Running head: SELF-REFLECTION 8.

Self-Reflection 8.1
Tracy Terrones
University of Arizona

Self-Reflection 8.1
Overview of Optimal Healing Environments
My explanation of an optimal healing environment (OHE) is when the caregiver unites
and provides care for a patients physiological, psychological, and spiritual wellbeing
(Zborowsky & Kreitzer, 2014). When the nurse implements integrative nursing and alternative
therapies with traditional medical treatments the patient benefits with chances for optimal
healing. In order to provide this type of nurturing attention the nurse must first practice self-care
(Quinn, 2014). NURS653: Healing Environments and Practices brought forth the discovery of a
new way of caring for my patients in the Cardiac Cath lab (CCL), bringing attention to ones
mind, body, and spirit for optimal healing.

My workplace atmosphere in the CCL for the past 17 years has very little practice of
alternative therapies. This facility is very fast paced, has five procedural suites, caring for up to
30 patients a day and emergent cases 24/7 for patients having acute myocardial infarctions
(AMI). I have 20 staff members and 14 Cardiologists providing patient care. The suites or labs
that the patients are transported to for their angiogram are not very inviting, they are very cold
(62 degrees), sterile, with white walls, and bright lighting. There are four health care providers
per suite, a nurse, two radiologist technologists and the cardiologist. The average time frame for
a coronary intervention is an hour and a half and the patient is under mild sedation. At no point
has integrative nursing been brought into this setting.
The Cath lab is in dire need of alternative therapy. As healthcare providers our focus is
definitely on delivering excellent patient care but also greatly influenced by the technologies of a
CCL. While caring for our patients everyone is genuinely kind and compassionate with the
attention being solely on the patient. When it comes to OHE, the provision of warm blankets and
the radio is about all that is offered. I now see many areas I can work toward improving an OHE
in my CCL. First I would like to assist the staff and physicians to see the benefits provided by
self-care and how it will improve their life. Starting with a revamping our break room by adding
pleasing aromas, relaxing music, inspiring posters, pamphlets for massage/yoga studios, and
possibly a massage chair. Myself and the employees stress will be reduced and they we will be
more relaxed for the recipients of our care (Quinn, 2014). As for the patients and families of the
CCL, I plan to provide a relaxation room with an aquarium, soft lighting, soothing music,
comfortable chairs, and pleasing artwork. This room can be utilized prior to procedure for the
patient but anytime for the families. In the procedural area the choice of an essential oil applied
on the patients pillowcase will be easily implemented. Updating our stereo system to offer

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patient requested music would be another task to complete. Alternative therapies are limited in
the CCL as the operating room policies dictate what is allowed. The lighting and paint are
hospital mandated in this sterile setting. Im exploring how I can incorporate touch therapy in the
CCL for our patients wellbeing.
Principles of Integrative Nursing
Humans and healing
In healthcare it is necessary to treat humans as a whole system rather than just their
medical condition. It has become a need and a demand by the population. Healthcare facilities
must provide the environment to foster total wellness with the body, mind, and spirit for their
clients. The integration of alternative therapies for hospital personnel, the patients and the
community increases overall wellbeing, happiness, and energy (Koithan, 2014). The eco system
of the facility weighs greatly on the health of individuals and as integrative nurses it is essential
to provide the healthy environment not only for diagnosis/treatment but also the whole human
(Koithan, 2014). When receiving my AMI patient from the emergency department personnel, I
consistently have the family come in the CCL and give their family member a quick kiss before I
whisk them on to the CCL table and begin the emergent life saving procedure. I do this knowing
my patient could die and that could be the last time they see each other. I know this comforts
both the patient and the family member and they see I am treating them as a whole human not
just an AMI.
It is natural for humans and exists from birth the power for wellness (Koithan, 2014).
Knowing humans have the innate capacity for health and wellness, an integrative nurse helps to
steer their patient/ family in the direction of self-care (Quinn, 2014). The nurse provides the
client awareness of the need to harmonize the mind, body, and spirit to achieve health wellness.

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Following a heart attack and receiving a stent, most patients are inclined to listen to any health
tip you can provide. They have the natural instinct to want to be healthy for themselves and to
help care for their families. It is at this point I am able to explain, the need for not only smoking
cessation and proper diet, but also how important it is to have self-care for their mind. I explain
how increased stress effects blood pressure and their arterial system negatively and a daily walk
will help their mind and spirit as well as their body.
Humans are complex adaptive systems that are intertwined instinctively with nature. It is
air, water, plants, and animals that effortlessly contribute to a humans wellbeing (Koithan,
2014). This affirmative relationship with nature rejuvenates the soul and promotes healing.
Encouraging my CCL staff to exercise and providing opportunities to make it to their boot
camp classes at the local park or a walk outside on our hospitals walking path supports their
wellness and decreases tension. Coming out of the cold basement and becoming one with the
outside environment invigorates their humanities and assists in providing ideal patient care.
Person-centered and evidence-based care
Forming a true bond or relationship with your patient and seeing them as a unique
individual not a medical diagnosis or room number is person-centered care (Koithan, 2014). By
building relationships with your coworkers and organization to create healing teams derived
from the individual relationships formed with each others patients we can move forward for
positive healthy outcomes for everyone involved. In the Cath lab as I prepare a patient for their
angiogram, I genuinely try to bond with them. I see forming a relationship, no matter how small,
it eases their soul. My co-workers visualizing this bond I try to make each time, rubs off on them
and I see them bond with the patients as well. The harmony we create enhances our patient care
in the Cath lab and our community.

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The integrative nurse incorporates different therapeutic modalities to enhance traditional

care (Koithan, 2014). The nurse reviews each patient and situation for the best intervention to
improve their healing. Combining touch therapy to ones ventilated patient or essential oil to a
patients or family members clothing aids in physical wellbeing. As the physician attempts to gain
arterial access I encourage the patient to imagine they are in one of their most relaxing places
and to calm their breathing as I hold their hand, all of these being therapeutic modalities (Foji,
Tadayonfar, Mohsenpour, & Rakhshani, 2015).
Focus on health and wellbeing
As a provider of health in integrative nursing you are aware that you must have self-care
in order to properly care for your patients (Koithan, 2014). If the caregivers balance of mind,
body, and spirit is out of equilibrium they are unable to bring harmony to patients will providing
their care. As an integrative nurse you emulate to others your self-care and healthy behaviors,
and in doing so promote optimal physical and spiritual wellness for yourself and others. By
bringing my positive energy to the CCL I encourage a healing environment for all the staff,
patients, and families. By actively caring for myself I am able to disperse this optimistic energy
naturally and create a superior healing ecosystem for the CCL and the community.
Leadership in Integrative Health
Role of Leaders in Facilitating an OHE
As a leader in integrative healthcare it is our duty as nurses to create optimal healing
environments for our patients and staff. Identifying areas that can benefit from an OHE
atmosphere and inspiring the population with the idea for implementing the change is the
valuable role of a leader (Kreitzer & Somerville, 2014). Organizing an integrative nursing team

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and combining the philosophies brought to the table of other health care providers is a start to
whole wellness for the patients and community.
Design of Optimal Healing Environment
Creating an OHE in our CCL waiting area, I will change the environment to promote
whole wellness for patients, families, and staff. The institution of an aquarium brings nature into
this waiting area and promotes a healing setting to contribute to the humans wellness (Koithan,
2014). My strategic plan in addition to the aquarium is to instill art therapy, music therapy, and
natural lighting. The facility has artwork available to hang and the local library has artwork to
rent, it just takes the initiative to make it happen to provide optimal healing area for everyone
(Steinke & Moore, 2013). Having maintenance review and update the already installed stereo
system is minimal effort to provide beautiful music therapy, which enhances ones soul (Spies
Ingersoll & Schaper, 2013). These small steps of complementary alternative methods will
maximize the patient and the staffs wellbeing.

Leadership Strategies for Implementation and evaluation of OHE

As a leader I will communicate with the staff the vital need to design an OHE in our
CCL. I will explain integrative therapies and how it benefits wellness when the mind, body, and
soul are in complete harmony. Sharing literature from this course and the Caritas video with the
CCL staff this week and together making a goal to implement our OHE by December for our
busy winter season. After a month of alternative therapies shared in this waiting area, we will
have an evaluation form created and dispersed to the staff and patients regarding how this OHE
affected their mind, body, and spirit. The foreseeable outcome will be seen with increased patient
satisfactory scores, patients, staff, and organization will verbalize the beauty of our updated

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methods of care. Patients will recommend our facility to family member, friends and other
members of the community. This will promote healing and wellbeing in our community.

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8
References

Foji, S., Tadayonfar, M. A., Mohsenpour, M., & Rakhshani, M. H. (2015). The study of the effect
of guided imagery on pain, anxiety and some other hemodynamic factors in patients
undergoing coronary angiography. Complementary Therapies in Clinical Practice, 21,
119-123. http://dx.doi.org/10.1016/j.ctcp.2015.02.001
Koithan, M. (2014). Concepts and principles of integrative nursing. In M. Kreitzer, & M.
Koithan (Eds.), Integrative Nursing (pp. 3-16). New York, NY: Oxford University Press.
Kreitzer, M., & Somerville, B. (2014). Building an integrative health program. In M. Kreitzer, &
M. Koithan (Eds.), Integrative Nursing (pp. 56-67). New York, NY: Oxford University
Press.
Quinn, J. F. (2014). The integrated nurse: wholeness, self-discovery, and self-care. In M. J.
Kreitzer, & M. Koithan (Eds.), Integrative Nursing (pp. 17-32). New York, NY: Oxford
University Press.
Spies Ingersoll, S. S., & Schaper, A. (2013). Music: a caring, healing modality. In B.
Montgomery Dossey, L. Keegan, C. C. Barrere, & M. Blaszko Helming (Eds.), Holistic
Nursing A Handbook for Practice (6th ed., pp. 397-415). Burlington, MA: Jones &
Bartlett Learning.
Steinke, P., & Moore, N. (2013). Relationship-centered care and healing initiative in a
community hospital. In B. Montgomery Dossey, L. Keegan, C. C. Barrere, & M. Blaszko
Helming (Eds.), Holistic Nursing A Handbook for Practice (6th ed., pp. 583-607).
Burlngton, MA: Jones & Bartlett Learning.

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Zborowsky, T., & Kreitzer, M. (2014). Creating optimal healing environments. In M. Kreitzer, &
M. Koithan (Eds.), Integrative Nursing (pp. 84-100). New York, NY: Oxford University
Press.