Whole-Person Caring: An Interprofessional Model for Healing and Wellness

45 Pages·2013·0.24 MB·English

Whole-Person Caring: An
Interprofessional Model for
Healing and Wellness
Instructor/Facilitator Guide for Nursing,
Medical, and Allied Health Students
and Practitioners
“Knowing is not enough; we must apply. Willing is not
enough; we must do.”
–Johann Wolfgang von Goethe
This study guide provides instructors with chapter overviews, learning
objectives, questions for discussion, and activities and assignments to help
students and practitioners integrate whole-person caring into their lives
and professional practice.
The model of whole-person caring (WPC) is a guide for personal and or-
ganizational transformation. The model operationalizes concepts that are
inherent to healing and provides a common framework so that personnel
from various disciplines and cultural backgrounds can work together to
provide quality care and compassionate service.
2 Whole-Person Caring: An Interprofessional Model for Healing and Wellness
Providing a Safe, Supportive, and Healing
Environment
In the new healing and wellness paradigm, health care providers are role models for healthy and
wholesome behavior. Likewise, as an instructor and facilitator for the WPC model, you serve as a
role model for your students.
One of the key concepts that you will be modeling for students is a caring and healing presence.
The way you interact with students, your genuine concern, and your authentic responses demon-
strate firsthand what it means to be a healing presence. It is your healing presence that will enable
the healing presence in your students. Providing a healing, safe, and supportive environment for
students is an important part of teaching this model. Providing unconditional acceptance to each
student creates an atmosphere of approval and encouragement and helps students grow and
develop.
Commitment to Your Own Personal Growth
Teaching the model of whole-person caring is best accomplished by those who are committed
to their own personal growth and development. This does not mean you need to be proficient
in the practice of numerous healing modalities or be the perfect weight or have the perfect diet
and habits. This does mean you are actively engaged in activities and practices on a daily basis
that bring you closer to a state of optimal health and well-being. Realizing your wholeness and
achieving optimal health is a lifelong process. It is vital that you take time each day for some form
of reflective, meditative, or spiritual practice that increases your awareness and clarity and brings
you closer to the infinite and sacred nature of your being. It is important that you care for and
learn to treat yourself with love and compassion. These are concepts that are foundational to the
WPC model. Modeling these attitudes will be your most effective form of teaching. Be open to
examining the patterns of your life and creating the intention that every day you will come closer
to achieving your potential.
Teaching the WPC model will facilitate your growth and transformation. Every time you teach trans-
formational material, you will be transformed. It is a wonderful process, and one that you will find
invigorates and enlivens you.
Whole-Person Caring: An Interprofessional Model for Healing and Wellness 3
Envisioning Personal Change
One of the most powerful tools you have at your disposal is the ability to help others envision
what is possible. There is an old saying: If you can see it, feel it, and believe it, you can achieve it!
As a facilitator, you can help students and practitioners visualize and bring into their lives what
had previously been outside their paradigm. Your belief and your understanding of what is pos-
sible will help others to expand their worldview.
You will invite students and practitioners to re-create attitudes and ways of behaving, think-
ing, and perceiving that will positively transform their lives. You will provide them with tools,
research, and methods that will enable them to create the lives they desire. Many students and
practitioners arrive in class or at work with severe burnout and feel overwhelmed by circum-
stances in their personal lives. It is very difficult for them to envision a different way of being or
a different set of circumstances. As a facilitator, you can open up new vistas. You can help them
expand their perspectives and create healthy and wholesome ways of being.
The WPC model has been taught to students, nurses, physicians, dieticians, social workers, chap-
lains, respiratory therapists, administrators, managers, and laypeople. The healing and wellness
concepts are universal, are simply stated, and can be understood by everyone. Although the focus
and the examples in the book primarily involve the hospital setting, these concepts can be adapt-
ed to any setting and any discipline. The concepts can be taught in undergraduate, graduate, and
doctoral programs for all health care professionals and to practitioners in the clinical setting.
Chapter 1: Shifting Toward a Paradigm of Healing
and Wellness
Overview
This chapter presents an overview of the current state of health care and emphasizes the need to
move from an illness-based system to a wellness-based system. A basic description of some of the
more common complementary and alternative therapies along with whole systems of comple-
mentary and alternative medicine (CAM) are provided to familiarize the reader with their utility
and application in clinical practice.
Shifting Toward a Paradigm of Healing and Wellness
Accomplishing a change from an illness-based system to a wellness-based system will be facili-
tated by the following:
`
A holistic approach that considers body, mind, heart, and spirit
4 Whole-Person Caring: An Interprofessional Model for Healing and Wellness
`
A system that values and encourages client/patient empowerment
`
An interprofessional, well-coordinated, collaborative approach to care
`
An interprofessional model to create a common framework for practice
`
The integration of efficacious healing therapies, modalities, and systems of medicine that
focus on prevention, patient empowerment, healthy lifestyles, and the low utilization of
high-cost interventions
Health Care: An Oxymoron
There are two things missing in our health care system: health and care. Herein is the crux of the

problem.When people seek health care, it is usually to treat a disease, alleviate symptoms, or
care for an acute injury. People do not seek health care to prevent illness, nor do they regularly
seek health care to maintain or manage their health and well-being or for health promotion.
Our system primarily addresses diagnosis, treatment, and management of acute and chronic
disease and illness. It seldom addresses the restoration and maintenance of health, the preven-
tion of illness and disease, or the promotion of health.
Returning “Health” to Health Care
There is a growing awareness that our focus must be redirected toward illness prevention and
health promotion, largely as a result of the increased incidence of chronic disease. Far-reaching
initiatives for health promotion, equitable insurance coverage, and illness prevention are con-
tained in the 2010 Affordable Care Act and have the potential to radically shift our emphasis
away from crisis management and toward wellness.
According to Koh and Sebelius (2010), this legislation “will reinvigorate public health on behalf
of individuals, worksites, communities, and the nation at large—and will usher in a revitalized era
for prevention at every level of society” (p. 1296). A new vision for health care is emerging. It is a
vision that brings health, healing, compassion, and wellness into the conversation.
Integrating Holism in Health Care
A holistic approach can help in our efforts to provide care that fosters optimal health and well-
ness. Holistic care involves caring for each person as a whole with an awareness of his or her
physical, mental, emotional, and spiritual dimensions and needs. Holistic practitioners work with
people in ongoing relationships that are based in trust and caring. The holistic practitioner fol-
lows the person throughout his or her health care challenges and is a therapeutic partner in the
person’s journey toward health and wellness. The holistic practitioner, whether a nurse, physician,
social worker, healer, or health coach, understands that various skills and approaches are needed
Whole-Person Caring: An Interprofessional Model for Healing and Wellness 5
to help a person reach his or her optimal state of health. This is particularly important in dealing
with the interrelated and numerous problems associated with chronic illness and disease.
The Importance of Interdisciplinary Collaboration and Coordination of Care
Practitioners of conventional medical therapies, mind-body interventions, biologically based
therapies, manipulative and body-based methods, exercise and movement programs, and energy
therapies can all play a role in helping people achieve optimal health. The key is coordinating
these practitioners to create a system that is focused on health, healing, and wellness.
Some of the barriers in collaborating among different disciplines include the following:
`
Lack of understanding of what each discipline can contribute
`
Mistrust of disciplines outside one’s own practice
`
Inability to work together as a team
`
Territorial and reimbursement issues
`
Lack of a common model to guide practice
Integrating Healing Practices and Healing Professions into Health Care
A wide variety of therapies, modalities, and practices not included in Western medicine are use-
ful in promoting health and healing. These practices are collectively referred to as CAM, which
stands for “complementary and alternative medicine.” The five major categories of complemen-
tary and alternative therapies are:
`
Botanicals and natural products: These include natural products such as herbs, vitamins,
and mineral supplements, and a variety of herbal and diet therapies.
`
Mind-body-spirit interventions: Meditation, relaxation, imagery, visualization, hypno-
sis, yoga, t’ai chi, prayer, art, music, dance therapies, cognitive-behavioral therapy, bio-
feedback, therapeutic counseling, and stress management are included in this category.
`
Manipulative and body-based therapies: These include chiropractic intervention, mas-
sage therapy, osteopathy, reflexology, Alexander technique, and craniosacral therapy.
`
Energy therapies: These include therapeutic touch, Reiki, qigong, acupressure, healing
touch, and magnet therapy.
`
Whole medical systems: Traditional Chinese medicine (TCM), Ayurveda, homeopathy,
naturopathy, and Native American, Latin American, and African indigenous practices
are included.
6 Whole-Person Caring: An Interprofessional Model for Healing and Wellness
The use of CAM and other systems of medicine will continue to increase as people seek more
affordable health care options and become more empowered to take control of their health. It
is important that nursing and medical students be aware of the efficacy and utilization of CAM
practices so they can help guide and coordinate their patients’ care. Many CAM practices are
more effective, have no (or fewer) side effects, and cost less than conventional interventions.
However, some CAM practices may not be as effective as conventional medicine and may have
some deleterious effects. Keeping abreast of current research on CAM practices is important for
the health care provider.
Medical systems such as traditional Chinese medicine, Ayurvedic medicine, naturopathy, home-
opathy, and osteopathy that treat the whole person have valuable contributions to make to our
health care system. They focus on prevention, patient empowerment, healthy lifestyles, and the
low utilization of high-cost interventions. This places these systems in a position to help shift
health care toward a paradigm of health, healing, and wellness and to provide affordable and sus-
tainable care.
Practitioners of conventional medicine best serve their patients when they have an understand-
ing of the various CAM practices and alternative systems of medicine. Many people who use
CAM are reticent to tell their medical practitioner for fear of reprisal. This can result in adverse
effects—for instance, from combining supplements and medications that are incompatible and/or
using alternative therapies that may be contraindicated. As health care professionals become more
informed of the indications for use, possible adverse reactions, and the benefits that CAM prac-
tices provide, greater collaboration between practitioners of conventional medicine and alternative
therapies can occur.
Learning Objectives
`
List four elements that distinguish a healing and wellness paradigm from the current
system of health care.
`
Identify three characteristics of a holistic approach to care.
`
Articulate the importance of interprofessional collaboration in a healing and wellness
paradigm, especially as it relates to care of the chronically ill population.
`
List the five major categories for complementary and alternative therapies.
`
Identify four frequently used alternative therapies that originated more than 4,000 years
ago.
`
List five of the most commonly used herbal supplements in the United States.
`
List three of the most commonly practiced energy therapies in the United States.
Whole-Person Caring: An Interprofessional Model for Healing and Wellness 7
`
Identify four alternative medical systems of practice.
`
Identify three characteristics of traditional systems of medicine that make them well-
suited for the new paradigm of healing and wellness.
Discussion Questions
1. What demographic factors in our current population make a holistic and interprofes-
sional approach to health promotion and disease prevention important?
2. Why is it important for health care providers to know about CAM practices and alterna-
tive systems of medicine? In what ways will this help them deliver better care and pro-
mote healthier outcomes for their clients or patients?
3. What experiences have students had related to alternative therapies or alternative sys-
tems of medicine? Why did they seek alternative care? What was the outcome? Was
there a difference in the way they were treated by the alternative practitioner versus a
conventional medical practitioner?
Assignment
1. Choose a specific alternative therapy or modality and review the literature to determine
the following:
`
Indications for use
`
Contraindication for use
`
Prevalence of usage in the United States
`
Research related to patient outcomes, efficacy, safety, and usage
Record your thoughts on two to four single-spaced, typed pages.
2. Compare and contrast the treatment of musculoskeletal pain in conventional Western
medicine with traditional Chinese medicine. Consider the following:
`
Supplements and/or medications used
`
Types of therapy utilized
`
How each perceives the etiology of pain
`
Other considerations
Record your thoughts on two to four single-spaced, typed pages.
8 Whole-Person Caring: An Interprofessional Model for Healing and Wellness
Chapter 2: Redefining Who We Are
Overview
This chapter examines how we are perceived through the lens of the biomedical model and how
that model can be expanded to incorporate concepts of modern science and meet the criteria
for a scientific body of knowledge. The way we define ourselves is one of the deepest underlying
assumptions in a culture. Assumptions at this level are often taken for granted and not usually
articulated. However, deeply rooted assumptions affect why things happen or fail to happen in a
culture (Carroll & Quijada, 2004).
Current Biomedical View
In the biomedical model, people are perceived to be an amalgamation of molecules and atoms
that interact in a predictable fashion based on laws of mathematics, chemistry, and physics (Curtis
& Gaylord, 2004). This has been the predominant model for the past 300 years. Once a paradigm
is embedded, it creates filters that determine what a scientific community sees and, consequently,
what research will be pursued and what results will be lauded and published.
Our current biomedical paradigm basically sees the physical body as the only dimension of hu-
man existence. The idea that we are only our bodies is one of the deepest underlying assumptions
in our scientific culture.
The Need to Expand Our Perspective
Listed here are five elements that most people want a scientific body of knowledge to provide:
`
A method of organizing and categorizing “things”; a typology
`
Predictions of future events
`
Explanations of past events
`
A sense of understanding about what causes events
`
The potential for control of events
(Reynolds, 1971, p. 4)
When examining CAM practices and healing modalities, the biomedical, reductionist model of-
ten fails to meet the criteria of predicting, explaining, and giving a sense of understanding to the
interventions. A primary reason that we need to expand our perspective beyond the mechanistic,
reductionist view is to meet the criteria for a valid scientific concept. It’s simply good science. Ex-
panding our perspective makes way for a larger body of knowledge and healing practices as well
as phenomena to be accepted into our health care system.
Whole-Person Caring: An Interprofessional Model for Healing and Wellness 9
We Cannot Measure What Enlivens Us
The most profound, remarkable experiences in our lives can never be captured in a double-blind
study. Love, moments of great joy, mystical experiences—these are not things that can be mea-
sured, predicted, explained, or captured in a double-blind study. The very things that make us
happy and healthy cannot achieve validity in the prevailing scientific paradigm. Our thinking, our
consciousness, and our science must expand to embrace that which we have rejected.
Moving Toward an Einsteinian Perspective
Creating a definition of who we are that has the capacity to explain the phenomena associated
with subtle energies and healing is not only useful but necessary to create a paradigm of health,
healing, and wellness. In his classic book Vibrational Medicine, Richard Gerber talks about mov-
ing from a Newtonian model of medicine to an Einsteinian view. Einstein, through his famous
equation E=mc2, postulated that energy and matter are dual expressions of the same universal
substance. Mass and energy are both—albeit different—manifestations of the same thing. Al-
though the Einsteinian view has found acceptance and application in the minds of physicists,
Einstein’s insights have yet to be incorporated into the way physicians look at human beings
(Gerber, 2001). Physics tells us that we are 99.9999% empty space and that what occupies that
space seems to be a dynamic energy. Developing a perspective that acknowledges the energetic
essence of who we are is important if we are to advance our knowledge and our practices.
Martha Rogers: A Visionary in Nursing
Martha Rogers created an expansive and futuristic definition of who we are. She stated that
each person is “an irreducible, indivisible, pandimensional energy field identified by pattern and
manifesting characteristics that are specific to the whole and which cannot be predicted from
knowledge of the parts” (Rogers, 1992, p. 29). Rogers explains, “Energy fields are infinite and
pandimensional and in continuous motion” (p. 30). She defines pandimensional as “a non-linear
domain without spatial or temporal attributes” (p. 29).
Learning Objectives
`
Identify the five criteria that a scientific body of knowledge should provide.
`
List three of the criteria for a scientific body of knowledge that the biomedical model
often fails to meet in relation to alternative healing therapies.
`
Identify and describe the two levels of physical reality postulated by Tiller.
`
Articulate Martha Rogers’s definition of human being.
10 Whole-Person Caring: An Interprofessional Model for Healing and Wellness
Discussion Questions:
1. In what ways has the biomedical model been useful? In what ways has the biomedical
model limited our scientific knowledge base?
2. What are some of the phenomena in life that cannot be explained or predicted by the
biomedical model?
3. What implications do the two states of physical reality postulated by Tiller pose for re-
search in CAM practice?
4. What are some of the implications of perceiving ourselves as “fields of energy”? Is this
congruent with your belief system? Is this congruent with modern science?
5. How does Martha Rogers define “pandimensional”? What implications does this have
for some of the phenomena associated with afterlife and paranormal experiences?
Assignment
1. Compare how people are defined and characterized from the biomedical perspective
with Martha Rogers’s definition of person. What definition or parts of each definition
do you feel are useful? Which, if any, do you disagree with? Can these definitions, or
concepts within these perspectives, be combined? Record your thoughts on one to two
single-spaced, typed pages.