Abstract
January 02, 2024
Editor-in-Chief, Journal of Holistic Nursing
W. Richard Cowling III, RN, PhD, AHN-BC, FAAN, ANEF
Dear Dr. Cowling,
I read with undivided attention the article titled “‘We’d Just Patch Ourselves up’: Preference for Holistic Approaches to Healthcare and Traditional Medicine among Members of a State-Recognized Tribe” (Reese, Dang, & Liddel, 2023). This study provided valuable insights into the disparities and inequities felt by marginalized Indigenous populations when seeking healthcare along with ways to integrate a holistic conceptualization of health and traditional medicine practices into Western healthcare institutions. I would like to add to the discussion by considering/reflecting on whether Indigenous healthcare disparities could be eased further when utilizing a holistic, integrative nursing approach.
As an Indigenous nurse and Integrative Nurse Coach, I believe Integrative Health and Wellness Nurse Coaches (HWNCs) are ideally positioned to usher Indigenous patients and their cultural practices, traditional beliefs, and natural therapies into Western healthcare. HWNCs are holistic change agents who facilitate healthy behavioral modification and consider the whole patient, mind–body–spirit–environment including unique cultural backgrounds (Dossey, Luck, & Schaub, 2014). Nurse coaching helps the patient leave their passive role as a recipient and become an active consumer and involved in their health care (Vincent & Sanchez Birkhead, 2013). An integrative HWNC has the requisite skills and knowledge to bridge the gap in healthcare for Indigenous patients in the following ways:
Integrative Nurse Coaches can empower Indigenous patients to reduce their health disparities without the influence of Western healthcare institutions and modalities. Both nurses and traditional Indigenous populations believe each patient has the ability to heal themselves when the environment, internally and externally, is conducive and balanced. Integrative Nurse Coaches can influence interest and inspire exploration into ancestral traditional diets and plant-based, natural, or herbal remedies. They can challenge each patient to learn about their nutritional heritage, analyze their current Western diet, and incorporate the modern ancestral equivalent into their lifestyles. In a sense, the Indigenous patients would have the control, the knowledge, and the ability to decolonize their own Western diet. Integrative Nurse Coaches can facilitate spiritual progression, awaken traditional religious curiosity or interest in the Creator, and bear witness to the reclaiming of ancestral beliefs. Nurse Coaches are known to question a patient's purpose in life and what meaningfulness they sense in this journey through varied interventions. Integrative Nurse Coaches can educate, teach, and most importantly clarify any misconceptions and misinformation about healthcare and diagnoses this population may have. The intimate one-on-one sessions allow for quality patient–provider time which is generally uncommon in healthcare. Integrative Nurse Coaches can begin to mend and repair historical healthcare trauma suffered by any marginalized and discriminated population by establishing trust and presenting a consistent, healthy patient–provider relationship model. There are no power dynamics as these nurses understand the patient is the expert of themselves and that therapy follows their lead. Nurse Coaches hold space for each patient and authentically walks with the patient while they navigate through their multilayered world.
These strategies have the capability to ignite a drive, or better yet a sense of responsibility in Indigenous patients to foster their own health outcomes in a way of honoring our ancestors. In addition, this can promote co-creating newly adapted traditional lifestyles with habits that benefit the health, well-being, and longevity of future Indigenous generations. Further research is fundamental to establish nurse coaching clinical significance and create valuable findings for not only Indigenous populations but any community burdened with health disparities, and inequities beyond their control.
