As a component of my doctoral examinations I was faced with having to
rewrite a clinical paper. This led to my deliberately and personally
choosing to conceptualize a synthetic construct of "clinical." This was
my decision. It speaks well for the value of having had the experience
of conceptualizing "comfort." Often it is said that man repeats that
which he finds as meaningful and good. This choice also signifies a real
overcoming of my resistance and ambivalence toward synthetic construct
development in a year's time.
"Clinical" was developed as a synthetic construct in 1968. It was a
conceptualized response to a dialectical process within myself. If I am
a clinician, then "how" I am in the health-nursing situation would
equate to "clinical." In conceptualizing this construct I teased out of
my lived-nursing-world the "how" of my working toward my own and others'
comfort.
Confusion, over what was meant when persons casually and currently
popularly attributed the term "clinical" to situations and persons,
called forth this conceptualization. It grew out of comparing and
contrasting two nursing consultation experiences in the
psychiatric-mental health area. Beginning this conceptualization I would
have referred to both these experiences as "clinical." At the
termination of the conceptualization they were both "clinical." They
were very different experiences for me, and yet of equal value in my
advancement toward my more of being. Prior to this conceptualization
because my attending emotions were so disturbing and unacceptable to me
in relation to one of these experiences, automatically I repressed part
of them and found reasons to suppress the rest of them. Unfortunately,
all else that was of value to me in having lived this experience was
integrally enmeshed with these emotions. This, too, became unavailable
to my conscious awareness. Conceptualization made recall and reflection
a necessity. Clinical includes inherently a process of experiencing
awarely and then recalling, looking at, reflecting on, and sorting out
to come to knowing.
Before knowing how to approach the rewriting of my clinical paper as a
partial requirement for receiving my doctoral degree I experienced a
depression. I felt frightened, angry, and inadequate. The original
clinical paper had been judged as more intellectual and scholarly than
clinical. I could conceive of only two alternatives. Both seemed
self-defeating. One, I could revise my former clinical paper into a more
intellectual and scholarly paper that still {104} would not be clinical
and would still leave my "I" out. Or, two, I could revise my former
clinical paper, dump all my feelings in the situational experience,
blame everyone else for these feelings, and culminate at least with my
clinical passions visible. Conflict resulted from my considering
pursuing either of these routes. I was immobilized for a time. A time
limitation and time passing pushed me to begin somewhere. I began.
Choosing the second alternative in the belief that at least through
writing I would better understand what I had lived in the experience.
I could support the value of dredging up these old feelings and looking
at them. Authentically letting myself be aware of what I had
experienced, not necessarily communicating this or acting out in
accordance with these redredged feelings; just really looking at them
might allow me choice in how I wanted to live with them. One support for
the value of looking at these old feelings was my own past three and
one-half years in psychoanalysis in which I profited through such a
process. The other support was my readings of the past two years. These
included works of Russell,[6] Nietzsche,[7] Plato,[8] Popper,[9]
Dewey,[10] Buber,[11] Bergson,[12] Cousins,[13] and de Chardin.[14]
As this experience became in shape and meaning through my writing, I
began to view this product as like an existential play filled with
blatant atrocities and absurdities that had to be nonrealities. This
production, also, made visible beautiful raw data. As meaning in this
clinical nursing consultation experience as a graduate student became
evident, comparison of it with the meaning of clinical work experiences
in nursing consultation situations flowed naturally. Then joy, it was
like sunshine burst forth and warmed my spirit.
Before entering school, I was, for two years, a mental health
psychiatric clinical nurse consultant to a staff of forty-five visiting
nurses. I had become intrigued {105} with what I had come to understand
about consultation related to clinical situations. I wrote a paper for
publication on the subject. Busy in the process of returning to school,
and awaiting the publication of two other papers--both of these
proceedings feeling unreal and out of my control, not to mention
self-exposing--I merely filed in my desk the typed submittable rendition
of this consultation paper. Now, I dug it out. This meant that I had two
conceptualized presentations of similar type personal experiences in
nursing consultation to compare and contrast. From these, my
conceptualization of clinical, and the values on which my clinical
practice rests, could be extrapolated.