When patients consider what they want in a hospital experience, they are looking for excellent and compassionate care, of course. But as patients think about a hospital experience, they are also looking for a factor many don’t know how to describe. Frequently, says Dr. Jesus Cepero, PhD, RN, NEA-BC and CNO of Stanford Medicine Children’s Health, patients describe wanting to be in an environment that doesn’t have a cold, sterile feeling. In short, they want to be in a place where they are being cared for in a way that feels most authentic for their needs.
Cepero says the missing link can be attributed to holistic care–caring for the whole patient–something he first became aware of after working in adult medicine and moving into children’s and women’s health services. “There’s a big cultural difference between the two environments,” he says, noting that he could feel the shift. “I thought it was more compassionate care, and it was more satisfying to patients.”
But the difference, he says, didn’t rest entirely with compassion as compassionate care is already a driving motivator in the nursing industry. “It was how we delivered the care,” he says, “and that has become a guiding principle for how I lead organizations.” Holistic care is a team approach, he says, and one that brings in a team dynamic that includes physicians, nurses, nursing assistants, and support personnel to work together, communicate well, and meet patient needs.
Typically when patients are asked what they hope to happen from their hospital visit or stay, they will say they want to feel better, says Cepero. Hospitals are places you go when you are sick and you need to get better, so that’s a pretty normal response. But there is more to getting better than just repairing the body, he says. It’s really an approach that sees the balance of body, mind, and spirit as essential.
Holistic care honors that and loops the patient into the care by asking, “How can we help you feel better?” The answers often have nothing to do with the science-based medications, procedures, or other therapies needed to help patients’ physical health improve. It can be reading a book or sharing a book with patients, he says, or it could be art or music therapy or a visit from a therapy dog. Patients could have spiritual needs that are feeling unmet so bringing in a faith leader can alleviate stress. Even need something as simple as someone helping them recharge their phone can relieve a stress point and make a difference in a patient’s day.
The psychosocial needs of patients are important to help heal a body and are also part of a holistic approach. If a patient can’t afford to buy enough healthy food or they lack transportation or access to a grocery store upon discharge, that will impact their healing. “If hospitals aren’t addressing things like food insecurity, they are not taking care of the whole patient,” Cepero says. “That’s what I see as holistic care,” he says, “and why it’s so valuable to the patient and the family.”
Despite the proven benefits to patients’ recovery, holistic care isn’t implemented at the rates that match the demand. Hospitals don’t always have the finances to hire additional support and therapy workers. And even if they do, it’s tough to find experienced people to do the work.
But patients expect this level and type of care and healthcare organizations that align the values and mission with a holistic care approach notice the difference. “Healing patients and making them feel better when they leave is what we are paid to do,” Cepero says. “We are not paid for that compassionate care that we provide.” But providing that compassionate, patient-focused care is so important for the patients so they can approach recovery from all angles. It’s also important for the healthcare providers who see the immediate impact of their work.
And Cepero says the patients are the key to creating an opportunity that allows the best chances for the kind of recovery that helps them. He notes, “It is listening to patients and families about their experiences.”
When Ortiz decided to pursue a PhD, she chose this topic to study. We interviewed her about it to see what all nurses could learn from her research.
How did you get interested in the traditional healing practices of Mexican-American Women? Why did you choose this for your PhD topic?
Growing up in deep South Texas on the coastal border with Mexico, I was raised in a bicultural/bilingual region where Mexican culture and traditions mixed with those considered American. My mom was a nurse, so when we were sick, she would take us to the pediatrician. However, if we were staying with our grandmother—my mom worked a lot—she would either administer home remedies or take us one block down the road to the local traditional healer.
As a child, I did not understand the difference between Western biomedicine and traditional medicine. I just knew that receiving care from my grandmother and the local healer felt so much more love-infused than when taken to the doctor. As I further explored complementary and alternative medicine and holistic nursing, the childhood memories of my grandmother’s healing rituals and remedies and the feelings of being deeply cared for returned.
My decision to study traditional healing practices among Mexican-American women of deep South Texas is more an act of honor and gratitude to my ancestral medicine-keepers than being strictly an intellectual endeavor. Through this work, I am returning home to learn from caregivers and healers with the intention of sharing what the traditional medicine from ancient Mesoamerica by way of Mexico can teach us today about well-being and healing in mind, body, spirit, and emotions.
Have you or anyone you know actually practiced these traditional healing techniques? If so, please say which ones and explain.
Plática – an organically unfolding heart-centered talk for arriving at the root of a problem and mutually working it through to resolution
Limpia – an energetic spiritual cleansing using various tools, such as healing herbs or a whole, uncooked egg, meant to harmonize imbalanced physical, emotional, mental, or spiritual aspects
Botanicals – the use of healing herbs and botanicals for numerous ailments (physical, emotional, or spiritual) in a variety of preparations, including infusions, tinctures, or in natural form; Commonly used are rue, basil, rosemary, chamomile, rose, sage, lavender, fever few, cinnamon, and aloe vera.
These practices are commonly noted in Mexican-American communities today, whether used by informal caregivers independently or with the assistance of a traditional healer.
How do you think that your research may help the nursing field? Should some of these practices be used in Western medicine? Or are you focusing more on how and why nurses should be aware of these practices?
My intentions are to share with nurses and health care practitioners and leaders what so many patients are practicing and have kept as valuable cultural expressions for improving health, healing, and well-being individually and collectively.
Why is it important for the health care field to be aware of these traditional healing practices?
The standard of high-quality health care includes being effective, safe, and culturally responsive. Knowing more about traditional medical practices in U.S. communities of Mexican origin and leveraging their potential for improving health expands opportunities for meeting those standards. Moreover, the U.S. medical system may come to learn additional approaches to health, healing, and well-being practiced by other cultures with positive outcomes. The World Health Organization’s Traditional Medicine Strategy has the incorporation of traditional medicine into Western health care systems as one of its goals for increasingly accessible and equitable health care worldwide.
Is there anything I haven’t asked you about that is important for our readers to know?
Curanderismo is the Spanish term describing traditional medicine from ancient Mesoamerica and currently practiced by many communities in Mexico, Central America, the Andes, and the Amazon. It comes from the word curar, meaning “heal.” In curanderismo, the health state means being in harmony internally and externally. Internal harmony balances the physical, mental, spiritual, and emotional aspects, while external harmony balances the self in relationship with others, the natural world, and the greater, multi-dimensional universe. However, this paradigm, in essence, acknowledges no separation between any of these elements.
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