Humanistic Nursing Part 9

Frequently persons express appreciation for the meaning these events have had for them through the years. They remember the pleasure, anger, pain, fear, and/or joy they experienced.

It is not loose performance that allows raw data to convey its message to a nurse. New data are sucked easily and immediately into old, worn out, known theoretical frames and networks of words. Severe self-discipline enters into describing nursing experience with the vigor of how it was lived. Too easily the description is let fall to mediocre common forms. Proper grammar and plain English should suffice. This would carry the nursing message, as jargon borrowed from other disciplines in which the nurse always speaks as an alien, never will.

Humanistic nursing practice theory in asking for description does not ask one to forget or deny known terms and knowledge. Rather it asks for a bracketing or holding of this knowledge to the side. The nursing experience should be given an opportunity to be seen in its pure form, rather than forcing it to conform to foreign prestigious terms borrowed from other areas of specialization, which beg the meaning of the nursing event. Prior to dispersion, of course, one should weigh one's expression in English against one's expression in one's known foreign jargon. Then one will be open to choose how one wants to express and share the meaning of her nursing world.

Phenomenology accepts categorization as a necessity of communicating. It holds, nevertheless, that this is secondary to initial aware experiencing. This study method acknowledges the unfathomable complexity of existing and knowing. It strives for as adequate conceptualization of the existential experience as possible. It honors the knowing person's continued capacity for surprise and wonderment. Phenomenology asks us to go beyond the common labels to the surprise of our own and other's unique existences-in-the-world. A nurse who had been struggling over many months with a family in their home, on the day she first experienced an "I-Thou" relations.h.i.+p with them said, "It was as if I had gone beyond the uncooperativeness and dirtiness of the situation."

Immediacy in labeling offers us the complacency and security of a wrapped up problem. How could a nurse be held responsible for what happened to a "dirty," "uncooperative" family. The many commonly heard labels humans attribute inhumanely to others rarely relate to answers in situations or to the dreadful human suffering problems generate.

Phenomenology seeks attestation of the meaning of a situation to a partic.i.p.ant. Positivism seeks general objective categories within the universal. Phenomenology prizes differences, variations, and struggles for their representation as parts of the whole. Rather than emphasize the majority as holding sway, it recognizes that the unique contribution can possibly be the weightiest in meaning. {63}

THE PROCESS: BECOMING A FREE RESPONSIBLE RESEARCH NURSE

For a nurse to become a free responsible research nurse in the health arena she accepts her lived nursing world as beyond the controls valued in positivistic science. She appreciates her lived nursing world as saturated with knowledge to be extracted or wrung. Then she must examine, recognize, appreciate, and unfold her history, her angular view, and her human nurse potential. In prizing her view, as nurse, she will ask relevant nursing questions. To attain her potential as nurse she will discipline herself rigorously for authenticity with the self.

With the self-acceptance that comes with self-authenticity she will know the importance of the difference she and the nursing profession make and can make in the community of man. Then out of her own human social need and for the survival of nursing she will describe to propel knowledge, nursing theory, and practice forward. In this process and in its effects she will become more human as she contributes to man's humanization.

FOOTNOTES:

[1] Martin Buber, _Between Man and Man_, trans. Ronald Gregor Smith (Boston: Beacon Press, 1955), p. 93.

[2] Carl G. Jung, _Modern Man in Search of a Soul_, trans. W. S. Dell and Cary F. Baynes (New York: Harcourt, Brace and World, 1933), p. 169.

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6

THE LOGIC OF A PHENOMENOLOGICAL METHODOLOGY

PERSPECTIVE: ANGULAR VIEW

In humanistic nursing practice theory we, Dr. Zderad and myself, propose that nursing practice when studied, like any other area studied, will only become available for human conceptualization if the study methods are appropriate to its nature. Therefore, the methodology presented in this chapter is relevant to humanistic nursing practice theory.

Embraced within this chapter is a methodology for studying nursing that evolved out of the process of my nursing practice. The logic of this method and of my process of nursing are one. It is not a method of another discipline superimposed on nursing. So this method did not force nursing or change nursing to have it mold or conform. As this method unfolded it arose from and in accord with nursing process. This methodology came into being only after years in which various attempts were made to get positivistic methodology to answer relevant nursing questions and to develop a professional scientific theory of nursing.

The method presented here was used initially to creatively conceptualize nursing constructs in 1967-68. The data for the development of the constructs "comfort" and "clinical" were gathered from my clinical nursing practice and while I was deeply engrossed in existential readings. The process or method used was not conceptualized until it was called for while writing my doctoral dissertation in 1968. It had then been used to study the clinical literary works of two psychiatric mental health nurses, Theresa G. Muller and Ruth Gilbert.[1] Its conceptualization at that time was rudimentary. Gradually it has been further conceptualized. "From a Philosophy of Nursing to a Method of {66} Nursology," an article published in _Nursing Research_ in 1972, was my next attempt.[2] Graduate nursing students studied this article and repeated the process of the methodology in their studies of their clinical nursing data. Reflecting on this article and realizing how others had to study and struggle with it. I became aware that still only the bare bones of my thinking were presented. Further elaboration of this methodology was called forth to share it with the _humanistic nursing practice theory_ course partic.i.p.ants. Since 1970 I have delved into phenomenologists' writings and at this time can say that this process of studying nursing is a phenomenological method of nursology.

Interesting to me is that the initiation of this method came when I first began to read the existentialist literature. Existentialism can be viewed as the fruits of phenomenological study. The process of this method has become clearer and clearer to me over time. Phenomenologically the process or method has grown out of the reality of the "thing itself"

to be studied, in this case, clinical nursing practice.

This chapter then is the result of reflecting on these past efforts and is a conceptualization of this method as I understand it now.

The following quote is offered to support and validate the efforts put into conceptualizing this method. The philosopher of science Abraham Kaplan says of methodology:

"The aim of methodology ... is to invite speculation from science and practicality from philosophy ... to help us understand in the broadest possible terms, not the products of scientific inquiry, but the process itself."[3]

The above quotation expresses the spirit in which this presentation is offered. Positivistic science aims at objectivity and its results are viewed as scientific facts. Nursing practice has been understood by many as an implementation of such theoretical facts. Considering my and other nurses' implementation of such facts it is apparent that in these endeavors nurses come to know much about human existence.

Philosophy is often viewed as man's contemplations, autobiographical revelations, and the values and belief systems that underlie man's actions, Can an explicit philosophy of nursing allow for more meaningful quality practice, be a resource for nurses, improve service, be available for reexamination, correction, and the forwarding of knowledge? If nursing practice is viewed as the implementation of scientific facts and what they call forth in the nursing situation related to man's condition of existence, is a heuristic science of nursing developed from this situation, by nurses, an appropriate practical professional aim?

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This presentation is my answer, a committed "Yes."

The method offered here, a phenomenological method of nursology, aims at the reality of man, how he experiences his world, or it aims at a subjective-objective state. It aims at description of the professional clinical nursing situation which in reality is subjective-objective world that occurs between subjective-objective beings. The description focuses on this between and preserves the complex mobile flow of the river of nursing to make apparent that superficial precise portrayals are only an overlay of its river bed, course, and eventual destinations.

The relevance of phenomenological nursology ranges from the formulation of nursing constructs to the creation of theoretical propositions. It is applicable to one's own clinical data and to others' clinical data, here and now, or in historical study of the literature.

METHODOLOGICAL STARTING POINT

This method addresses itself to the question: How can a nurse, a subjective-objective human being know self and the other and compare and complementarily synthesize these known betweens?

Basic to this method is a belief system, a philosophy about the nature of man explicitly commented on by thinkers throughout human history.

Plato said:

"I cannot be sure whether or not I see it as it really is; but we can be sure there is some such reality which it concerns us to see."[4]

Nurses are with other men in times of peak life experiences under the most intimate circ.u.mstances. We, too, can not be certain about what we come to know in our betweens. We can be sure that these realities of human experience are worthy of exploration. Our opportunities are unique, only we can describe man in the nursing situation.

In _Let Us Now Praise Famous Men_, James Agee voices a similar concern about the need to describe man-in-his-world and the adequacy of human description.[5] Aware of the wonders and complexities of man he considers not trying to describe worse than the inadequacy of description.

Thinkers have also acknowledged that we can come to know from others. A poem by Goethe expresses an att.i.tude about this:

"Somebody says: 'Of no school I am part, Never to living master lost my heart; Nor anymore can I be said To have learned anything from the dead.'

{68} That statement--subject to appeal-- Means: 'I'm a self-made imbecile.'"[6]

In nursing what better master than the nursing situation in which we become through our relations with others. Each human person has something unique to teach us if we can but hear.

About our inadequacies of expression, many things are, are true, "all-at-once." The law of contradiction does not apply in-the-lived-experienced-world. We each view the world through our unique histories. Wisdom is many sided truth. Wisdom cannot be expressed "all-at-once." Truths can be stated only in sequence or metaphorically.

If I were supercritical of my human limitations to express "all-at-once"

wisdom, I would say nothing. Jung points up the dangers of this, he says:

"I must prevent my critical powers from destroying my creativeness. I know well enough that every word I utter carries with it something of myself--of my special and unique self with its particular history and its particular world."[7]

Each nurse's uniqueness dictates then a responsibility to share her particular knowing with fellow struggling human beings. Only through each describing can there be correction and complementary synthesis to movement beyond.

The nurse's world is an experiential place for becoming influenced by each partic.i.p.ant's "here and now" inclusive or origin, history, and hopes, fears, and alternatives of the confronting future. Positivistic science focuses on selected particulars. Henri Bergson says:

"... for us conscious beings, it is the units that matter, for we do not count extremities of intervals, we feel and live the intervals themselves."[8]

Each human partic.i.p.ant in the nursing situation has a unique flow of consciousness which is intersubjectively influential.

So as human nurses we are limited in our ability to express the reality of our-lived worlds. Yet, also, this world depends on and demands that we, as human nurses, give it meaning, understand it in accordance with our {69} humanness. Will and Ariel Durant, historians, professionals who are forced to selectively present the world for other humans, say:

"The historian will not mourn because he can see no meaning in human existence except that which man puts into it: let it be our pride that we ourselves may put meaning into our lives, and sometimes a significance that transcends death."[9]

Humans are the only beings conscious of themselves. Nurses are human beings. As such we are capable of looking at our existence, choosing our values, giving our world meaning and of constantly transcending ourselves, or becoming more. If we value and prize our human nursing world and our human potential for consciousness and expression, we will actuate our potential and conceptualize our human nurse-world. This suggests questions to me. What do I want nursing to be? How can I influence the meaning of the term, nursing? How committed am I? What investment am I willing to make? Will I risk exploring and saying what I see in my nursing world? Am I open to knowing? How can I actuate my uniqueness to allow the realistic potential of my nursing profession to become, become ever more? Am I contributing my "nursing here and now" to nursing's history through a lasting form of expression? Of what importance is what I think or say; do I make any difference? Hermann Hesse says of each man's uniqueness: