The Baseline is Being Well

C reative Nursing 2015 has been about empowerment—of patients; of their families, friends, and other primary caregivers; and of health professionals as we partner in the care of those we serve. In this issue, we confront and explore the need to redefine health in this era of the medicalization of everything from childbirth to obesity to sadness. It sometimes seems that illness rather than health has become the baseline or default human condition.

Societal ills and workplace stresses challenge our ability to lead healthy lives. To address the former, nursing professor Mary Ann Pascucci acquaints us with an initiative known as place-making, which “focuses on all aspects of a place, including economics, political agendas, culture, growth and sustainability, and power relations.” She states, “Nursing has a role in the synergy between the health aspects and the principles of place-making.” In the workplace, a wellness bundle of drinking water, standing, and stretching developed by nursing systems specialist Kathryn Koehne counteracted the effects of prolonged sitting and repetitive motion in a group of ambulatory care nurses. Nurse informatician Susan Marcella-Brienza and birthing center director Tina Mennillo remind us that for nurses who are grieving the loss of loved ones, “Frequent reexposure to death, dying, and bereavement in the workplace can affect whether bereaved nurses are able to continue working in an environment that reminds them of their loss.” These authors advocate for very intentional and individualized manager support. Behavioral health nurse Christine Cochrane describes an uplifting workplace scenario in which a behavioral health unit staff provided expert, compassionate, person-centered care to a severely depressed patient who also had a left ventricular assistive device.

The role of nutrition in making health the baseline human condition is addressed in two articles. Nurse practitioner Laura Sandquist advocates for considering food first when assessing and assisting those we serve. She says, “The ultimate goal of using Food First is to create a healthy and respectful relationship with food and to prevent and reverse food relationships based on nutritional perfectionism, shame, and abstinence.” And in her review of Gregory Plotnikoff and Mark Weisberg's Trust Your Gut, nursing professor Mary Johnson reminds us that “the human microbiome is now recognized as a key factor in maintaining not only our health but also our energy, our metabolism, our mood, our behavior, and our immune function.”

In this issue, we confront and explore the need to redefine health in this era of the medicalization of everything from childbirth to obesity to sadness.

Two of the core principles of integrative nursing are that human beings have the innate capacity for health and well-being and that nature has healing and restorative properties that contribute to health and well-being. In “The Promise of Integrative Nursing,” nursing professor and our guest editor Mary Koithan presents three scenarios that beautifully depict the flexibility, whole-systems thinking, and mutuality of true integrative nursing. She says, “Practicing in a supportive role affords nurses the opportunity to focus on strengths rather than deficits, possibilities rather than problems.” The six foundational principles of integrative nursing are used as an outline for nursing professors þóra Gunnarsdóttir and Gísli Kristófersson's report on an international integrative nursing symposium held in Iceland this year.

Another core principle of integrative nursing is that it focuses on the health and well-being of caregivers as well as those they serve. Nurse informatician and former professional ballet dancer Emily Hahn describes the aspects of dance that have informed her nursing practice: “rehearsing” processes and procedures in her mind, taking correction and advice gracefully, and maintaining physical fitness. “I realized early on that nursing, like dancing, was physically demanding, and that if I wanted to do my best, I had to keep my own body healthy.” And PhD student Stephanie Chung presents Daoism as a philosophical system whose precepts can inform and enhance nursing practice. The word Dao is often expressed in synonyms such as course, method, practice, fashion, or technique; she states, “These words all relate to nursing preparation.” And pediatric nurse Natalie Lu narrates the process by which she has become a host of nursing salons: “I am forever inspired by hearing how people found their way to answer whatever called them to their life's work, and my kitchen table is forever enhanced by hosting a platform for these stories to be told.”

Part of the process of returning to health as the baseline human condition is acknowledging the presence of chronic illness. In our “Voices of Patients and Families” feature, Barby Ingle, who describes herself as an author, pain educator, pain patient, and philanthropist, describes living with, and thriving despite, a chronic pain condition, offering sage, practical guidance to people living with chronic conditions and to those who care for them. She advises, “It is up to you to become the chief of staff of your health care team and to make sure you have a strong team willing to help, learn from, and treat you.” In “It Was Not on My Christmas List,” Nancy Endress presents a stream-of-consciousness description of experiences as a newly diagnosed cancer patient, its meaning for her life, and the ways in which kindness makes a difference. Oncology nurse Maureen O'Hara talks with nursing professor Hans-Peter de Ruiter about her 42-year career at Stanford Medical Center. The technological and pharmacological advances she has seen in that time have changed the face of oncology nursing practice and transformed many previously fatal cancers into curable diseases or chronic illnesses compatible with well-being.

For our 2016 publication year, the editorial board of Creative Nursing have chosen the overarching theme of “Determinants of Health.” We will explore social determinants, structural determinants, caregiver determinants, and global determinants. We welcome submissions on this important theme from all walks of nursing life.