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A holistic approach to healthcare is based on the belief that the treatment of medical conditions needs to address not only a patient’s physical symptoms but also the mental, emotional, spiritual, and social factors affecting a patient’s health. A holistic nurse approaches the practice of traditional nursing and patient care with this holistic view. The American Holistic Nurses’ Association (AHNA) states that the goal of holistic nursing is to heal the whole person.
In 2006, the American Nurses Association (ANA) defined holistic nursing as a distinct nursing specialty. Then, in 2007, the AHNA and ANA co-published the Holistic Nursing Scope and Standards of Practice. Most recently the AHNA and ANA worked together to develop the Holistic Nursing Scope and Standards of Practice 2nd Edition, which was published in 2013. This publication seeks to:
- Define holistic nursing, including its scope.
- Explain practice settings.
- Define the education needed to practice.
- Show the evolution of holistic nursing.
- Explain the focus, philosophy and concern of holistic nursing.
- Explore current issues and trends.
- Define The Standards and Competencies of Holistic Nursing Practice at both the basic and advanced level.
- Discuss the Core Values of Holistic Nursing:
- Holistic philosophy, theories, and ethics
- Holistic caring processes
- Holistic communication, therapeutic environment, and cultural diversity
- Holistic education and research
- Holistic nurse self-car
Holistic nurses are educated in both conventional and complementary healing practices and can act as a bridge between the two. Some holistic nurses incorporate specific alternative or complementary healing modalities into their practices. A few of the modalities that nurses might choose to practice include:
- Manipulative and body-based practices, such as massage, acupressure, acupuncture, and movement therapy
- Mind-body medicine, such as art therapy, hypnotherapy, and meditation
- Biologically based practices, such as herbal therapy and nutritional counseling
- Energy medicine, such as healing touch, prayer, or reiki
Some holistic nurses maintain separate licenses or certifications to practice a modality in which they choose to specialize.
Holistic nurses work with all populations and in all areas of healthcare, including emergency rooms, intensive care units, outpatient surgery clinics, and private practices. An area where holistic nurses are becoming increasing involved is wellness coaching, according to the Winter 2011 issue of Beginnings, a publication of the AHNA. Wellness coaching integrates fitness, nutrition, and any number of holistic interventions used to manage weight, stress, health risks, and life issues.
Becoming a Holistic Nurse
Holistic nurses occupy the spectrum from entry-level RNs to advanced practice nurse practitioners (NPs). Although bachelor’s degrees specifically in holistic nursing are rare, many nursing programs do promote a holistic view. Typically, a nurse with an undergraduate nursing degree who wants to work in holistic nursing goes on to complete continuing education in the field.
Nurses who want to become holistic NPs have the option to pursue master’s degrees or post-master’s programs specific to holistic nursing practice. Programs typically cover both traditional advanced practice nursing core competencies, such as advanced pathophysiology, health assessment, and pharmacology, along with complementary healing modalities. However all these courses are taught within the context of holistic nursing philosophy. In addition to offering knowledge on complementary healing modalities, core concepts to holistic nursing such as self-care, presence, intention/intentionality, spirit-mind-body perspectives, holistic health and healing, holistic ethics, as well as other core essentials are included in the curriculum of these programs.
Some schools offer programs that combine the holistic specialty with a patient population focus. For example adult nurse practitioner/holistic nurse practitioner programs are not uncommon. Other schools offer a holistic nurse practitioner program or an advanced holistic nursing program outside of the patient population focus. There are also post-master’s certificates in holistic nursing for clinical nurse specialists.
Holistic Nursing Certification
Four holistic nurse certifications are available from the American Holistic Nurses Credentialing Corporation (AHNCC):
- Holistic Nurse, Board Certified (HN-BC) is available to all RNs who completed a nursing program at an accredited school that awards at least a diploma or associate’s degree.
- Holistic Baccalaureate Nurse, Board Certified (HNB-BC) is available to RNs who completed a nursing bachelor’s degree from a school accredited by the Association of Schools and Colleges.
- Advanced Holistic Nurse, Board Certified (AHN-BC) is available to RNs who have a graduate degree in nursing from an accredited school and an existing APRN license.
- Advanced Practice Holistic Nurse, Board Certified (APHN-BC) is available to RNs with a graduate degree conferred by an accredited school as well as an existing APRN license.
The following requirements apply to all four certifications:
- Nurses must have a current, unrestricted RN license in the United States
- Nurses must have at least one year full-time experience as a holistic nurse or have at least 2,000 hours part-time experience during the five years prior to sitting for the exam
- Nurses must have completed at least 48 contact hours of continuing education in holistic nursing during the two years prior to sitting for the exam
- Signed attestation (Candidate’s Agreement with AHNCC) agreeing to AHNCC terms
The AHNCC also offers two certification options for those interested in nurse coaching:
- Nurse Coach, Board Certified (NC-BC)
- Health and Wellness Nurse Coach, Board Certified (HWNC-BC) (only available to current Board Certified Holistic Nurses)
The following requirements apply to both nurse coach certifications:
- Nurses must have a current and unrestricted RN license
- Nurses must have a bachelor’s degree at minimum conferred through an accredited school of nursing
- Nurses must have two years of full-time experience or 4000 hours of part-time experience within the five years immediately prior to sitting for the exam
- Nurses must have completed at least 60 hours of continuing education during the three years immediately prior to sitting for the exam (at least 10 hours of experience in personal coaching is recommended)
- Sixty hours of experience under the mentorship of a Certified Nurse Coach Supervisor (a letter from the supervising nurse coach that validates this experience is required)
- Nurse Coach Self-Reflective Assessment
- Signed attestation (Candidate’s Agreement with AHNCC) agreeing to AHNCC terms
The Professional Testing Corporation administers the exams March through October for two weeks in more than 700 locations nationwide. Certification is valid for five years. Recertification requires continuing practice as a holistic nurse and meeting continuing education requirements.
Holistic Nursing Association
The American Holistic Nurses Association (AHNA) supports education about holistic healing and its philosophy, concepts, practice, and research for nurses, other healthcare professionals, and the public. AHNA publishes the Journal of Holistic Nursing and maintains a list of continuing nursing education programs that teach content in alignment with the mission, vision, and purpose of the organization.
Some states have holistic nursing associations, such as the Oregon Holistic Nurses Association and the Minnesota Holistic Nurses Association.