As an intersubjective, transactional experience, nursing necessarily
involves both a mode of being and a doing of something. The being and
doing are interrelated so inextricably that it is difficult, even
distorting, to speak of one without the other. Descriptions of nursing,
however, often focus primarily (sometimes exclusively) on the doing
aspect of the process, on the nursing techniques or procedures. The
observable acts are more easily discerned and discussed. They can be
measured, counted, and charted. Yet, in the actual interhuman experience
of nursing the weight of being is felt. Presence and the effect of one's
presence can be known much more vividly than they can be described.
Still, not to attempt to describe them is to present only a half, or
perhaps less than half, of the nursing picture.
When a nurse refers to a nurse-patient interaction during which a change
in the patient's condition or behavior was noted, one hoping to get a
description of nursing may ask, "What did you do?" Often the answer is a
description of a {14} manual action or a verbal interchange. Sometimes
the nurse responds, "Nothing, I was just there." Perhaps it is the
question that is wrong. The respondent usually interprets "doing" in a
limited sense. In reality, everything the nurse does is colored by the
character of her being in the situation. The nursing act itself is a
behavioral expression of the nurse's state of being, for example,
concerned, fatigued, hurried, confident, hopeless.
Furthermore, there is a kind of being, a "being with" or a "being
there," that is really a kind of doing for it involves the nurse's
active presence. To "be with" in this fuller sense requires turning
one's attention toward the patient, being aware of and open to the here
and now shared situation, and communicating one's availability.
Whether the nursing act is verbal, or manual, or both, a silent glance,
or physical presence, some degree of intersubjectivity is involved and
warrants recognition. To become more aware of and explore more fully
this essential constituent of nursing we need to focus on the
participants' modes of being in the situation. Rather than ask the
nurse, "What did you do in the nurse-patient situation?" we ought to
ask, "What happened between you?"