We have learned that with the escalating cost of healthcare, it is more economical for employers, insurance companies, and consumers of healthcare to stay out of the hospital. In fact hospitals are now seen as cost centers, and with fewer inpatients hospitals are redirecting their focus to wellness. At the same time, healthcare consumers are becoming increasingly more dissatisfied with traditional medicine and are looking for a more holistic and complementary approach to healthcare. As a result of this paradigm shift healthcare consumers are taking more responsibility and accountability for their health.

Defining Wellness

Nurses, physicians, healthcare providers and healthcare consumers must clearly understand what wellness means. As hospitals make the shift from illness to wellness they must be clear on the meaning to stay strategically focused and meet the needs of the community and healthcare consumers.

The concept of wellness is not new to healthcare. In fact, in 1947 the World Health Organization defined health as a "state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." The National Wellness Institute defines wellness as "an active process of becoming aware of and making choices toward a more successful existence."

Wellness is a positive, holistic process, not necessarily the absence of disease nor the opposite of illness. Wellness focuses on the whole person and involves the domains of physical, emotional, mental, and spiritual balance.

What makes wellness an ideal approach for managing healthcare is that it involves changing unhealthy behaviors or habits to goal setting, adding new experiences, and assimilating new information. In using a positive approach and focusing on good health versus illness, the healthcare consumer feels less deprived and more responsible for his or her health and well-being.

The Nurse as the Wellness Coach

Wellness begins with you. How do you define wellness? What are your health values and beliefs? Are you a role model in promoting wellness? What new behavior or healthy habit would you like to incorporate into your lifestyle? What wellness goal would you like to set? What would you like to learn more about? If you see wellness as a positive process and journey you will be in a better position to coach and collaborate with healthcare consumers.

Traditionally healthcare has taken the "treat-em and street-em" approach. We would treat the symptoms or disease and with an arsenal of information and proceed to teach patients everything that we thought that they needed to know without their input. We called this patient teaching. In many cases patients would be readmitted to the hospital, and we could not understand how this could have happened, as after all, we did teach them everything that they needed to know.

As hospitals are quickly developing wellness options and programs nurses are in a prime position to serve as coaches and collaborate with the healthcare consumer. We need to provide the services or "menu" of options available to the healthcare consumer. We must see the healthcare consumer as the prescriber and the nurse as the coach who facilitates the selection from the menu of options. For example the nurse may be caring for a healthcare consumer who would like to stop smoking. The nurse can discuss and collaboratively assist with the selection of several menu options to select from, for example, smoking cessation program, nicotine patch, medication options, or hypnosis. The healthcare consumer in turn based on his or her values, beliefs, needs, and health status, can select which option is best for him or her. As nurses we must keep in mind that even though healthcare consumers may not select the option we think may be best, we do know that they may do best in what they choose to do.

It is important to listen to the needs of healthcare consumers and community. Nurses are in a great position to add or enhance the menu of options as they are often aware of the needs of the healthcare consumer and community. For example, are you getting many requests for a stress management, fitness, massage, or meditation program? If so are these options available? If not, how could they be developed and implemented? Perhaps your healthcare system has a wellness committee, wellness department, or community education department that you could collaborate with. If not, you may be the right person to champion wellness initiatives at your agency.

A Lifelong Process

As healthcare consumers continue to become more savvy and better educated about their health and wellness needs, nurses must serve as coaches, offering a menu of options to select from. In turn, healthcare services will be used more appropriately with the results of less costly health care. Enjoy the positive journey of wellness and remember to strive for the domains of physical, emotional, mental and spiritual balance. Wellness is a lifelong process, and we must work collaboratively with healthcare consumers and the community to improve health status.