NUR 392 Module 7 Reflections on Health and Holistic Practice Example

Why Health Matters, Seen From the Night Shift: A Reflection on Holistic Practice and the Barriers Patients Bring

Student Name

Edson College of Nursing and Health Innovation, Arizona State University

NUR 392: Health Promotion Across the Life Span

Instructor Name

Month Day, Year

Why Health Matters, Seen From the Night Shift: A Reflection on Holistic Practice and the Barriers Patients Bring

At the start of this course I defined health as the capacity to do what matters, now and later. Seven modules later, I still hold that definition, but I understand it better. This reflection looks back at my personal goal, considers what holistic nursing practice means in an intensive care unit, describes barriers to health I see in my patients, and explains what I will do differently.

A Second Look at My Definition

My Module 1 definition tied health to having the energy for what matters, today and decades from now. I would now add a third element: health depends on conditions people do not choose. My own schedule limited my sleep in ways no walking goal could fix, and many of my patients face far heavier constraints, such as two jobs, no car or no insurance. A definition of health that ignores those conditions puts all the responsibility on the individual. Including them reminds me, as a nurse, to ask what stands in a person's way before asking what they are willing to change. That shift, from motivation to circumstance, is probably the lesson from this course I value most, and it shapes each section that follows.

My Own Goal, Revisited

My first-week goal was a 20-minute outdoor walk before sleeping after night shifts, four days a week. I met it in five of the seven weeks. The two weeks I missed were both weeks with four shifts in a row, when I went straight to bed. My step count rose by about 2,000 steps a day on the days I walked, close to the gain an umbrella review of activity trackers reported for tracker users on average (Ferguson et al., 2022). When I repeated the Life's Essential 8, my physical activity score improved, but my sleep score did not change. That taught me something I will use with patients: a goal can succeed and still leave the bigger problem untouched. Walking helped my activity; it did not give me more hours of sleep. My next goal has to address the schedule itself, such as asking for no more than three shifts in a row.

What Holistic Practice Means in an ICU

Holistic nursing treats the person as a whole, with physical, emotional, social and spiritual needs that interact, and it sees the nurse's own well-being as part of practice (Friberg & Saewert, 2023). In the ICU, it is easy to treat the person as a set of organ systems and numbers. This course made me notice how much of what I already do is holistic, such as explaining procedures to frightened families or arranging for a chaplain, and how much I leave undone because the shift is busy.

The clearest example is health promotion. Before this course, I did not think it belonged in the ICU. In Module 6 I critiqued how our unit addresses smoking, and I realized that a patient recovering from a heart attack may be more ready to talk about quitting than at any other time. Holistic practice means seeing that moment and using it, even in a unit where survival comes first. The evidence supports this: brief advice alone does little, but counseling that starts in the hospital and continues afterward helps people quit, especially with medication (US Preventive Services Task Force et al., 2021).

Barriers to Health I See

Three barriers stand out in the patients I admit. The first is access: many patients arrive with conditions that were never diagnosed because they had no regular source of care. The second is cost, which leads patients to ration medications such as inhalers and insulin. The third is time and work, the same barrier I faced in my own goal, but much harsher for patients who work two jobs or care for family members. These barriers are not personal failures, and a health promotion plan that ignores them will fail. Our readings on barriers in the health care system describe how fragmented services and insurance gaps shape what people can do; I see the results every night.

What I Will Carry Into Practice

First, I will ask about health behaviors and barriers when patients are able to talk, not only at admission. Second, I will set goals with patients the way I set mine, small and measurable, and check whether they address the real problem. Third, I will take my own health more seriously, because a nurse who is exhausted cannot practice holistically. Finally, I will remember that health promotion is not only for clinics. Every patient who leaves the ICU leaves with a future, and that is why health matters.

References

Ferguson, T., Olds, T., Curtis, R., Blake, H., Crozier, A. J., Dankiw, K., Dumuid, D., Kasai, D., O'Connor, E., Virgara, R., & Maher, C. (2022). Effectiveness of wearable activity trackers to increase physical activity and improve health: A systematic review of systematic reviews and meta-analyses. The Lancet Digital Health, 4(8), e615-e626. https://doi.org/10.1016/S2589-7500(22)00111-X

Friberg, E. E., & Saewert, K. J. (Eds.). (2023). Conceptual foundations: The bridge to professional nursing practice (8th ed.). Elsevier.

US Preventive Services Task Force, Krist, A. H., Davidson, K. W., Mangione, C. M., Barry, M. J., Cabana, M., Caughey, A. B., Donahue, K., Doubeni, C. A., Epling, J. W., Jr., Kubik, M., Ogedegbe, G., Pbert, L., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2021). Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. JAMA, 325(3), 265-279. https://doi.org/10.1001/jama.2020.25019