Part 1 (1/2)
Humanistic Nursing.
by Josephine Paterson, and Loretta Zderad.
FOREWORD to the 1976 Edition
These essays will evoke different reactions from different readers. ”Well, I know that,” for example, may be the reaction of a beginner in nursing; ”I wouldn't have said it that way but I knew that is really nursing.” ”Since they've given us a methodology,” perhaps from one more experienced in nursing; ”I'll give it a try.” Others with still more or different kinds of experience may respond, ”It's about time nurses put that into words; it's about time.”
Timely as these essays are I would prefer not to use up the foreword with a listing of the crises, the ”eco-spasms,” and scientific triumphs that would doc.u.ment their timeliness. It is my pleasure, rather, to use this opportunity to relate the six elements of my own reaction:
Nursing has a solitariness until we find it has many companions in philosophy, science, and art. It has a steadiness about its pace yet holds a potential for flights to higher elevations. It is constantly changing yet has an enduring component of permanence. Good is the word we use every day; our vision, however, is of excellence. Its tasks often have the appearance of homeliness until we glimpse that kind of beauty that is humanness. Nursing even sings very softly because our ears are attuned to ”a different drummer.”
Lilyan Weymouth, R.N., M.S. Northampton, Ma.s.sachusetts October 1975
PREFACE to the 1976 Edition
Out of necessity nursing, as a profession, reflects the qualities of the culture in which it exists. In our culture for the past quarter of a century nursing has been a.s.sailed with rapid economic, technological, shortage- abundance, changing scenes' vicissitudes. In the individual nurse these arouse turmoil and uncertainty. These cultural stirrings inflame that part of the nurse's spirit capable of chaotic conflict and doubt. Often she questions her professional ident.i.ty. ''Just what is a nurse?” Her nurse colleagues, other professionals, and nonprofessionals freely, directly and indirectly-on television, in the theater, through the news media and the literature-pummel her with their mult.i.tudinous varied views.
As searching, wondering, reflecting, relating microcosms within this perplexing health nursing world for longer than a quarter of a century, we present this book. Descriptively we view the chapters as hard-wrung, philosophical foundations, synthesized extracts from our lived experiences. These metatheoretical essays on practice present an existential alternative approach for a professional nurse's knowing and becoming.
These conceptualized existents are available because Miss Marguerite L. Burt, formerly Chief of Nursing Service, Northport, N.Y. Veterans Administration Hospital called them forth from us. These chapters are our response to her call. In 1972 Miss Burt requested us to develop a course for the professional nursing staff at Northport V.A.H. This book has evolved from the original presentations offered to the ten partic.i.p.ants in the first course. While we taught and worked with five subsequent groups, we learned and continually revised and clarified our conceptualizations. The course is ent.i.tled Humanistic Nursing.
Fifty-three nurses have been involved in this course. Interest, appreciation, wonderment, effort, and investment characteristically depict their response. They convey that the humanistic nursing practice theory reflects what nursing means to them. Their hungry approach to the suggested readings has both surprised and pleased us. Our amazement persists over the partic.i.p.ants' ability to concentratedly discuss abstract theory and concrete nursing practice for weekly day-long sessions over six-to nine-month periods. Presently requests to partic.i.p.ate in the next humanistic nursing course are mounting from nurses both within and outside the Northport complex.
The course, the theory, and this book are the fruits of our individual and collaborative efforts. While sharing seminar responsibility for graduate students in 1960, we began to dialogically and -dialectically struggle with professional and /clinical nursing issues. Discussing and searchingly questioning ourselves and our students became a value. Through conveying, struggling for clarification, openness to honest argument, we grew in our awareness that each was moved beyond her beginning thoughts. Through reflection we have come to view, describe, and distinguish our dialogues as struggles with, and not against, others' ideas. Differences in response are valued for what they can tell us of our chosen area-nursing. So dialectical dialogue has gradually become our predominant teaching method. We convey our ideas, are open to others' questions, struggle to clarify and really communicate, and question ourselves, and others. In the process of the humanistic nursing course, using this methodology, which is deliberate and, yet, natural and authentic for us, we and our professional nursing staff students have learned and become more human, more questioning, more clinical, and just, more.
We value our moreness. Appreciating and valuing the effects of our actualizing selves as human beings, we must attest to our existential modes of nurse being; our inner mandate is: share. Hence, Humanistic Nursing has come into being.
To find the meaning of nursing we have returned ”to the thing itself,”
to the phenomenon of nursing as it occurs in the everyday world. Our reflections on nursing as a lived experience flowed into the realm of metanursing. Obviously, these thoughts are only a beginning. They are offered in the hope of stimulating response and further development.
Dialogue may be difficult at first because humanistic nursing represents one of our discipline's less articulated streams. Yet, it is a stream traceable to nursing's foundation and, as such, is related to nursing's artistic, scientific, and technological currents. It is not being, cannot be, developed in opposition to them.
Science and art are forms of human responses to the human situation.
They are valued in genuine humanism. Thus, the humanistic nursing approach does not reject advances in nursing technology, but rather it tries to increase their value by viewing their use within the perspective of the development of human potential. The same holds true for scientific, artistic, and clinical developments in nursing practice. They are the necessary means through which and in which humanistic nursing (a being and doing) is experienced and developed.
At this time when serious concern is being expressed about the survival of nursing as a profession, humanistic nursing offers a note of optimism. By examining the values underlying practice, it focuses on the meaning and means of nursing's particular' mode of interhuman caring. It increases respect for that caring as a means of human development. Nurses have the privilege of being with persons who are experiencing all the varied meanings of incarnate being with men and things in time and s.p.a.ce in the entire range from birth to death. They not only have the opportunity to co-experience and co-search with patients the meaning of life, suffering, and death, but in the process they may become and help others become more-more human.
Beyond this, the humanistic nursing approach respects nursing experience as a source of wisdom. By describing and conceptualizing the phenomena experienced in nursing situations, nurses could contribute to the development of nursing as a discipline. Even more, they could add to the knowledge of man.
Humanistic nursing, then, is neither a break with nor a repet.i.tion of nursing's past. It is neither a rejection of nor a satisfaction with nursing's present. Rather it is an awakening to the possibilities of shaping our nursing world here and now and for the future.
Thanks to Miss Marguerite L. Burt are in order for she provoked our conceptualizations of our lived nursing worlds. Dr. Frederick H. Wescoe, while Chief of Nursing Service, Northport, N.Y., VAH administratively facilitated the time and the means for our compiling these materials into a ma.n.u.script. Past nursing students challenged and grappled with our ideas and theirs insisting always on our forwarding our thinking. Our consultants, Miss Lilyan Weymouth and Miss Rose G.o.dbout, were marvelous resources and counselors.
Immediately we are most grateful to the partic.i.p.ants in the six humanistic nursing courses taught here at the Northport VAH. As nurses, they received and accepted our expressed ideas to the extent of testing them in the fires of their real lived nursing practice settings. While struggling with our ideas and us, they gave to us. They were supportive, loving, and truly present with us in the community of nurses at Northport, VAH. Miss Sue McCann, clinical nurse specialist, one of our first course partic.i.p.ants, has read and reviewed our materials. More than this Miss McCann has been a counselor, resource person, and a dependable friend in our humanistic nursing effort of the last three years. We hope our chapters give back to others, at least just a part of what we have received from them in our travels in the nursing world.
J.G.P L.T.Z.
PREFACE