As a human response to a person in need, the nursing act is necessarily
an intersubjective transaction. Or to put it in other words, regardless
of the complexity of need and/or response, when nurse and patient meet
in the event of nursing both have "to do" with each other. Since both
are human, their doing with means being with. (Reflect for a moment on
the personally experienced patient encounter you recalled at the
beginning of this exploration. Relive it and see clearly again that the
nursing dialogue involves being with and doing with the patient.)
Men can do with and be with each other because they are able to see
others and things as distinct from themselves and enter into relation
with them. What distinguishes the human situation is that men can enter
into a dialogue with reality. They have a capacity for for internal
relationships, for knowing themselves and their worlds within
themselves, they can relate as subject to object (for example, as knower
to thing known) and as subject to subject, that is, as person to person.
Both types of relationships are essential for genuine human existence.
It is natural, in fact unavoidable, for man to relate to his world as
subject to object. How could a person survive even one day without
knowing and using objects? Therefore, man's abilities to abstract,
objectify, conceptualize, categorize, and so forth, are necessary for
everyday living. Even beyond this, the human capacity for relating to
the other as object is basic to the advancement of mankind for it
underlies science, art, and philosophy. It is simply one way of being
human.
Another mode of relating is open to men. Whenever two persons are
present to each other as human beings, the possibility of
intersubjective dialogue exists. Since both are subjects with the
capabilities for internal relationships, they can be open, available,
and knowable to each other. They can know each other within themselves.
Furthermore, they can be truly with each other in the {27}
intersubjective realm because while maintaining their own unique
identities, they can participate in an interior union. Intersubjective
relating is also necessary for human existence. For it is through his
relationships with other men that a person develops his human potential
and becomes a unique individual.
Nursing, being an interhuman event, has within it possibilities for
various types and degrees of relationships. Both nurse and patient can
view themselves and the other as objects and as subjects or in any
variation or combination of these ways. A person can view and relate to
another person as an object, for instance as a mere function ("patient,"
"nurse," "supervisor," "medicine nurse," "admitting nurse,"
"administration") or as a case or type ("schizophrenic," "cardiac,"
"outpatient," "readmission," "bed patient," "wheelchair patient," "total
care patient," "terminal patient"). Such subject-object or "I-It"
relationships differ essentially from subject-subject or "I-Thou"
relationships.
As the derivation of the term indicates, an object is something placed
before or opposite; it is anything that can be apprehended
intellectually. Through objectification the object is de-individualized
and therefore made replaceable for the purpose of study by any other
object with the same properties. It is indifferent to the act by which
it is thought and, therefore, the subject studying the object may also
be replaced by a similar subject.
Although it is possible to view a person as an object, persons and
things are necessarily different kinds of objects. A thing, as object,
is open to a subject's scrutiny, while a person, as object, can make
himself knowable or set up barriers to objectification. He can keep his
thoughts to himself, remain silent, or deliberately conceal some of his
qualities.
Through the scientific objective approach, that is, subject-object
relating, it is possible to gain certain knowledge about a person;
through intersubjective, that is, subject-subject relating, it is
possible to know a person in his unique individuality. Thus, both
subject-subject and subject-object relationships are essential to the
clinical nursing process. Both are integral elements of humanistic
nursing.