AHN-BC cheat sheet

Holistic nursing is defined by the American Holistic Nurses Association as nursing practice that has healing the whole person as its goal.

The five core values of holistic nursing are holism, caring, intuition, spirituality, and cultural diversity.

Nightingale's legacy frames the discipline: attention to environment, observation, and the unity of mind, body, and spirit.

Holism holds that the whole person is greater than and different from the sum of parts; treating only a diagnosis is reductionistic.

Holistic nursing integrates conventional care with complementary and integrative modalities, used as adjuncts rather than replacements for indicated treatment.

The nursing process is applied within a holistic framework, so assessment addresses physical, emotional, social, spiritual, and environmental dimensions.

Scope and Standards of Holistic Nursing Practice are published by AHNA and aligned with ANA standards, adding holistic-specific competencies.

Board certification (HN-BC) requires licensure as an RN, a qualifying degree, supervised practice hours, and continuing education in holistic nursing.

Modalities commonly within holistic nursing scope include guided imagery, progressive relaxation, therapeutic touch, aromatherapy, and mindfulness-based interventions.

Self-care is treated as a professional obligation, not a luxury: the nurse's own health is the instrument of care.

Reflective practice uses structured self-inquiry (what happened, what did I feel, what will I change) to convert experience into learning.

Watson's Caritas processes include 'developing and sustaining helping-trusting, authentic caring relationships' and self-care as prerequisite to caring for others.

Burnout has three dimensions: emotional exhaustion, depersonalization (cynicism), and reduced sense of personal accomplishment.

Compassion fatigue differs from burnout: it arises from empathic engagement with suffering and can include secondary traumatic stress symptoms.

Mindfulness-based stress reduction (MBSR) is an 8-week structured program using meditation and body awareness to reduce stress reactivity.

Journaling, peer debriefing, and clinical supervision are recognized reflective self-care strategies for nurses.

Personal knowing (Carper's pattern) is knowledge of self and of the therapeutic use of self in the nurse-patient relationship.

Signs of impaired self-care include sleep disruption, irritability, avoidance of patients, and errors; these warrant intervention, not concealment.

The holistic caring process uses the nursing process steps (assessment, diagnosis, outcomes, planning, implementation, evaluation) applied to the whole person.

Assessment includes the patient's story (narrative) alongside objective data; subjective meaning is treated as data.

A holistic assessment screen covers physical, emotional, social, spiritual, cultural, and environmental domains.

Nursing diagnoses are written as problem, etiology (related to), and defining characteristics (as evidenced by); holistic etiologies may include spiritual distress or disrupted energy field.

Outcomes are stated in patient-centered, measurable, time-bound terms and reflect the patient's own goals and values.

Carper's four fundamental patterns of knowing are empirics, esthetics, personal knowing, and ethics; a fifth, emancipatory knowing, was later added.

Implementation may include energy-based and mind-body modalities; these require patient consent and documented rationale.

Evaluation compares observed outcomes with stated goals and restarts the process when goals are unmet.

Documentation of holistic interventions should record the modality, duration, patient response, and any change in plan.

Active listening includes full attention, paraphrase, and reflection of feeling; it is distinct from advising or reassuring.

Therapeutic communication is patient-centered and goal-directed; social conversation is not therapeutic.

Open-ended questions elicit narrative; closed questions confirm specific facts.

Nontherapeutic responses include false reassurance, giving advice, changing the subject, and minimizing the patient's experience.

Silence and presence are therapeutic techniques that allow the patient to process and to lead.

SBAR (Situation, Background, Assessment, Recommendation) is a structured handoff format that reduces communication error.

Teach-back confirms understanding by asking the patient to restate the information in their own words.

Health literacy-limited communication is addressed with plain language, chunking, and avoiding jargon.

Interpreter use is required when the patient's preferred language differs; family members, especially children, should not serve as medical interpreters.

Watson's caring theory centers on transpersonal caring moments and ten Caritas processes.

Swanson's theory of caring has five processes: knowing, being with, doing for, enabling, and maintaining belief.

Peplau's interpersonal theory describes phases of the nurse-patient relationship: orientation, working, and termination.

Therapeutic partnership is power-sharing: the patient is the expert on their own life; the nurse brings clinical expertise.

Boundaries protect the relationship; self-disclosure must be purposeful, brief, and patient-centered.

Unconditional positive regard (Rogers) means accepting the person without endorsing every behavior.

Empowerment supports the patient's autonomy and decision-making, including the right to decline recommended care.

Motivational interviewing uses open questions, affirmation, reflection, and summarization to evoke the patient's own reasons for change.

Transference and countertransference are recognized dynamics that must be examined, not acted out, within the partnership.

Cultural competence progresses through awareness, knowledge, skill, and encounters; cultural humility adds self-critique and openness to correction.

Leininger's culture care theory identifies preservation, accommodation, and repatterning as culturally congruent care decisions.

The four ethical principles are autonomy, beneficence, nonmaleficence, and justice; fidelity and veracity are also commonly cited.

Informed consent requires capacity, disclosure, comprehension, and voluntariness; it is the patient's decision, not the clinician's recommendation.

Advance directives include living wills and durable power of attorney for health care; they apply when the patient lacks decisional capacity.

Complementary therapies must be disclosed and evaluated for interactions; the nurse's duty is to discuss, not to endorse unproven claims.

Confidentiality is bounded by duty-to-warn and mandatory reporting laws, which vary by jurisdiction.

Scope of practice for holistic modalities is defined by state nurse practice acts and institutional policy, not by certification alone.

Professional boundaries and the ANA Code of Ethics apply across all settings, including private practice and telehealth.