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Theory of Integral Nursing

Dossey, Barbara Montgomery PhD, RN, AHN-BC, FAAN

doi: 10.1097/01.ANS.0000311536.11683.0a
Article Available Online Only for the January-March Issue

Anchored in one of the most dramatic social shifts in healthcare history, a Theory of Integral Nursing can inform and shape nursing practice, education, research and policy—local to global—to achieve a healthy world. A Theory of Integral Nursing, informed by integral theory, presents the philosophical foundation and application of an integral worldview and process. This theory also recognizes Florence Nightingale's philosophical foundation and legacy, healing and healing research, the meta-paradigm in a nursing theory (nurse, person(s), health and environment [society]), 6 patterns of knowing (personal, empirics, aesthetics, ethics, not knowing, sociopolitical), and other nonnursing theories.

A Theory of Integral Nursing can inform and shape nursing practice, education, research and policy-local to global-to achieve a healthy world. This article presents the philosophical foundation and application of an integral worldview and process.

Corresponding Author: Barbara Montgomery Dossey, PhD, RN, AHN-BC, FAAN, International Co-Director Nightingale Initiative for Global Health, 878 Paseo Del Sur, Santa Fe, NM 87501 ( The Theory of Integral Nursing Power/Point is available on request.

A Theory of Integral Nursing does not exclude or invalidate other nurse theorists who have also informed my theory, specifically Florence Nightingale, Jean Watson, PhD, RN, AHN-BC, FAAN; Helen Erickson, PhD, RN, AHN-BC, FAAN; Margaret A. Newman, PhD, RN, FAAN; Patricia Benner, PhD, RN, FAAN; Rosemarie R. Parse, DNSc, RN, FAAN; Anne Boykin, PhD, RN; Martha E. Rodgers, PhD, RN; Peggy Chinn, PhD, RN, FAAN; Afaf I. Meleis, PhD, RN, FAAN; and Madeline Leininger, PhD, RN, FAAN.

I thank H. Lea Gaydos, PhD, RN, CS, AHN-BC; Cynda H. Rushton, PhD, RN, FAAN; James Baye, BSN, RN; Barbara Barnum, PhD, RN, FAAN; Jennifer Reich, MA, MS, APRN-BC, ACHPN, Darlene R. Hess, PhD, NP, AHN-BC, and Geneie Everett, PhD, RN, for their suggestions for the Theory of Integral Nursing.

Credit is given to Andrew Harvey, who coined the term sacred activism; to Patricia Hinton Walker, PhD, RN, FAAN, who coined the terms “nurses as health diplomats,” “integral health coaches,” and “coaching for integral health;” and H. Lea Gaydos, PhD, RN, CS, AHN-BC, who introduced me to the jewel metaphor for healing and integral health.

I also acknowledge my American Holistic Nurses Association colleagues with whom I have worked for over 2 decades, particularly Cathie E. Guzzetta, PhD, RN, AHN-BC, FAAN; Lynn Keegan, PhD, RN, AHN-BC, FAAN; H. Lea Gaydos, PhD, RN, CS, AHN-BC; Charlie McGuire, MSN, RN, AHN-BC; Noreen Frisch, PhD, RN, AHN-BC, FAAN; Carla Mariano, PhD, RN, AHN-BC; Charlotte Eliopoulos, PhD, RN, MPH, ND, AHN-BC; and all the members of the AHNA Elder Council, the former and present Journal of Holistic Nursing editors, and the former and current AHNA Leadership Council. In November 2006 the collective holistic nursing endeavors were recognized as a holistic nursing specialty by the American Nurses Association. This author believes that our challenge now is to move the holistic paradigm to an integral paradigm and language.

I acknowledge the exciting endeavors with my Nightingale Initiative for Global Health (NIGH) and the Nightingale Declaration Campaign (NDC) colleagues Deva-Marie Beck, PhD, RN; Cynda H. Rushton, PhD, RN, FAAN; Wayne Kines; Eleanor Kibrick, MS; William Rolph; and Don de Silva, and our future collaborative endeavors that are in development and scheduled through 2020 (

I recognize the work of Nightingale scholars Deva-Marie Beck and Louise Selanders with whom I have worked for over 2 decades, and who have assisted me in the Florence Nightingale Services at the Washington National Cathedral in 2001 and 2004 and future services yet to be scheduled. I also recognized the dedicated work of Nightingale scholar Lynn McDonald, editor of The Collected Works of Florence Nightingale (16 volumes) The work of Florence Nightingale scholar Alex Attewell, former director, Florence Nightingale Museum, London, is also recognized.

I thank Ken Wilber, Diane Hamilton, Willow Pearson, Sophia Diaz, Clint Fuhs, Nicole Fegley, Kelley Beacer and the entire integral team who have challenged me to bring my Theory of Integral Nursing forward.

I express deep gratitude to Roshi Joan Halifax, PhD; Cynda H. Rushton, PhD, RN, FAAN; and the faculty and facilitation team of the Being With DyingTM Professional Training Program in Compassionate End-of-Life Care at Upaya Zen Center, Santa Fe, New Maxico, for the wisdom we have shared in council process, bearing witness, and mindfulness practices.

© 2008 Lippincott Williams & Wilkins, Inc.