Holistic Nursing: A Basis for Curriculum

Abstract

Dissatisfaction with the basis of curriculum designs in use, and movement of nursing education from hospitals into educational settings have led schools of nursing to experiment with their curricula. The former emphasis on diseases or conditions which patients suffer is being replaced by interest in how people function in health and illness both as individuals and members of communities. The new emphasis is brought out in various ways. One curriculum plan focuses on the kind of health care required; short term, acute care or care over a long period of time. Another concentrates on the nursing process, defining the specific care problem and seeking a solution or solutions for it (l). Still another centers around the adaptive capacity of the person when faced with challenges to his current adaptation (2). We found the following approach to curriculum design, based on Myra Levine's theory of holistic nursing, useful in a two year college nursing program. The merit of using this theory is that it provides a comprehensive yet easily understood way of looking at human response to challenges to its well-being. Levine's theory of holistic nursing, stated in the 1960's, is that people respond physically, psychologically, and socially to changes in themselves and in their environment. While this statement is not new, her division of the individual's complex response so it can be examined and used as a basis for nursing care is unique. Levine outlined four principles which are useful in planning and implementing care. These are the individual's need for energy and for structural, personal and social integrity. The principles are called conservation principles because care is centered around the preservation of personal well-being. In the holistic approach, the goal of nursing intervention is to preserve the basic entirety of the person. In addition, a thorough reading of Levine suggests that nurses need not just help a person maintain the status quo in his adaptation to life if that adaptation is less than optimum. Levine also sees the conservation principles as guiding care so it is "kept together with" the patient's ability to participate in his care (3).