Jane Dickinson’s wonderful post of February 24th, “Replacing words that shame and blame in nursing care” touched on one of my own favorite topics – the words we use! Our language is steeped in euphemisms – particularly where medicine and health are concerned. Years ago Jo Ann Ashley often pointed out ways that the term “health care system” is a misnomer – it should be call “Sickness” or “disease” care system. Even our conception of “prevention” is distorted, in that very little actual prevention happens. 
Mostly, the activites that this term refers to is “disease detection” – not prevention. With the exception of the development and use of vaccines, very little prevention happens. Early detection of disease is a good thing, of course, and can “prevent” progression of disease to an advanced stage, but this is not prevention.
The term “holistic” is particularly important to consider where nursing is concerned. Wholism (my preferred spelling) is, in my view, is one of the foundational values that distinguishes nursing as a discipline. From this point of the view, the term “holistic nursing” could be seen as redundant. However, now the term “holistic nursing” is taken to refer to a nursing speciality that draws on complementary or alternative healing modalities. We do need a term to refer to this particular focus, but it seems to me that even someone whose practice includes a complementary modality does not necessarily mean that it is wholistic, in terms of the extent the nurse takes into account not only the whole person, but the family, envieonment and social determinants of health. Given the nature of the modalities we refer to as “complimentary” or even “holistic,” it is likely that the practice is indeed more “wholistic” than many medicalized specialties, but it is still too easy, in many of the contexts in which nurses work, to be overly focused on a part, not the whole.
I would be very interested in your thoughts and ideas on this! Reaching for that which is “whole” is not easy, and is made more difficult in the contexts of specialization, and our language is a barrier as well. So share you thoughts and insights here – let’s have a discussion!
NurseManifest 
Person First language is a term I recently learned from my daughter,a social work student.
Example: A person experiencing homelessness, or a person in recovery from substance abuse.
We easily dismiss someone with our language: this is a personality disorder. Let us keep our ears open to the language used around us and the language we use. Let us change the paradigm.
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Person First language is a term I learned from my daughter, a social work student.
Person experiencing homelessness, person in recovery from substance abuse.
People are easily dismissed by us with the language we may use: borderline, personality disorder. Let us listen to the words and terms we and others use. We can change the the paradigm..
..
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This is such an important point, Susan! Thank you so much for bringing it up! This has been a standard in writing “best practices” for years now, but for those of us in health care, it is a huge challenge because of the typical practices in our language that happen all the time — particularly using a disease in place of the person. So thank you!
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At the AHNA conference in 2014, we had a speaker who said something to the effect of , “all nursing is holistic nursing… if what you are doing as a nurse can’t be categorized as holistic, it’s not nursing.”
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YES Carey! That’s EXACTLY what I was thinking as I read this. Holistic Nursing IS the VERY essence of nursing!! Glad you wrote this Peggy. I’m on the Advocacy Committee with AHNA & we’re working on how best to deliver our message to the State Boards of Nursing so that they really understand what Holistic Nursing is. Agreed that there’s widespread public confusion-when I say I am a Board Certified Holistic Nurse- whaaat??? Grateful for this dialogue!!
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Thank YOU for being int ouch with us on this issue! You are so well positioned to do this important work, and to help work on changing perceptions around this! Peggy
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Right on!
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The foundation of nursing and/or holistic practice requires we be self-inclusive in the process of nursing, including exceptional self-care. Only insofar as we include all parts of our own human self, can we stand as witness to that which our clients are experiencing.
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As I work on a current doctoral project, I have been studying the impact of oppression in nursing. I read an article entitled, Doctor’s Orders and the Language of Representation by Em M. Pijl-Zieber, in which the author delves into our use of certain language elements. Words and phrases embedded in our practice, such as the term, “doctor’s orders”, have implications that are far-reaching. Like so many other facets of our profession, we must become aware and refrain from silence. Dr. Chinn’s article reminded me of this especially with her reflection of the terms “holism” and “wholism”.
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Thank you for this, Deborah! Grayce Sills, one of our important leaders in psychiatric-mental health nursing, speaks of changing the term “doctors orders” to physician prescriptions, and also have a place for “nurses prescriptions” as well. prescriptions may not be the best term, but this illustrates really important ideas that we could in fact start to take up, if we have the will to do so!
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An important movement in language as well as practice…especially for the community-based, private practice RN who often has many inputs for clients/patients based on relationship-based assessment and diagnosis. I would love to see the arena of nursing diagnosis used more often in the practice of nursing….and nurses taking ownership of their own thinking and prescriptive plan. As someone who works both in a hospital setting and in private practice, I can see that hospital-based nursing is often paperwork-laden and nurses are often used as work horses. The entire atmosphere of hospitals these days is not so user-friendly to the outlook and practice of “wholistic” nursing. I love this discussion – it is important. We are “moving the molecules” in the mind field of the profession. I refer the readers to the work of our dear Martha E. Rodgers, RN PhD – “The Science of Unitary Human Beings”.
This for me, her work, is a beginning of understanding and consideration of how to hold the very potent and sacred field of nursing science, what I like to call the Science of Care. We can build forth from this nursing theory into language which can bring nursing back its potency, in practical application in alignment with the cutting edges of how we understand wellness, wholeness, and the ground of consciousness in our new and highly inclusive grasp of biophysics, biology, immunity, neurology, the role of perception/thought/emotions and DNA. This level of acknowledging who we are as humans can bode an entirely new landscape for the practice of nursing, in whatever field or arena we practice. Our own self-awareness, our own consciousness care, our own self-care, becomes central to our practice. We need to be emphasizing this in our nursing education, for sure. 🙂
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Thank you so much for this response, Kathryn. Right on! Years ago, Jo Ann Ashley often said that nurses will have to leave the hospitals in order to practice nursing. While I agree in principle, I do appreciate the moments I have experienced with nurses in hospitals who are managing to practice nursing magnificently. Not as consistently as they would prefer, but there are those who try. So I believe this is a challenge to tackle .. by someone some where some time!
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Kathryn, I like your thoughtful post! I invite you to look at Barbie Dossey’s impressive contributions in this area. Her & Susan Luck founded the International Nurse Coaching Association based on Rogers theory, as well as many others including Dossey’s own Theory of Integral Nursing. They have truly encapsulated a program that includes ” Our own self-awareness, our own consciousness care, our own self-care, becomes central to our practice.” You, and they- are spot on!! Yes, I am a proud graduate of the program. More importantly, a 30+ year nurse who knew there was a better way to nurse- and found it. They’re visionaries who truly hope all nurses learn how to care for themselves as the foundation AND how to hold the sacred space for others.
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Thanks, Peggy, for this post, and everyone, for this valuable discussion. I am a nurse and diabetes educator. Nurses who are diabetes educators are often referred to as “nurse educators.” A colleague once said to me, “‘Nurse educator’ is redundant.” I agree, and I’ve never forgotten that! Teaching is one of the most important things nurses do – in every aspect of care.
I agree that “holistic nursing” is also redundant. Considering the whole person is also a hallmark of nursing. In fact, when I hear or read about physicians referring to the “whole person,” I think, “they learned that from nurses!” I am glad that nursing organizations are thinking about how to integrate wholism into nursing from every angle (education, registration, publication, and whatever other “-tions” are out there).
I teach in an interprofessional program and I will admit that the students I work with are getting a “nursing” education. We discuss and emphasize a wholistic approach every day. Is it even possible to view health any other way?
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