Ambassador of Integrative Health: Dr. Deborah Williams Weaves Integrative Care Techniques into Local Assisted Living Facility

Her experience as a fellow in the University of Arizona College of Nursing’s inaugural 2016-2017 Integrative Nursing Faculty Fellowship (INFF), has uniquely positioned faculty member Deborah Williams, PhD, MPH, RN, to advance the College’s commitment to the science, theory and practice of integrative health. As the liaison between the College of Nursing and The Hacienda at the River, the latest assisted living community in the Watermark Retirement group, she has helped incorporate various integrative health interventions into the community’s care, including yoga, massage therapy, meditation, aromatherapy, reflexology, healing touch, acupressure and acupuncture. Under Dr. Williams’ supervision, the partnership between the College and The Hacienda creates a unique environment where nurse faculty can practice and nurse students can learn person-centered and relationship-based care that inspires optimal health and wellbeing.

What did you learn from the INFF?

The INFF taught me that it is acceptable to teach these integrative interventions to nursing students. To be brave and introduce new ideas in the classroom and in the clinical setting. In our fast-paced society, we need to care for people in a way that allows nurses to have the time to really listen to them and find out what works for them. People respond differently and we can advocate for their chosen interventions. Integrative nursing is a process which is centered on the person and the relationship we create with each other. The impact on health outcomes and wellbeing is remarkable.

What changes have you seen in students since you incorporated these techniques into your teaching?

Recently, I heard from a graduate who told me about a job interview she had at a hospital. She wanted to say thank you because in her interview she talked about how she had learned the integrative nursing approach that I introduced in the medical/surgical and psychiatric mental health clinical rotations. She felt like that knowledge set her apart from the other candidates and she ended up getting the job. When I began teaching the integrative approach to managing symptoms, I started to see students thinking beyond prescribed medications and offering things like guided imagery and breathing techniques instead of Tylenol. And interestingly, their care plans started to reflect these interventions, choosing less invasive treatments.

Tell us more about the integrative techniques you’ve incorporated into your work?

Each fellow chose two modalities to focus on and I chose relaxation response and music. Music does wonders. At The Hacienda, I see its effectiveness in terms of behavior changes and happiness in assisted living and memory care residents. I have been writing policies and protocols for many of the integrative interventions. Our administrative team starts the day together with Qi Gong, a meditative quote, or centering. I am in the process of bringing to The Hacienda integrative practitioners from the community for a full repertoire of integrative services.  

One of the six principles of integrative care focuses on the health and wellbeing of caregivers as well as those they serve. What is particularly important about self-care for nurses?

In nursing you are used to taking care of other people. I remember very well being a nursing student. There was no down time. You have academic work you need to do and on top of it you are in clinical, taking care of people and learning and then you are going back to the books again, reading about what it was you saw in practice. It’s this constant back and forth and it’s easy to forget to take care of yourself, but if you are not in top form it is hard to fully focus on the needs of your patients. In clinical post conferences sometimes I have my students do a brief meditation or I’d ask them about their weekend plans, and I would encourage the students to take time -- even if it’s just an hour – to give themselves a break. And then I would check back with them and find out what they did as a way of keeping them accountable.

Tell us about some of the other integrative health activities you supervise at The Hacienda.

We have a Zen Down hour every day of the week. Every day focuses on a different topic such as mindfulness, gratitude, and wellbeing. Recently, I introduced mindfulness and we had an engaging 45-minute conversation. We used clementines in an exercise. It was all about being mindful, so we talked about the texture, the flavor, being present in the moment – it was just a really neat conversation and exercise together. That probably is my greatest challenge right now in training caregivers: You’ve got to become comfortable and not afraid to try new things.