Holistic care has always been a core element of nursing practice. The principles of all-round health espoused by Florence Nightingale, widely regarded as the mother of modern nursing, are essentially holistic in nature. Where doctors and physicians may either be specialists or necessarily focused on immediate treatment for a single problem, the role of a nurse has always involved multifaceted care with the goal of establishing and maintaining a patient’s overall wellbeing.
Nursing is about patient care, not just treatment, and to achieve this, emotional, mental and even spiritual factors must be considered alongside physical healing. Today, family nurse practitioners (FNP) are the experienced, highly qualified generalists who carry on this holistic nursing tradition. Often acting as primary care providers for entire communities, FNPs take every aspect of their patients’ lives into consideration.
A family nurse practitioner plays an important role in fulfilling healthcare needs.
The role of an FNP
A family nurse practitioner is a qualified and knowledgeable jack of all trades. As advanced practice registered nurses (APRNs), they provide primary healthcare to a wide range of people from multiple demographics and backgrounds, with a particular focus on health education, preventative healthcare and the promotion of healthy lifestyles.
An FNP will often treat the same person throughout that person’s lifetime. They are trained to care for infants, children, adolescents and the elderly, as well as adult patients. As family nurse practitioners, they will frequently see all the members of the same family in the course of their work, observing, treating and caring for that family as it grows and changes, and seeing them through important milestones like births, deaths and the changing health needs of different life stages.
As such, the role of an FNP can be varied and far-reaching. Day-to-day duties might include conducting routine physical examinations, diagnosing conditions and illnesses, deciding on treatment plans and prescribing medication. They may also assist with minor operations and make referrals when necessary.
A large part of a family nurse practitioner’s practice is looking at a patient’s overall health and, if appropriate, advising them on lifestyle changes, such as a more suitable diet, exercise programs and the moderation or cessation of unhealthy habits like drinking alcohol or smoking. Through health education, FNPs give patients the tools to make informed choices about their own health. This allows them greater autonomy where their own bodies are concerned and grants them more control over their future.
Communication and collaboration
Excellent communication skills are an essential asset for FNPs, as they will spend a lot of time talking with patients and establishing long-term relationships based on trust and confidentiality. This ability to get to know the patient in depth is one of the great benefits of becoming a FNP, as well as being a core principle of holistic health. For those interested in pursuing this career, reputable institutions such as American International College (AIC) offer an online MSN-FNP program that enables students and working nurses to qualify as family nurse practitioners. Students develop holistic and evidence-based practices to ensure they give patients a high quality of care.
Another important facet of being an FNP is collaboration. Although in many states, FNPs have full practice authority, they still collaborate with doctors and other healthcare professionals when appropriate, to give their patients the best all-round care. They may also choose to refer patients to alternative or complementary medical practitioners. In many areas, FNPs have an excellent relationship with local acupuncturists, homeopaths and other alternative practitioners, and will recommend their services in certain cases.
Empowering patients
Family nurse practitioners are primary care providers who are often the main healthcare resource for underserved communities. Empowering the people that they care for to take charge of their own health is just as important as administering treatment or prescribing medication. The relationship between an FNP and their patient is also collaborative and is based on taking a long-term view of the patient’s health.
As an FNP may see the same patients over the course of that patient’s lifetime, they are less concerned with short-term fixes and more focused on addressing the bigger picture in terms of helping patients live long, healthy and independent lives. This requires training in multiple disciplines, from nutrition to mental health, and amounts to a truly holistic approach to patient welfare that sees good health as the optimal outcome.
Overall wellbeing
A holistic approach to health looks at the whole person, not just the specific condition, injury or disease that prompted the consultation. The aim is to promote overall wellbeing rather than simply the absence of illness. To this end, the patient’s mental, emotional, social and spiritual welfare are considered alongside their physical wellness.
Holistic health theory is also concerned with how the different aspects of our being affect each other. Traditionally, mental health and physical health have been considered as entirely separate matters, with the latter being very much prioritized by official healthcare providers. Today, we are much more aware of both the importance of mental health and how our state of mind can affect our physical wellbeing and vice-versa, something holistic practitioners have known for thousands of years.
By taking the whole person into account, holistic healthcare works actively towards long-term positive outcomes for the patient. This approach is reflected in the life-long, all-round care provided by a family nurse practitioner.
Know thyself
As a confidant, adviser and health mentor to their patients, an FNP encourages self-knowledge and exploration by those patients. A key holistic tenet is ‘know thyself’ and patients are encouraged by their FNP to observe and understand their own needs, impulses and influences. By seeing how the mind and body work together, and how both interact with a person’s environment, cultural background and spiritual values, among other factors, patients can discover their own personal path to better health and a more fulfilling life.
A holistic practitioner will always look for underlying causes and long-term solutions rather than the immediate symptoms that present on the surface. For instance, in the case of disease, they may ask what makes the body prone to infection, and how that can be changed. A holistic approach is preventative and proactive, improving overall health in order to reduce the risk of future sickness.
Family matters
Getting to know the whole person helps an FNP to decide on an appropriate course of treatment. FNPs have an advantage over some other medical practitioners in that they often care for several members of the same family, which allows them to see how that family interacts and what common qualities may affect individual family members’ health.
A knowledge of the family’s health history, as well as its general background, economic status, cultural attitudes and even religion can help FNPs to understand health issues better. FNPs will often spend a significant amount of time talking to their patients and getting to know them. This allows them to build a complete picture of the patient, so they can recommend treatment or courses of action accordingly.
Symptoms as signs
Many signs of poor health are often ignored or accepted as unavoidable, such as feeling tired or ‘out of sorts’, having little appetite or being stressed and irritable. By talking with patients, FNPs can uncover symptoms that patients might otherwise not have disclosed and can take these into consideration as well as the primary complaint. A holistic approach will prioritize proper nutrition, exercise and sleep, while also accepting that each person may have slightly different requirements in terms of what is appropriate for their needs.
Physical injuries that appear to be random accidents may have underlying causes that are not obvious. These causes may be environmental, such as an unsafe workplace, or psychological, where a person is ‘accident-prone’ due to distraction or depression. Sometimes, a physical accident may be a ‘wake-up call’ to let a person know that they need to make changes in their life.
A holistic approach to physical injury isn’t just about treating cuts and bruises or setting bones. It’s also about taking steps to reduce the risk of similar injuries happening again. In some cases, the injury can be a surface manifestation of a more deeply rooted problem, which a holistic approach recognizes and seeks to address.
Mental and emotional needs
Addressing our mental and emotional needs alongside our physical health is important if we are to achieve a balanced state of overall health and wellbeing. Our minds need both a sense of security and regular stimulation. This means that while we naturally want to feel valued, loved and safe, we also need regular challenges. All these things, in balance, are necessary for good mental health.
Older people in particular can benefit from keeping their minds active and exercised as well as their bodies. Mental activities ranging from Sudoku and crosswords to learning new languages can create or strengthen neural pathways in the brain, reducing the risk of memory loss, depression and dementia.
Self-expression in a creative sense is also valuable in giving us a feeling of purpose and connection. Playing a musical instrument is an example of a positive holistic practice, as it exercises the body, the mind and the spirit as we work to produce results that are satisfying both physically and emotionally. A holistic FNP may recommend such an activity alongside more conventional medical intervention.
Social connections
Our relationships with other people can also contribute to our overall health. Setting boundaries, feeling valued, strengthening social connections and giving back to those that have supported us can all help us to feel better in a holistic sense. Negative or toxic relationships need to be repaired or cut out in order to support healthy personal growth and wellbeing.
Connecting with nature by spending time in green spaces or with animals can be of enormous benefit. Conversely, environmental factors like noise, pollution, lack of daylight or a negative and threatening atmosphere can cause stress or even physical illness, directly impacting our health. When FNPs use holistic methods, they look at where and how their patients are living as contributory factors to their total health.
Managing conditions
A holistic approach can be especially useful when addressing a chronic condition that cannot be cured and needs to be managed instead. Looking at the condition in the context of the patient’s lifestyle, their cultural values, their family history, their aspirations and their immediate surroundings, provides the basis for ongoing treatment and effective health management strategies.
Family nurse practitioners can help by educating patients on self-care and managing stress as well as suggesting mental and physical exercises that may assist in controlling symptoms. A condition that affects a patient’s whole life is also affected by their whole life, and discussions with the patient about how they feel, how their condition interacts with other life challenges and what they would like to achieve from treatment, can contribute towards creating a collaborative health roadmap.
Additional steps, such as building a strong support network, improving mental and emotional resilience and developing an immediate environment that improves rather than hinders quality of life, are all holistic approaches that have been successfully adopted by FNPs and others.
The biopsychosocial model
Many medical professionals, including FNPs, use the biopsychosocial model as first defined by George Engel in 1977 as a lens through which to understand health conditions, especially those involving chronic pain. This can be thought of as a holistic approach as it takes social and psychological factors into account alongside biological ones. Sample factors might include trauma, coping methods, self-esteem and beliefs about one’s condition (psychological), alongside economic circumstances, family status and work issues (social).
There is a growing consensus that psychological treatment should be used alongside physiotherapy when managing chronic pain, as the experience of pain is as much mental as it is physical. This approach is intrinsically holistic as it does not look at a problem in isolation but in the context of the whole person’s experience and life history.
The family nurse practitioner’s role in holistic care
Caring for a community is about more than patching up injuries and sending people on their way. An FNP is increasingly expected to think about the overall wellbeing of those they serve. Accordingly, family nurse practitioners working in a primary care role often find that holistic methods provide the most effective treatment for their patients.
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