Part 8 (2/2)

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As clinical supervisor and thesis advisor to a young graduate nursing student in her twenties the benefits of authenticity with the self were again brought home to me. She was taping her therapy sessions with two patients. These taped materials were to become her thesis data.

One of her patients was not much younger than herself. The other was a divorced woman in her forties, around my age. This young graduate nursing student was receiving clinical nursing supervision as a necessity in her particular situation not by personal choice or awareness of need.

>From the onset of her clinical supervision with me I was aware that it aroused her feelings about dependence. At her age this had meaning since she was still struggling for independence and interdependence. This is a difficult time. Her response to me was ”respectful,” sweetly and unawarely hostile, and she made it apparent that I was another nurse authority to be appeased, manipulated, and outsmarted. This behavior had been successful for her with past authorities. She was bright and had been able to complete intellectual requests and a.s.signments at the last minute with little effort. During the initial phase of our relations.h.i.+p awareness of her struggle, her difficulties and her a.s.sets, allowed me to maintain a supportive kind of being with her.

In listening to her therapy tapes I realized that another clinical supervisory approach was called for. She was defending against relating to her older patient by behaving toward her as she probably felt toward her own mother, and often toward me. Also, she was defeating her therapeutic purpose with her younger patient by viewing her as if the patient were herself. The older suicidal, depressed patient was begging her for an understanding therapeutic relations.h.i.+p. She needed terribly to share her suffering. This woman did not need a ”rejecting daughter”

working hard to outwit her. The younger patient needed to share her angry feelings and sense of worthlessness.

Through the tapes and through weekly sessions with the graduate student, I came to know and understand her existing nursing situations. At this time neither the student's need to understand nor the patients'

therapeutic needs were being met. The student, too, was aware of this in a sort of suppressed way. Indirectly, in responding to her patients, knowing I would be listening to the tape she would take a ”sweet swipe”

at me which placed the responsibility of all our efforts on my shoulders. So if there were no beneficial outcomes, obviously the blame could be placed.

During the initial phase of my relations.h.i.+p with the graduate student and during the initial phases of her relations.h.i.+p with her patients I came to understand. I listened, got into the rhythm of these other spirits, reflected on what I had come to know, and out of this experience a.s.sessed and planned.

Later, taking what I had come to know, as just how it was for all of us, I shared my knowing with the graduate student and budding first-rate therapist. Together we explored the implications of the above. She became invested, involved, and excited about herself becoming more. We, myself and each of her patients, become for her more whom we essentially were. Most important to her and to me, this graduate student grew in her recognition and acceptance {60} of herself and her ability as an adult nurse therapist. The thanks and meaningful praise she received from both her patients on termination of therapy made this apparent. It brought tears to both her eyes and mine. I felt joy in being with a now-respected colleague, as opposed to the earlier being with a person who felt like an unasked for ”awe struck defensive daughter.”

Authenticity with myself, and this graduate student's ability for authenticity with herself allowed these patients' progress to occur. It allowed a realistic articulation in this student's phenomenological master's thesis of her lived nurse experience. From such articulation will a theory and scientific-artistic profession of nursing ever mold, flow, and form.

WORDS DISTINCTLY HUMAN: LIMITING, YET HUMANIZING

Through words we humanly share the meaning to us of our behavior, experience, and profession. Words attest to and endure. Thus, a professional history is possible, accrues, and has lasting duration. The study of the nursing event itself and its conceptualization as proposed in humanistic nursing practice theory is an application of phenomenology. Articulation of our perspective, experience, and ideas is the human way of phenomenology.

Words are symbols to which man gives meaning as an outgrowth of his civilization within his culture. Through words man attempts to communicatively describe his experienced states of being-in-his-world.

In describing, of necessity, he relegates his uniquely known experiences to already known word symbols or categories. Thus, the conceptualized experience is limited, or less real than the lived unique experience.

So, while words prevent the loss of the wisdom of lived experience, they are both a wonder of humanness and a limitation of humanness.

In describing human experiences there are efforts that can cut back this limitation. If we truly wish to convey meaning to others, really want to share what we have experienced in living, we will put forth the effort.

To put forth such effort requires going beyond ”I must publish to publish.” It takes writing, structuring, rewriting, and restructuring often to a point where for a period one comes to hate materials he once held dear.

Through the years many of us come to use words as a means of pa.s.sing a course, or we view words as a mode for self-explosion, expression, and self-understanding. In these ways they hold much purpose. The requirement that words convey unique experiences of being to others demands much more. This necessitates one selecting words that depict one's perspective, his unique human angular view; or depict for another, this particular man as he perceives and responds to his unique experience. Such a depiction has to be unknown to the other; each one's vantage point, given his history as an existent in this time and place, is singular. Then it requires finding words and putting them {61} together in a way that best conveys the meaning the nursing event had to the nurse. An adequate dictionary and thesaurus can be useful.

The actual presentation of experience for an audience demands an ordering of data in a sequence that will be sensibly logical for them.

We live experience in an order that flows from our being and history within a multiplicity of calls and responses. Presently human expression is limited to sequentiality. So again we see that the conceptualized experience is different from and lacks the reality of the uniquely lived event. Structuring a logical sequential presentation of data, deciding on those aspects that influenced meaning, and having it conform as closely as possible to the real is difficult.

Often, when it seems that one has done his very best, it is wise to have a trusted other react to conceptualizations. Another's questions can bring to the conceptualizer's awareness thought connections that moved him along and that he has failed to convey. Also, such a reader can indicate aspects of thought trips the writer took that add nothing to the issue at stake and weaken his message. Too, another's response can make apparent to a writer the need to clarify meaning. This clarification may merely entail a better choice of words or phrases, or it may suggest the use of a meaningful metaphor, a.n.a.logy, or parable.

These last imaginative forms of expression we frequently use meaningfully, sometimes like a shorthand, with our intimates. A phrase, metaphor, or a.n.a.logy conveys with an immediacy the quality or spirit of an event. For example, a nurse working in a psychiatric hospital unit speaking of a patient said, ”He came down the hall looking like an accident about to happen.” A page of technical description could not have given me as much feeling for what she and the patient were experiencing at that moment. In nurses' efforts to express objectively, scientifically, and eruditely such modes of expression are often deleted from our written professional works. It is as if we enforce the rules of medical record charting of precision, conciseness, and use of ”weasel”

words onto all our written works to the detriment of a theoretical and professional enduring body of nursing knowledge being actualized. It takes considerable pain and endeavor to find egress from such human programming. With it we have purified, equalized, wearied, and dehumanized supreme experiences of human existence. And, we have negated the meaning and importance of ourselves and nursing. How often have you heard, ”I am _just_ a nurse”?

Phenomenology requires rigorous investment into respectfully, appreciatively, and acceptingly making evident our lived worlds and their ramifications for the now, the past, and the antic.i.p.ated future.

Nursing literature of this caliber would call and inspire those who attended it to further nursing practice and responsibly share the meaning they attribute to their area of specialized dedication.

The raw data of our lived nursing worlds do not easily reveal their meanings or messages. Many see their worlds only superficially, and themselves as mere functions. How often a nurse is surprised, confounded, on hearing a relative or friend speak of a nursing event in their lives that may have occurred {62} from 10 to 40 years previously.

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