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Discussion: Level of Trial and Error


Discussion: Level of Trial and Error

The newness of the theory means many

nurses have not yet had an opportunity to

fully understand its meaning and test its

integrity. Nurses must engage in a certain

level of trial and error as understanding

of the theory becomes more prevalent and

its precepts become more integrated into

everyday practice, a process likely to take

time and require the involvement of nurses

who are willing to be leaders and change

agents. Strategies that will facilitate

application of the theory of integral nursing

must be seated in the current world

of healthcare practice—a world often

characterized by timelines, capitation

Exploring the Theory of Integral Nursing
32 International Journal for Human Caring

payment models, and embedded, long-

standing practices. The theory brings a more

open vision of the client-nurse relationship,

especially as it relates to the roles of each

partner who is part of the pain management

experience. Many questions remain open for

investigation through both qualitative and

quantitative research, such as: How will

nurses talk about the differences in their

everyday practice when practicing from a

holistic theory that views healing as the

central focus of care? How will holistic

pain management care be perceived by

clients and families? What is the

relationship between care driven by the

theory of integral nursing and quality of

life for clients experiencing pain? To what

extent might the creation of a sacred place

for care produce tangible and satisfying

outcomes for clients and nurses? The nurse’s

role is to carry out interventions with and

for clients—interventions that manifest

caring and mutual respect and promote

health and healing, especially in the area of

pain management care. Application of the

theory of integral nursing challenges nurses

to engage clients and families in their own

healing and work collaboratively with

clients, families, and other members of the

healthcare team to design novel initiatives

that advance pain management practice.

Nursing needs this holistic, caring theory

to return the client to the center of care

and to push the envelope of grounding

practice in theory.


The multidimensional, individualized,

and complex nature of the pain experience

requires nurses to design and apply new,

theoretically driven pain management

interventions not only rooted in the

assumptions of holistic nursing, but

grounded in the realities of relationship-

centered care. The theory of integral

nursing offers a unique framework for

nurses to collaborate with clients in

mutually beneficial, interactive, and trusting

relationships centered on healing. The

complex nature of the pain experience

requires nurses to listen carefully to clients

so as to co-create theoretically driven

strategies that guide nursing practice and

are focused on the assumptions of client

and relationship-centered care. By focusing

on the integral nature of client experiences,

theory-driven holistic outcomes foster a

closer client-nurse relationship and press

the client and nurse to strive for outcomes

that help unravel the complexity of the pain

experience. By substituting a holistic vision

of care for the habitual, task-driven ways

of managing pain, nurses partner with

clients and families and come to understand

the power inherent in theoretically driven,

autonomous nursing interventions that

create new ways of practicing while

remaining focused on client healing.

Designing individualized nursing

interventions grounded in the assumptions

and concepts central to the theory of integral

nursing requires nurses to be committed to

involving the client in the design of care as

they collectively create new forms of care—

care that emerges from the synthesis of

theoretical constructs, client’s experience,

and the nurse’s knowledge and expertise.

Translating integral theory concepts into

practice and disseminating knowledge about

the theory’s usefulness in everyday care is

critical to refocusing 21st century practice.

The novelty of integral nursing theory

mandates additional research that tests the

theory’s propositions in clinical practice

and encourages clinicians to describe the

impact of the theory from their own


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