Holism From a Bird’s Eye View
I consider myself to be a rogue nurse. A few years ago I was burned out after working inpatient behavioral health with children and adolescents, and later, in outpatient radiation-oncology. I was disgusted with the treatment protocols for children with behavior issues. Pharmaceuticals and sugar were the two main prescriptions I had to ensure children on the psych ward received. With the strong knowing that food is medicine, this practice was out of alignment with my values and I was appalled.
I became disheartened by the lack of holistic tools available to share with my cancer patients in one of the largest and most “progressive” healthcare systems in the country. I knew there was more to medicine than following a single protocol for cancer treatment. Consequently, I dismissed myself from mainstream medicine and followed my heart toward natural medicine.
For three years I assisted in the growth of a single provider, naturopathic clinic into a booming, 23-provider, integrative clinic. Holism was my middle name in this position as I broadened my nursing toolbox and immersed myself in natural and Chinese medicine. Once I felt complete in this role, I transitioned upstream like the salmon returning home, to yet again the mainstream healthcare system– Elder care. Little did I know, my angels were divinely guiding me. I was skeptical about re-entering the Western medicine arena and venturing into the sad reality of elder care in this country. Alas, my angels do not steer me wrong. If a rogue nurse was to work in elder care, this was the place to be!
Imagine a residential care facility for elders with Alzheimer’s and dementia where the doors to the outside are unlocked, promoting a culture of autonomy and freedom. Imagine an open floor plan, where the elders just simply walk out of their one-bedroom apartment to find themselves in the heart of the house—the kitchen. Comforted by the smell of nourishing meals, home-cooked by the house chef, the elders’ sense of belonging is heightened upon hearing the chef call them by name. Imagine a loving, home-like atmosphere, with a large organic garden, flowerbeds galore, and free-range chickens roaming around outside.
In this setting, where the sense of freedom is paramount to living well until the end, our elders are similar to the free-range chickens! They are not locked-up, but rather, given space to flourish within reason. Recently, I was struck by a profound epiphany… Elite Care (the facility where I now work) is the holistic model for elder care in this country. A new precedent is being set and I’m part of it!
As the sole nurse for this 24-apartment facility, I supervise and educate unlicensed caregivers who provide medication administration, and sometimes total care, to the residents. I am the support person for the residents, staff and families. It is challenging to keep holism in focus when immersed in the many aspects of my role: the dynamics of the community, when doing due diligence to prevent making a mistake, ensuring adherence to the many Oregon Administrative Regulations, and preparing for the Oregon state compliance audits.
I have judged, and felt disappointed in myself when my ego perceived that holism was not being incorporated into my nursing practice. Am I becoming complacent in my passion for holistic nursing? Is there more that I could be doing?
Now, with nearly two years of experience in this position, I am able to zoom out and examine the bigger picture. Like an eagle flying overhead, scanning the horizon, I see that holism can have many appearances. It doesn’t always have to be acupuncture and massage, reiki or aromatherapy. It’s in the way we plant peppermint and chamomile for the residents’ tea. It’s in the request for cranberry pills and D-Mannose powder from the doctor to prevent further UTIs. Holism is the way the chefs blend nutrient-dense protein smoothies each morning for those without an appetite. It’s the way the elders harvest and package seeds from the garden in the fall to give back to the community.
But most of all, holism is about Presence. It’s about pinpointing that missing puzzle piece which helps the elder feel a sense of purpose and connection. It’s locating just the right “key” to unlock an antique memory held hostage by the deteriorating brain. Here we employ individualized interventions to avoid the use of anti-anxiety or anti-psychotic medications during times of agitation. Here we recognize the slightest change in behavior and act to prevent illness. This is holism, all right.
I am grateful to the guidance that brought me to Elite Care and the opportunity to travel into my shadows and doubt, to come out into the light of hope and inspiration. I am grateful that now I see the gems surrounding me each day; grateful that my definition of holism has expanded to encompass the one-on-one time spent with each patient. This understanding enables me to see I was always providing holistic care, even when I perceived to be limited in my holistic expression. My very nature is holistic and that’s enough.
My prayer is that this alternative to elder care will become the mainstream; that Medicare will begin to cover the high costs of care. And from this prayer, stems a prayer for the bigger picture of healthcare. May those in power of our healthcare system recognize the importance of, and begin creating holistic models where all people can thrive in prevention, holism and the presence of dedicated, whole nurses.
Jess Young, RN, BSN