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Discussion: Level of Trial and Error
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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.
Summary
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
perspective.
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