such a great way to improve anything in our lives. There are no side or adverse effects ever. If you are finding it difficult to use these as often as you would like, just keep trying, eventually your mind will get the hang of it and you will think about positive thoughts and affirmations without even knowing it. GOOD LUCK!!!

* I AM VERY HAPPY!

* I AM HEALTHY!

* I LOVE MYSELF!

* I AM LOVED!

* UNLIMITED PROSPERITY FLOWS IN MY LIFE!

* I AM AT PEACE!

* I AM VERY SUCCESSFUL!

* I AM ABUNDANT!

* I AM FILLED WITH JOY!

* I AM GRATEFUL FOR__________________________. Fill it in everyday with something new.

* I AM GIVING!

        So far these are very simple and fundamental positive thought words and phrases. Please feel free to expand on them and make them personal with your name and your circumstances.

With Love, Chandra

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Thoughts on Nursing Theory

Quote:

“Caring is the essence of nursing.”

-Jean Watson

        

            My philosophy of caring, values, and belief system are amazingly similar to all of the Watson’s 10 carative/caritas assumptions. All relevant at different level’s of my own philosophy. Watson’s first carative factor formation of a humanistic altruistic system of values (Alligood, 2010) ascertain my beliefs of loving-kindness, sharing sense of self with a deep caring consciousness. This typically learned at an early age is believed to be changes within a patient through nurse education (Alligood & Tomey, 2010).

            Watson’s second carative factor, instillation of faith-hope (Alligood, 2010) is one of the strongest and closest to my philosophies. Positive and wholistic health seeking behaviors along with teaching the patient and giving them the tools and support to take care of themselves. The third carative factor, cultivation of sensitivity to self and to others, being genuine authentic and sensitive to others (Alligood, 2010). Nurses must be in touch with their feelings and have a strong recognition of self-acceptance and self-actualization (Alligood & Tomey, 2010). My philosophy directly correlates to the caritas process that going beyond the ego and being in touch with our transpersonal self and self-spiritual health. 

            Developing of a helping-trust relationship is the fourth carative/caritas (Alligood, 2010) and is so important in the relation to my philosophy that a trusting transpersonal caring relationship with empathy helps to understand the person’s perceptions and feelings ultimately creating a bond and increasing effective communication. The fifth carative factor, promotion and acceptance of the expression of positive and negative feelings, recognizes that intellectual and emotional actions and reaction will differ in all situations. The safe expression of positive and negatives feelings encourage sustaining the care transpersonal relationship developed between patient and nurse or Nurse Practitioner (Alligood, 2010). 

            Systematic use of the scientific problem solving method for decision-making is the sixth carative (Alligood & Tomey, 2010). My philosophy and the caritas process both strongly support the artistry and expertise in caring-healing practices. The seventh carative factor promotion of interpersonal teaching-learning (Alligood & Tomey, 2010) is strongly ascertain with my beliefs that this technique of shifting the patients responsibility to the patient, to provide self-care and personal growth. Provision for supportive, protective, and corrective mental, physical, socio-cultural, and spiritual environment is the eight carative factor (Alligood, 2010) and again directly relates in my philosophical beliefs that to create well-being, these entire factors must be looked at and taken in consideration when treating the patient as a whole. Assistance with gratification of human needs agrees with my philosophy that taking care of self and intra-personal needs of self is just as important as taking care of patients. Recognition needs extend to; psych-physical self, biophysical self, psychosocial self is which are all inter-related and need to be nourished. The tenth carative allowance for existential-phenomenological forces, indicate spiritual care for self (Alligood, 2010).

            Nursing care is an art, an essence and dedication of healing and helping others (Alligood & Tomey, 2010). To accomplish this we must take care of ourselves first. Body, mind and spirit are connected as one and are considered the basis for holistic healing. Treating the patient and self as a whole, considering all aspect of healing including physical, emotional and spiritual.  Caring for patients is individualized with compassion and considering all aspects of the patient’s health and life. 

            The major characteristic within those situations stem directly for the 10 carative/caritas assumptions such as: expressing positive and negative feeling, developing strong trusting interpersonal relations, offering a genuine sense of ourselves with compassion and empathy for the other person, caring-healing practices, loving-kindness with a intentional caring consciousness in all interactions. Staying in touch with ones own feelings, thoughts and spirit while meditating and deep breathing on a daily basis. Expressing genuine, caring, moments, words, thoughts, senses, feelings, behaviors and energy field to those all around us everyday.  Creating peaceful and healing environment all around us. Surround our selves with beauty, comfort, wholeness; consciousness, basic needs and dignities, which will all, contribute to wonderful feeling and opportunities in my everyday clinical practice (Alligood & Tomey, 2010).

My wholistic approach to healing compares to Nurse Theorist Watson, which encompasses my entire body, mind and spirit philosophy. The Seven Basic Assumptions of the Science of Caring Model is the caring aspect and perceptions of wholistic healing. The art of caring is very beneficial and healthy for the patients and families in their relationships with self and others. 

As stated in Bailey (2009):

          1. Caring can be effectively demonstrated and practiced only interpersonally.

          2. Caring consists of carative factors that result in the satisfaction of certain human needs. 

3. Effective caring promotes health and individual or family growth. 

4. Caring responses accept a person not only as he/she is now but as what he/she

may become. 

5. A caring environment is one that offers the development of potential while

allowing the person to choose the best action for him/herself at a given point of

time. 

6. Caring is more “healthogenic” than is curing. The practice of caring integrates

biophysical knowledge with knowledge of human behavior to generate or promote

health and to provide ministrations to those who are ill. A science of caring is

therefore complimentary to the science of curing.

7. The practice of nursing is central to nursing.

                                            References

Alligood, M. R. (2010). Nursing theory: Utilization and application.

         Maryland Heights, MO: Mosby Elsevier.

Alligood, M.R., & Tomey, A. M. (2010). Nursing theorists and their work.

         Maryland Heights, MO: Mosby Elsevier.

Bailey, D.N. (2009). Caring defined: a comparison and analysis.

         International Journal For Human Caring, 13(1), 16-31.