As Integrative Nurse Coaches who practice holistically, we are leaders, advocates, teachers, direct whole person care providers, and the only healthcare professional who touches a patient to provide assessments, treatments, and comfort. As a leader, you are also a role model, and perhaps seen as a visionary among your peers.
These qualities cannot be any more needed than they are today.
As Holistic and Nurse Coach leaders, we need to advocate in our organizations not only for our patients but for our nurse colleagues if we are to alleviate the commonly known nursing profession experience of burnout, distress, grief, and suffering.
Nursing Resilience – From Walking Wounded to Wounded Healer
The nursing profession is in the midst of a phenomenon known as the Journey of the Walking Wounded. We understand the increased magnitude of nurses’ pain and suffering over the past 18 months, and it is not over yet. Conti-O’Hare (2002) wrote of this phenomenon to emphasize that resilience is a process.[1] Self-Development, such as Self-Assessment, Self-Reflection, and Self-Care, are the first steps on this journey to heal pain and suffering and emerge as a resilient Wounded Healer.
Resilience is the 2021 concept used to describe the working through of pain and suffering. It is further defined as the ability to face adverse situations, remain focused, and continue to be optimistic for the future.[2] As Integrative Nurse Coaches who practice holistically, we want to be able to bounce back from these difficult times and face, overcome, and personally be strengthened to be able to adjust to what comes our way. Some believe that inherent personality traits for resiliency exist. But trauma and burnout can happen to anyone. And when it does, we must do the self-work to overcome it.
The concept of wounded healer goes back to Greek mythology 2500 years ago. Alex Gray, an artist, portrays the wounded healer (Panel 1 below) as self-trapped in a dizzying vortex. The prisoner yearns for freedom and becomes sick with materialist limitations. Holistic and Integrative Nurse Coaches can feel trapped in a medical system that does not support the core of practice: holistic health promotion. You can easily find additional interesting art with interpretations online by Alex Gray.
Conti-O’Hare’s Theory of the Nurse as Wounded Healer concepts can be used to resolve personal and professional pain, build therapeutic relationships, and to promote positive work environments.
The Wounded Healer journey expands our own personal awareness, through which the trauma or suffering is processed, converted, and then healed. But the scar always remains, giving the person a greater ability to understand other’s pain. When you have this experience, it creates an awareness of a greater vision beyond yourself and allows you to see a larger world view. Through this greater view, the wounded healer can use past experiences to assist others who are suffering now. However, if the nurse’s wounds are not healed there can be negative outcomes for the nurse, patient and organization. This suffering is verbally expressed by nurses as stress and burnout and could also easily become lateral violence towards colleagues.
Theory developed by Marion Conti-O’Hare (2002); Figure © 2013 Wanda Christie 2. Christie, W.& Jones, S. (2014). Lateral Violence in Nursing and the Theory of the Nurse as Wounded Healer. Online Journal of Issues in Nursing, 19(1).
Holistic and Nurse Coach Leaders as Advocates
Nurses need to focus on Self-Development to recognize their wounds in order to take action to process and transform it into something positive. This is the point we are at presently. Self- Development could be seen as a normal part of the nurse’s human growth and development evolution, and as Holistic and Nurse Coach Leaders we need to advocate for this in our places of employment and in the schools of nursing curricula so that it becomes the norm.
If a nurse can resolve her pain, she begins to use her experience therapeutically, has increased empathy with patients and sees a positive work environment. If a nurse is not able to recognize and heal personal experiences of pain and fear, or emotional distress, self-destructive behaviors can result and of course, burnout, job dissatisfaction and then instead speaks of a negative work environment. [2] The recognition of the importance of Self-Development could help with the large attrition rates we are seeing. Despite the numbers applying to nursing school, we see the National RN turnover rate at 19.5% and we know that translates into big money for healthcare organizations.
We know that Self-Development allows nurses to continue to sit with and witness the suffering of others and be able to continue to provide excellent nursing care. Nurses must have transformed and developed the resilience qualities that are so important in understanding how to assist others with their healing process. And we shouldn’t wait until he next pandemic to address and develop these skills.
As Holistic and Integrative Nurse Coaches, we promote health and wellbeing in our patients, and must also promote the same in ourselves and one another.
Our journey must begin today as a recognized role model and leader. Programs provided by Integrative Nurse Coaches for nurses allow for the deepest level of Self-Development and reflection that is necessary for healing to occur and resilience to emerge. One example is a hospital in Brooklyn, one of the first areas to be hit by COVID, which had nurses who developed COVID. Some nurses were ventilated, some died and some survived.
One Integrative Nurse Coach® colleague is running a Group Coaching Healing Circles program for the nurses affected to improve not only their pulmonary function but their overall health & wellbeing, assessing and focusing on the 8 dimensions of the whole person. This is true patient-centered care that is relationship based and nurse centric.
© 2015 Integrative Nurse Coach® Academy | International Nurse Coach AssociationAnother Integrative Nurse Coach® is working in Occupational Health, coaching nurses who show up with stress and anxiety. Another Integrative Nurse Coach® manager is making time for expression of feelings and reflective activities in her unit meetings, and together as a holistic team at the beginning of each shift, set the intention for the workday ahead.
Have you seen the Future of Nursing Report 2020-2030?
It was thrilling to see the goal of promoting the health & wellbeing of nurses encouraged, with structure and systems, and evidence-based interventions in place, especially as we take on new roles to advance health equity. We need to raise awareness, provide programming, and have organizational policy to protect nurses.
It needs to become part of the holistic culture across all levels of the organization.
So, I’d like you to consider
What is it that you can do as a Holistic and Integrative Nurse Coach® Leader to help make a make a difference in healing and resilience for your nurse colleagues, where you are- starting tomorrow?
Carl Jung suggested that professionals are just as vulnerable as the rest of mankind, and should strive for self-wholeness rather than just ‘clean-hands perfection’ when attempting to facilitate healing[3].
[1] Conti-O’Hare, M. (2002). The theory of the nurse as a wounded healer: From trauma to transcendence. Sudbury, MA: Jones and Bartlett Publishers.
[2] Kester, Kelly BSN, RN, CCRN, NE-BC; Wei, Holly PhD, RN, CPN Building nurse resilience, Nursing Management (Springhouse): June 2018 – Volume 49 – Issue 6 – p 42-45 doi: 10.1097/01.NUMA.0000533768.28005.36
[3] Jung, C. G. (1953). The practice of psychotherapy: The collected works o f C. G. Jung. In H. Read, M. Fordham & G. Adler (Eds.), Bollingen Series XX(Volume 16). New York: Pantheon Book.
Karen Avino is the Executive Director of Education for the Integrative Nurse Coach® Academy and the International Nurse Coach Associationproviding online and onsite continuing education programs for nurses. As a consultant, Karen helps healthcare organizations create optimal healing environments and integrate holistic nursing into practice. Karen taught Holistic Nursing and Integrative Health for 20 years in online and on campus classes at the University of Delaware. She received the Faculty Senate Excellence in Academic Advising and Mentoring Award. She also received the Delaware Excellence in Nursing Practice Award as Nurse Educator. She has over 40 years of experience in Maternal-Child Health, Administration, Community Health, Holistic Nursing and Nurse Coach practice. She is board certified as both an Advanced Holistic Nurse and a Health & Wellness Nurse Coach. Karen is a Reiki Master, Stress Management Instructor, HeartMath, and Clinical Meditation and Imagery Practitioner. Karen is a Director-At-Large board member of the American Holistic Nurses Association and a founding leader of the Delaware Chapter (DEAHNA). She is an author and editor of Holistic Nursing: A Handbook for Practice(2016, 2021) and Core Curriculum for Holistic Nursing (2014). Karen is a Peer Reviewer for the Journal of Nursing Scholarship and Holistic Nursing Practice journals. She is an international and national speaker on holistic and integrative topics.
