6 – Client Assessment Mandala Applications

Contributor: Ellen E. Swanson
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One of the first things we do in health care when someone comes to us is to assess their health status. I prefer to think of this as accessing the client. When you access a person, you walk a mile in their shoes, so to speak. That’s why presence, connecting or joining, using the felt sense, relationship-as-intervention, and listening from the heart (i.e., body intelligence) are essential tools.

If the circular mandala isn’t a practical tool for this, it offers a definite conceptual benefit. As one business owner said, “When I have a difficult decision to make, I just think about that mandala circle and it really helps me make better decisions.”
Perhaps then just thinking about the mandala circle during the assessment process could change the way we perceive the person. Instead of perceiving of them in a linear fashion, we could more easily embrace their essence and thus their model of their world.

There are several ways to apply the mandala template during the assessment. The first option uses empirical knowledge and incorporates intuitive, innate, body intelligence/felt sense, and reflective knowledge, all holistic nursing theory concepts.

In this first option the rings are used as follows.

Ring 1, the Rainbow Ring: Divide the body up into seven systems (empirical knowledge).

1. Gastrointestinal
2. Respiratory/circulatory
3. Nervous
4. Musculoskeletal
5. Genitourinary
6. Endocrine/immune
7. Ear, eye, nose, and throat

Ring 2: Assessment and diagnostic information for each system (what you learned about the client). The space under the rainbows could be used to include the intuitive, innate, body intelligence/felt sense, and reflective knowledge.

Ring 3: Plan of care for body, mind (includes emotions), and spirit based on how the client currently cares for self.

Ring 4 and Center: The goals for, or how the plan manifests in, each life aspect, taking into consideration what the patient currently values in each life aspect.

The mandala that follows gives a glimpse of how the essence of the person could be visualized and honored using the rings as defined above.

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The second application option would cover the social information about the person.

Ring 1, the Rainbow Ring: The client’s resources or sources, such as people, organizations, interests, etc.

Ring 2: What each resource or source provides and the contact information for each. Again, use the space under the rainbows to include the intuitive, innate, body intelligence/felt sense, and reflective knowledge.

Rings 3, 4, and Center would be the same as the nursing model above.

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Historically, our downfall has been to use only the empirical and linear knowledge we gain in such information gathering, whether initially in the assessment or in the ongoing care of the client. Hopefully just reflecting on these visual models will help us to remember and use the intuitive, innate, body intelligence/felt sense, and reflective sources from within the client and the health-care practitioner.

Holistic nursing concepts source:

Frisch, N. (2013).  Nursing theory in holistic nursing practice.  In B. Dossey & L. Keegan (Eds.) Holistic nursing a handbook for practice, 6th Ed.  (pp. 117-128).  Burlington, MA:  Jones and Bartlett Learning.