How does a nurse searcher, who wonders, notices, relates, and comes to
know, become humanly responsible? Nietzsche's philosophical works would
direct a nurse searcher to look at her values. The values known through
looking at what determines her actual behavior considering how these
values correlate with her privilege of calling herself, nurse. Empathy,
knowing how another experiences, when coupled with the title, nurse,
dictates a performance that encompasses no harm to others and hopefully
benefits them. Despite the human excitement of discovery, disciplined
effort and rigorous evaluation enter into preparing knowledge of man for
dispersal. Revelation should not merely shock; rather, professionally we
use shock to awaken surprise, a fundamental, for human constructive
movement toward moreness. The former, mere shock, needs to be guarded
against. The latter, shock to awaken surprise needs to be exactingly,
uncompromisingly attended for the communicability of knowledge and the
actualization of the phenomenon, nursing.
In considering confidentiality and the quality of knowledge of man
available to me, as nurse, my consciousness is confronted with my former
mentor, and internalized "Thou," Paul V. Lemkau, M.D., psychiatrist. He
{55} emphasized repeatedly that the professional person, as he
increasingly understands man, should take on increasing responsibility
to man, one's self and one's others. Buber says, "As we become free ...
our responsibility must become personal and solitary."[1] One can extend
this and say that to help others struggle for freedom one must realize
that others must responsibly decide and that although they do this
through and in the authentic presence of a nurse, these others are alone
in deciding. And nurses in deciding what and how to convey of their
knowing must decide freely, responsibly, personally, and alone.
The nurse in deciding what and how to convey, considering the
professional necessities of both confidentiality and dispersion of
knowledge, can be guided by a conception of the nature of
man-in-his-world. Man in humanistic nursing practice theory is viewed as
a conflictual, contradictory, inconsistent dilemma. One horn of the
dilemma is ideal spirituality that wrestles against the other horn,
protective materialistic animalism. This "all-at-once" struggling,
stretched, mixed nature of man needs recognition. Recognition of man's
nature, as such, supports greater self-acceptance. Self-acceptance and
this view of man-in-his-world, like a magnifying glass, unmasks for a
nurse her possible responses, motivations, and alternatives. Cognizant
of these, she can responsibly select what knowledge to disperse to
protect individuals and to continually shape and conceptually actualize
the nursing profession. Utilizing this magnifying glass on self in
humanistic nursing practice theory to let one's existing mixed, varied,
struggling responses, motives, and alternatives into self-awareness is
an axiom referred to as authenticity with self.
Acceptance of the others' human nature or human condition of being is
usually easier than acceptance of our own. Usually each man is his own
severest judge. Lilyan Weymouth, R.N., clinical specialist, my past
teacher and present friend, in sympathetic moments, speaking of
suffering others, often says, "the poor devils." Once, feeling anxious
and annoyed, I responded, "we are all poor devils." She retorted, "I am
glad you recognize that." Stopped short, I found myself continuing to
ponder the phrase, "poor devils." Man's dilemma is that he is neither
saint nor devil. He is a "poor saint" and a "poor devil," and by his
nature he is pushed and pulled in both directions, "all-at-once." Our
human existence in the world calls for an enduring with our virtues and
vices, our energy and our laziness, our altruism and our selfishness, in
a word with our humanness.
What meaning does this conception of man have for humanistic nursing
practice theory? This theory necessitates a nurse who accepts and
believes in the chaos of existence as lived and experienced by each man
despite the shadows he casts interpreted as poise, control, order, and
joy.
Labeled mental patients in therapeutic situation, in the sun beyond the
shadows, express how they set themselves apart from the rest of the
community {56} of man. They express how they experience themselves.
They view themselves as the worst, the noblest, the unhappiest, the most
maligned, and the most afraid. It comes out as if these superlative
distinctions are their only claims to fame. In my humanness I appreciate
the awesome dreads they live. They need to know that they exist in their
unique distinctness. And yet, the separation and loneliness with which
they adorn themselves and which professionally we have fostered with
fear engendering diagnostic labels seem a heavier than necessary burden.
In the light of existential loneliness, a part of each human existence,
often I invite them to see themselves as not so unlike other men and as
suffering the turmoil of existence as part of the human community, such
as it is. One usually can note their surprise and disbelief of my view.
Then, momentarily at least, tension seems to visibly fall from their
faces and forms. When this idea of them is heard by them, its effect
corresponds to how I experienced the technique in sensitivity group of
literally being allowed to dance into what felt like the circle of man,
our group.
To hear opportunities for humanistic nursing acceptance and support
nurses, too, need to question their self-nurse-image within the nursing
and health community. Do they know that they make and have real
potential for making a difference, an important difference? Do they
accept themselves as nurse? To me, a nurse is a being, becoming through
intersubjectively calling and responding in her suffering, joyous,
struggling, chaotic humanness, always trying beyond the possible while
never completely free from ignoble personal human wants. And, through
her presence it is possible for other persons to be all they can be in
crisis situations of their worlds. For the nurse to be humanistic it is
necessary for her to live her human condition-in-her-nursing-world
proudly with all its vulnerability and all its wonders. As man, the
nurse can recall and reflect on her "I," on her past "I-Other"
experiences, and she can come to know and accept more and more of
herself, as she becomes more. In humanistically recalling and reflecting
a nurse will understand and respond empathetically and sympathetically
to both her own humanness and the other's. She will recognize both self
and other as "poor devil" and "poor saint," all-at-once.
On the other hand, if a nurse denies her own struggling humanness, she
self-righteously will be apt to accuse either self or her other. This
way of being denies, suppresses, and represses one's own and the other's
ability to be, to be as much as potentially possible. Understanding man
through this conception of him is important to the possibility of
augmenting the implementation of humanistic nursing practice theory.