CONVERSATIONS
Barbara Dossey, PhD, RN: Expanding Holistic
and Integrative Nursing to a Global Scale
Interview by Craig Gustafson
Facilitated by the Academy of Integrative Health and Medicine (AIHM) Annual Conference to be held September 22 to 26, 2018
in San Diego, California. http://wwwaihm.org/.
Barbara Dossey, PhD, RN, is Co-Director, International Nurse
Coach Association (INCA) and the International Director,
Nightingale Initiative for Global Health (NIGH). She has
played an instrumental role in expanding the domain of
traditional nursing. As a pioneer in the holistic nursing and
nurse coaching movements, she has worked to advance the
practice and philosophies of holistic care, both within the health
professions and in the lives of lay people. Barbara articulates
how healing is promoted by attending to the delicate interaction
of body, mind, and spirit, and how centuries-old concepts can
be successfully applied in the care of patients and in everyday
living. Dr Dossey is the author of many respected and
award-winning books. Her book, Florence Nightingale: Mystic,
Visionary, Healer,1 focuses on the philosophical and practical
impact of Florence Nightingale’s life and work on modern
nursing and humankind. Other recent publications include
Nurse Coaching: Integrative Approaches for Health and
Wellbeing,2 The Art and Science of Nurse Coaching,3 and
Holistic Nursing: A Handbook for Practice.4
Alternative Therapies in Health and Medicine (ATHM):
What topics are you going to be involved with at the
conference?
Dr Dossey: I will participate in a panel discussion with two
nursing colleagues. We will explore the role and the skills of
holistic and integrative nurses and the emerging paradigms
of how we truly create health. Holistic and integrative nurses
incorporate complementary and integrative practices that
can improve health outcomes.
Holistic and integrative nursing involves all nursing
practice and has healing the whole person as its goal. Holistic
nursing is person-centered and relationship-centered.
Currently in health care, a nurse is required to do so much in
a short period of time. They have checklists, assessments,
58 ALTERNATIVE THERAPIES, SEP/OCT 2018 VOL. 24 NO. 5
evaluations, protocols, treatments, medications, and teaching
patients on aspects of their illness or self-care for discharge.
We know that many patients want to learn how to
become healthier. One of the topics that I will share will be
integrative nurse coaching. There are several types of nurse
coaching. One is laser coaching that is done in a short period
of time. Another type of nurse coaching is to engage clients/
patients in learning new behaviors to manage life balance and
stress in a 20- to 30-minute session over two to three weeks
or over several months. People can make temporary changes;
however, the key is learning how to sustain these new
behaviors, and this takes longer.
Nurse coaching is not about fixing problems. It is a
co-creative nurse–patient process of assisting the person to
access her or his inner wisdom towards change and
transformation. One way to begin this process is to ask a
curious question such as, “Tell me one thing that you want
me to know about you?” This allows the nurse–patient
relationship to unfold in a flowing manner. The patient
actually feels as if the nurse is actually listening in the present
moment. I want to include that the nurse must also engage in
her or his own inner work and self-care practices. This is
truly a thrilling way to practicing the art and science of
nursing.
ATHM: Are you saying that nurses can support and coach
patients along a holistic pathway to health when they
themselves are traveling the health pathway, too?
Dr Dossey: This is absolutely correct. When nurses engage in
their own self-development, a process of self-reflection, self-
assessment, and self-evaluation, they recognize what it
means to be in the present moment with self and others.
The American Nurses Association (ANA) launched
the Healthy Nurse, Healthy Nation in May of 2016 in
Conversations With Barbar Dossey, PhD, RN
recognition of the fact that nurses can be healthier. They
have enormous burnout and stress. Please visit,
http://www.healthynursehealthynation.org/.
Nurses are valued in the culture. Throughout the 21st
century, the Gallup poll has ranked nurses as the most ethical
and trusted profession with the exception of 2001 after 9/11
when firefighters were ranked first. When nurses are healthier,
patients view them as being more credible. Patients respond
better to suggestions that a healthy nurse will share about
improving health.
Nurses’ works never stops. Self-care in any work setting
requires the nurse to value her or his time for self-care and go
to the bathroom, drink water, take a lunch break, and also
take a 15-minute break to get off of the fast work treadmill.
For example, a simple breathing practice can help one
become more relaxed and to release tightness and tension.
When in the present moment one more easily listens to one’s
intuition and has more focused intention with the work in
the present moment. A short practice as I just describe
allows a person to down regulate. Otherwise, we stay in
overdrive the entire shift, unless we are doing these health
practices for ourselves.
If I am making healthier life choices, then my
conversations with clients/patients and people whom I work
with, and my family are different. If I am healthier, I am
going to have more success in partnering with and coaching
clients/patients. I become more aware of what behaviors they
want to change and their other health concerns.
Nurses that are engaged in improving their own health
are more in tune with their own inner wisdom and thus,
sessions with clients or patients become more focused on
positive strengths to make a change and then to how to use
these strengths to sustain the change over time.
ATHM: And so you have adopted health practices in your
own work and life?
Dr Dossey: It became clear to me many years ago that I
would be in a better place if I applied self-care principles in
my own life. And consequently, I have learned to recognize
stress eating, [failing to] taking time for myself, and how to
inform myself differently about setting goals—what is
realistic. Then, when I begin to work with like-minded
colleagues, clients, or patients, my conversations are different.
I listen differently; I ask curious questions that take people
into a deeper space for self-reflection to discover new
insights about their current behaviors and how to change.
I am more excited, right now, about nursing than I have
been in my 53-year career. It has to do with shifting from
life-span and chronic-disease management to a focus on
health span with holistic and integrative philosophies and
living from this space daily. This nurse-coaching philosophy
has taking my life work to a deeper level.
ATHM: What else will be discussed?
Conversations With Barbar Dossey, PhD, RN
Dr Dossey: Our panel will also focus on the role of
consciousness and what is meant by one mind-one health-one
planet. To align with this, I will contribute my work as a
Florence Nightingale scholar and share Nightingale’s legacy
for the 21st century.
Florence Nightingale (1820-1910), the founder of
modern secular nursing and the first nurse theorist, began to
write in the 1870s that it would take 100 to 150 years for the
kind of nurses and nursing she envisioned that would focus
on the health of the world. She left all nurses and concerned
citizens with an expansive worldview of how to carry forward
her vision of health, including what we would today call the
environmental and social health determinants. Environmental
determinants of health are clean air, water, food, houses, etc.
The social determinants of health are poverty, education,
family relationships, employment, etc. Nightingale foresaw
the complex global problems and challenges and anticipated
the 17 United Nations (UN) Sustainable Development Goals
(SDGs) and the 2030 UN Agenda to transform to a healthy
world—local to global. See: https://sustainabledevelopment.
un.org/sdgs.
The SDGs are very relevant for health as they apply to
our work and home environment. For example, when I hear
a hospital nurse say, “Every time I go to work, my asthma
flares up. I had a terrible time the whole 12-hour shift. My
hospital unit is making me sick.”
The first thing that I want to know is what products are
being used to clean and wax the floors or what air freshener is
being sprayed. Regular cleaning products are toxic chemicals
called human endocrine disruptors. They cause symptoms as
they interrupt the healthy immune system pathways.
An important organization for information about green
products is Health Care Without Harm. See: https://noharm.org.
This information must also be considered in one’s personal
environment. People are beginning connect-the-dots to work
environment, home environment, and the community
environment where they live.
Many nurses are now serving on hospital committees to
review what kind of supplies are being ordered and how
greener products can be purchased. I recently heard a nurse
declare, “I am a Green Nurse and serve on the Hospital
Green Committee.”
ATHM: How does that anecdote align with the SDGs?
Dr Dossey: The example that I gave addressed SDG number
three, Health and Well-Being. Green products are considered
under SDG number 12, Responsible Consumption and
Production.
When we make our hospitals healthier, the effects aren’t
limited to that hospital, but people from the community who
come into the hospital. This awareness of green products can
be shared to build a green community. The key is SDG
number 17, Partnerships for the Goals.
This interview helps spread the momentum from local
to global. We can always ask, “How can I be healthier?”
ALTERNATIVE THERAPIES, SEP/OCT 2018 VOL. 24 NO. 5 59
 Nightingale foresaw all of these SDGs in her lifetime.
She wrote about these ideas in her Notes on Hospitals in 1859
and her Notes on Nursing in 1860, and for the next 40 years
in various articles and documents. Health is a major theme
that runs across all of Nightingale’s work. She called her work
her must. My must is to assist nurses to realize that they are
engaged in global nursing. All things that we do at the local
level impact the global level. Thinking about the word glocal
can remind us that everything that we do is local to global.
When nurses engage in their own hospital, in their own
community, and also explore their [own] health, they are
being involved in global nursing. Your interview with me will
have broad implications because it will reach, not only people
that will register for the AIHM conference, but others, as
well. AIHM is very generous, too, in giving a lot of interviews
and putting them out there in the public space.

60 ALTERNATIVE THERAPIES, SEP/OCT 2018 VOL. 24 NO. 5 Conversations With Barbar Dossey, PhD, RN
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