Interview with Barbara Dossey

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Barbara Dossey [2] is the author of many award-winning books including her latest, "Florence Nightingale: Mystic, Visionary, Healer." Focusing on the philosophical and practical impact of Florence Nightingale's life and work on modern nursing and humankind, it has been awarded the 2005 book of the year by the American Journal of Nursing. Dr. Dossey was interviewed at the Center for Spirituality and Healing after her talk Healing Environments: What Do We Mean?, which is available at www.csh.umn.edu [2] .

Please describe your background and your area of expertise.

Dr. Dossey: My background is critical care and cardiovascular nursing. Then along the way, starting back in the early seventies, I began to work at what we now call "holistic nursing." What my colleagues and I were doing at that time was saying, "What else can we offer these patients who are so anxious after open heart surgery and in a critical care setting?"

So, we were doing this long before there were protocols. And then, in the early eighties, we formed the American Holistic Nurses Association. Specifically, my expertise right now is how we truly integrate the holistic model with traditional therapies. What I am privileged to be doing right now is working with different groups in nursing, different colleagues, and discovering how we get it to the next level of integration.

Has your work with Florence Nightingale guided you greatly?

Dr. Dossey: It has, since 1992. The reason that I went back to do that historical research is that I was getting very frustrated in the early nineties [asking myself], what is the next step? What can take us there? We act like we're inventing all of this stuff when we do have a historical record. [At first] I just went back to read a few articles [on Nightingale]. I absolutely wept when I read an original copy of Notes on Nursing. I just went, how can we as nurses not know our history? And it was just clear that we didn't get it. I would say now though young nurses in school today are getting it because professors are understanding how important it is for them to know that.

What are some of the exciting transformations taking place in your area of expertise right now?

Dr. Dossey: I think the most exciting thing that's going on right now in nursing is beyond nursing: it is the collaboration. In many of our hospitals now we're calling for a true deep dialogue - collaboration among different disciplines. And what that requires is that people come to the table. We've gotten very territorial...but we're here to serve the patients. Regardless of what the different departments are in the hospital, it belongs to the patient. [We must ask] what can we do in all of our department to make sure that a person really is taken care of, so that we have this healthcare system driven by the needs of patients, not by the bottom line and money.

Do you think that education for nurses is changing in response?

Dr. Dossey: Yes. It is changing, and right here in this city it is absolutely thrilling to see what is going on at the University of Minnesota School of Nursing [3], at the Center for Spirituality and Healing [4], at Abbott Northwestern [5] with the integration of holistic nursing, and to look at Woodwinds [6]...and it's just so thrilling because this is what I've been for since the sixties. The joy of what we have right now is curriculum that is well developed and focused. We have a frame of reference. We have identified the core values within holistic nursing.

Holistic philosophy, theory, and ethics is the first core value. Holistic education and research is the second core value. The third core value is holistic self-care [7]. If we don't do self-care, we can't do this work. And then other core values are holistic communication, therapeutic environment, and cultural diversity.

The uniqueness of what is going on through holistic nursing is that we recognize that nurses have to take breaks, have to have time out. Patients are sicker than ever in the hospital; there is more work than ever that has to be done. And what we have is technology that has been very exciting, but that has also added another layer of complexity onto the system...What nurses are doing right now is really finding their voice. And because of this increased complexity in the system, there is a new value placed on what nurses do at the bedside.

What initiated your interest in integrative health?

Dr. Dossey: There were two parallel things that were going on. One way into this work for many people is one's own health condition. I had a recurrent viral infection in my right eye from 1965 to 1975. At that time we didn't have medications for it. Finally, I got to a place where I couldn't see out of my right eye, but it was still some time before I was eligible for corneal transplant surgery. And even now, with the surgery, I still run a thirty percent rejection for the rest of my life. So prior to [the transplant], I began to look at stress management [8] strategies. It behooves me to integrate self-care [7] and create balance for myself. So it has been a true gift to my life to learn so many of these complementary and alternative therapies.

What is the best thing people can do to improve or maintain their health?

Dr. Dossey: The biggest thing is really straight forward. I think if we can just look at basic things like sleep, good nutrition [9], taking a walk or finding some way to do some exercise [10], and finding some means of stress management [8], then we are more able to be present for relationships [11] and more engaged with our work.

I think that the big challenge is that our lives get very, very busy. Today, for example, I am getting ready to get on the airplane and take two airplane rides, and I have literally 45 minutes between my flights, [but] I don't want to eat the junk food in the airport, so I ate a good breakfast this morning with some protein and some fruit. If I hadn't planned, I would have had [to settle for whatever junk food I could find]. I think the other thing that is very important is that if we set a goal, cut it in half because most of the time we make it too big...I call it the "50% Rule."

What is a common health-related mistake that you see your patients making, and how can it be avoided?

Dr. Dossey: Life is very complex, and very busy. If we can find one stress management [8] modality or therapy, [it is enormously beneficial]. What I think is very useful is that rather than calling it "exercise" or something, [we should ask] what is a daily practice that we can integrate into our lives? One of the things that has been best for me is breathing exercises [12]. We can put too much on our plate and it can help us focus. To take that rhythmic deep breath and to learn how to just be helps us to integrate the being into our lives, not just the knowing and doing. I think it is key to our health to remember that we carry the key to our health [within ourselves] at all times.

What is your next professional endeavor?

Dr. Dossey: Several things. One is working with international Nightingale scholars on the Nightingale Initiative for Global Health. We will be joining many professional nursing organizations. There are many different initiatives, but the first one is that we are calling for 2.5 million signatures by February 2007 for a UN proposal that we are bringing to them. (For more information, or to participate in this initiative, please go to the website at www.NIGHcommunities.com [2] ).

We are asking for 2010 to be the international year of the nurse. The 10 million nurses around the world are the largest group of healthcare workers throughout the world. We want 2010 to 2020 to be the international decade for a healthy world. Right now we have a lot of people that are discussing healthy world, but [we need] a clear UN proposal that sets it forward in the wording.

Simultaneously, I am working with the American Holistic Nurses Association (For more information, please go to the website at www.AHNA.org [2] ), and again working with like-minded colleagues to further the integration of complementary and alternative therapies with traditional health care. I've been doing a lot of work with the integral model based on Ken Wilber's work and looking at the integration of objective and subjective experiences. Right now in health care we have a lot of quantitative data, but what's just as important is to look at how do we care for the nurse, how do we come together in that collaborative practice to have a dialogue that puts the families and patients at the center of healthcare.