Dr. Avino has over 40 years of experience in Maternal-Child Health, Administration, Community Health and Holistic Nursing, and is a board certified Advanced Holistic Nurse and Health & Wellness Nurse Coach. She is a Reiki Master, Stress Management Instructor, HeartMath, and Clinical Meditation and Imagery Practitioner, and uses these skills in coaching sessions. At the University of Delaware she teaches Holistic Nursing and Integrative Health. Presently she is developing an Integrative Health Institute at Beebe Healthcare. Karen is a founding leader of the Delaware Chapter of the American Holistic Nurses Association (AHNA). She is an author and co-editor of Holistic Nursing: A Handbook for Practice and Core Curriculum for Holistic Nursing.