,copyright 7,c7 #bjjg by ,joseph9e ,pat]son & ,loretta ,zd]ad4 ,humani/ic ,nurs+ 7,meta-!oretical ,essays on ,practice7 by ,joseph9e ,pat]son & ,loretta ,zd]ad ,copyright 7,c7 #bjjg by ,joseph9e ,pat]son & s,loretta ,zd]ad all rights res]v$ except z foll[s4 ,?is e-text may be freely copi$ = academic & s*ol>ly "w ) ! copyright notice cle>ly affix$ to all copies4 ,no comm]cial use may be made ( any "p ( ! text )\t ! express p]mission ( ! copyright hold]s4 ,?is e-text v]sion ( ! classic text ,humani/ic ,nurs+ is made available ) ! k9d p]mission ( ! au?ors & copyright hold]s1 ,joseph9e ,pat]son & ,loretta ,zd]ad4 ,! book 0 orig9ally writt5 to def9e ! ,humani/ic ,nurs+ ,!ory :i* pres5t$ a way = ea* nurse to become-m z a p]son & to ext5d t becom+-m to ! community ( nurses 9 :i* he or %e practices4 ,! (f]+ ( ?is book 9 ! free e-text =mat reit]ates ! cont9u+ contribution ( ^! two nurses long aft] _! retirem5t f practice4 ,x is _! hope t nurses ev]y:]e w take _! vision = nurs+ & exp& on x & integrate x into _! nurs+ practice4 ,at ! reque/ ( ! au?ors ?is e-text v]sion is complete ) ! orig9al #aigf ,front ,matt]4 ,susan ,kleiman ,= m in=mation or que/ions ab\t ! subject ( ,humani/ic nurs+ or ?is e-text y may contact ,pr(essor ,susan ,kleiman1 ,ph,d1 ,,rn1 ,,cs1 ,,npp at3 susankhumani/ic-nurs+4com4 ,alt]natively y may visit ! web site3 www4humani/ic-nurs+4com4 ,! ,humani/ic ,nurs+ ,inquiry web site provides context = ! major initiatives ( humani/ic nurs+1 :i* celebrate ! endur+ & immutable ideals ( ,humanism t give u insight into ! fundam5tal tru?s ( be+ 9 ! _w ( nurses1 pati5ts1 families1 colleagues1 & /ud5ts4 ,,=eword to ! #aigf ,edition ,^! essays w evoke diff]5t reactions f diff]5t read]s4 ,well1 ,i "k t1 = example1 may be ! reaction ( a beg9n] 9 nurs+2 ,i w\ldn't h said x t way b ,i knew t is really nurs+4 ,s9ce !y've giv5 u a me?odology1 p]haps f "o m exp]i5c$ 9 nurs+2 ,i'll give x a try4 ,o!rs ) /ill m or diff]5t k9ds ( exp]i5ce may respond1 ,x's ab\t "t nurses put t into words2 x's ab\t "t4 ,timely z ^! essays are ,i w\ld pref] n to use up ! =eword ) a li/+ ( ! crises1 ! eco-spasms1 & sci5tific triumphs t w\ld docum5t _! timel9ess4 ,x is my pleasure1 r1 to use ?is opportunity to relate ! six elem5ts ( my own reaction3 ,nurs+ has a solit>9ess until we f9d x has _m companions 9 philosophy1 sci5ce1 & art4 ,x has a /ead9ess ab\t its pace yet holds a pot5tial = flights to high] elevations4 ,x is con/antly *ang+ yet has an endur+ compon5t ( p]man5ce4 ,good is ! ^w we use e day2 our vision1 h[ev]1 is ( excell5ce4 ,its tasks (t5 h ! appe>ance ( homel9ess until we glimpse t k9d ( beauty t is humanness4 ,nurs+ ev5 s+s v s(tly because our e>s are attun$ to a diff]5t drumm]4 ,lilyan ,weym\?1 ,r4,n41 ,m4,s4 ,nor?ampton1 ,massa*usetts ,octob] #aige ,,preface to ! #aigf ,edition ,out ( necessity nurs+1 z a pr(ession1 reflects ! qualities ( ! culture 9 :i* x exi/s4 ,9 our culture = ! pa/ qu>t] ( a c5tury nurs+ has be5 assail$ ) rapid economic1 te*nological1 %ortage- abundance1 *ang+ sc5es' vicissitudes4 ,9 ! individual nurse ^! ar\se turmoil & unc]ta9ty4 ,^! cultural /irr+s inflame t "p ( ! nurse's _s capable ( *aotic conflict & d\bt4 ,(t5 %e que/ions h] pr(essional id5tity4 '',j :at is a nurse8 ,h] nurse colleagues1 o!r pr(essionals1 & nonpr(essionals freely1 directly & indirectly-on television1 9 ! !at]1 ?r\gh ! news m$ia & ! lit]ature-pummel h] ) _! multitud9\s v>i$ views4 ,z se>*+1 wond]+1 reflect+1 relat+ microcosms )9 ?is p]plex+ heal? nurs+ _w = long] ?an a qu>t] ( a c5tury1 we pres5t ?is book4 ,descriptively we view ! *apt]s z h>d-wrung1 philosophical f\ndations1 syn!siz$ extracts f our liv$ exp]i5ces4 ,^! meta!oretical essays on practice pres5t an exi/5tial alt]native approa* = a pr(essional nurse's kn[+ & becom+4 ,^! conceptualiz$ exi/5ts are available because ,miss ,m>gu]ite ,l4 ,burt1 =m]ly ,*ief ( ,nurs+ ,s]vice1 ,nor?port1 ,n4,y4 ,vet]ans ,adm9i/ration ,hospital call$ !m =? f u4 ,^! *apt]s are our response to h] call4 ,9 #aigb ,miss ,burt reque/$ u to develop a c\rse = ! pr(essional nurs+ /aff at ,nor?port ,v4,a4,h4 ,?is book has evolv$ f ! orig9al pres5tations (f]$ to ! t5 p>ticipants 9 ! fir/ c\rse4 ,:ile we taught & work$ ) five subsequ5t gr\ps1 we le>n$ & cont9ually revis$ & cl>ifi$ our conceptualizations4 ,! c\rse is entitl$ ,humani/ic ,nurs+4 ,fifty-?ree nurses h be5 involv$ 9 ?is c\rse4 ,int]e/1 appreciation1 wond]m5t1 ef=t1 & inve/m5t *>act]i/ically depict _! response4 ,!y convey t ! humani/ic nurs+ practice !ory reflects :at nurs+ means to !m4 ,_! hungry approa* to ! sugge/$ read+s has bo? surpris$ & pleas$ u4 ,our amazem5t p]si/s ov] ! p>ticipants' ability to conc5trat$ly discuss ab/ract !ory & concrete nurs+ practice = weekly day-long sessions ov] six-to n9e-mon? p]iods4 ,pres5tly reque/s to p>ticipate 9 ! next humani/ic nurs+ c\rse are m\nt+ f nurses bo? )9 & outside ! ,nor?port complex4 ,! c\rse1 ! !ory1 & ?is book are ! fruits ( our individual & collaborative ef=ts4 ,:ile %>+ sem9> responsibility = graduate /ud5ts 9 #aifj1 we began to dialogically & -dialectically /ruggle ) pr(essional & _/cl9ical nurs+ issues4 ,discuss+ & se>*+ly que/ion+ ourselves & our /ud5ts became a value4 ,?r\gh convey+1 /ruggl+ = cl>ification1 op5ness to hone/ argum5t1 we grew 9 our aw>5ess t ea* 0 mov$ beyond h] beg9n+ ?\ghts4 ,?r\gh reflection we h come to view1 describe1 & di/+ui% our dialogues z /ruggles )1 & n aga9/1 o!rs' ideas4 ,diff]5ces 9 response are valu$ = :at !y c tell u ( our *os5 area-nurs+4 ,s dialectical dialogue has gradually become our pr$om9ant tea*+ me?od4 ,we convey our ideas1 are op5 to o!rs' que/ions1 /ruggle to cl>ify & really communicate1 & "q ourselves1 & o!rs4 ,9 ! process ( ! humani/ic nurs+ c\rse1 us+ ?is me?odology1 :i* is delib]ate &1 yet1 natural & au!ntic = u1 we & our pr(essional nurs+ /aff /ud5ts h le>n$ & become m human1 m que/ion+1 m cl9ical1 & j1 m4 ,we value our mor5ess4 ,appreciat+ & valu+ ! effects ( our actualiz+ selves z human be+s1 we mu/ atte/ to our exi/5tial modes ( nurse be+2 our inn] m&ate is3 %>e4 ,h5ce1 ,humani/ic ,nurs+ has come into be+4 ,to f9d ! mean+ ( nurs+ we h return$ to ! ?+ itself1 to ! ph5om5on ( nurs+ z x occurs 9 ! ev]yday _w4 ,our reflections on nurs+ z a liv$ exp]i5ce fl[$ into ! realm ( metanurs+4 ,obvi\sly1 ^! ?\ghts are only a beg9n+4 ,!y are (f]$ 9 ! hope ( /imulat+ response & fur!r developm5t4 ,dialogue may be difficult at fir/ because humani/ic nurs+ repres5ts "o ( our discipl9e's less articulat$ /reams4 ,yet1 x is a /ream traceable to nurs+'s f\ndation &1 z su*1 is relat$ to nurs+'s arti/ic1 sci5tific1 & te*nological curr5ts4 ,x is n be+1 _c be1 develop$ 9 opposition to !m4 ,sci5ce & art are =ms ( human responses to ! human situation4 ,!y are valu$ 9 g5u9e humanism4 ,?us1 ! humani/ic nurs+ approa* does n reject advances 9 nurs+ te*nology1 b r x tries to increase _! value by view+ _! use )9 ! p]spective ( ! developm5t ( human pot5tial4 ,! same holds true = sci5tific1 arti/ic1 & cl9ical developm5ts 9 nurs+ practice4 ,!y are ! necess>y means ?r\gh :i* & 9 :i* humani/ic nurs+ 7a be+ & do+7 is exp]i5c$ & develop$4 ,at ?is "t :5 s]i\s conc]n is be+ express$ ab\t ! survival ( nurs+ z a pr(ession1 humani/ic nurs+ (f]s a note ( optimism4 ,by exam9+ ! values und]ly+ practice1 x focuses on ! mean+ & means ( nurs+'s p>ticul>' mode ( int]human c>+4 ,x increases respect = t c>+ z a means ( human developm5t4 ,nurses h ! privilege ( be+ ) p]sons :o are exp]i5c+ all ! v>i$ mean+s ( inc>nate be+ ) m5 & ?+s 9 "t & space 9 ! entire range f bir? to dea?4 ,!y n only h ! opportunity to co-exp]i5ce & co-se>* ) pati5ts ! mean+ ( life1 suff]+1 & dea?1 b 9 ! process !y may become & help o!rs become m-m human4 ,beyond ?is1 ! humani/ic nurs+ approa* respects nurs+ exp]i5ce z a s\rce ( wisdom4 ,by describ+ & conceptualiz+ ! ph5om5a exp]i5c$ 9 nurs+ situations1 nurses c\ld contribute to ! developm5t ( nurs+ z a discipl9e4 ,ev5 m1 !y c\ld add to ! k ( man4 ,humani/ic nurs+1 !n1 is nei!r a break ) nor a repetition ( nurs+'s pa/4 ,x is nei!r a rejection ( nor a satisfaction ) nurs+'s pres5t4 ,r x is an awak5+ to ! possibilities ( %ap+ our nurs+ _w "h & n[ & = ! future4 ,?anks to ,miss ,m>gu]ite ,l4 ,burt are 9 ord] = %e provok$ our conceptualizations ( our liv$ nurs+ worlds4 ,dr4 ,fr$]ick ,h4 ,wescoe1 :ile ,*ief ( ,nurs+ ,s]vice1 ,nor?port1 ,n4,y41 ,,vah adm9i/ratively facilitat$ ! "t & ! means = our compil+ ^! mat]ials into a manuscript4 ,pa/ nurs+ /ud5ts *all5g$ & grappl$ ) our ideas & !irs insi/+ always on our =w>d+ our ?9k+4 ,our consultants1 ,miss ,lilyan ,weym\? & ,miss ,rose ,godb\t1 7 m>vel\s res\rces & c\nselors4 ,imm$iately we are mo/ grateful to ! p>ticipants 9 ! six humani/ic nurs+ c\rses taught "h at ! ,nor?port ,,vah4 ,z nurses1 !y receiv$ & accept$ our express$ ideas to ! ext5t ( te/+ !m 9 ! fires ( _! real liv$ nurs+ practice sett+s4 ,:ile /ruggl+ ) our ideas & u1 !y gave to u4 ,!y 7 supportive1 lov+1 & truly pres5t ) u 9 ! community ( nurses at ,nor?port1 ,,vah4 ,miss ,sue ,mc,cann1 cl9ical nurse speciali/1 "o ( our fir/ c\rse p>ticipants1 has read & review$ our mat]ials4 ,m ?an ?is ,miss ,mc,cann has be5 a c\nselor1 res\rce p]son1 & a dep5dable fri5d 9 our humani/ic nurs+ ef=t ( ! la/ ?ree ye>s4 ,we hope our *apt]s give back to o!rs1 at lea/ j a "p ( :at we h receiv$ f !m 9 our travels 9 ! nurs+ _w4 ,j4,g4,p ,l4,t4,z4 ,transcrib]'s ,note3 to ! #aihh ,edition ,italic text has be5 m>k$ z text4 ,bold text has be5 m>k$ z text4 ,obvi\s punctuation errors 9 ! orig9al h be5 correct$4 ,o!r corrections are not$ at ! end ( ! text4 ,! orig9al page numb]s h be5 reta9$1 e4g4 #a m>ks ! />t ( page #a 9 ! orig9al text4 ,,humani/ic ,,nurs+ ,joseph9e ,g4 ,pat]son1 ,d,n,sc1 ,,rn ,loretta ,t4 ,zd]ad1 ,ph,d1 ,,rn ,,preface ,some:]e !re's a *ild a cry+ ,some:]e !re's a *ild a cry+ ,some:]e !re's a *ild a cry+ ,cry+ = fre$om 9 ,s\? ,africa4#a ,b until someone he>s ! cry & responds1 ! *ild w cont9ue to suff] ! oppression ( ! curr5t ,s\? ,african regime2 & ! _w w cont9ue to be less ?an x c\ld be4 ,to cry al\d :5 !re seems no *ance ( be+ he>d1 belies a hope--p]haps an inh]5tly human trait--t someone1 some:]e1 someh[ w he> t cry & respond to x4 ,?is same hope1 t someone w\ld he> & respond1 all[$ exi/5tial psy*ologi/ ,viktor ,frankl to survive ! sy/ematic torture & degradation 9 ,nazi dea? camps4 ,z ,frankl & o!rs s\ght _! way1 !y f\nd mean+ & salvation ?r\gh love & 9 love2 & by *oos+ to believe t life /ill wait$ = him1 t a human be+ wait$ = 8 return4#b ,!re is p[] 9 ! call ( "o p]son & ! pot5tial response ( ano!r2 & incr$ible p[] :5 ! pot5tial response becomes real4 ,!re is ! p[] = ea* p]son to *ange z %e becomes m ?an %e 0 be=e ! dialogue4 ,!re is ! p[] to transc5d ! situation z two p engage ! ev5ts t are :irl+ ar\nd !m & toge!r try to make s5se ( _! worlds & f9d a mean+ to _! exi/5ce4 ,:5 ! call & response betwe5 two p is z hone/ z x c be1 !re is ! revolution>y p[] :i* ! poet ,muriel ,rukeys] speaks (3 ,:at w\ld happ5 if "o woman told ! tru? ab\t h] life8 ,! _w w\ld split op54#c iv ,! call & response ( an au!ntic dialogue betwe5 a nurse & pati5t has great p[]--! p[] to *ange ! liv$ exp]i5ces ( bo? pati5t & nurse1 to *ange ! situation1 to *ange ! _w4 ,x is ! same au!nticity we se>* = 9 relation%ips ) our fri5ds & lov]s4 ,! p]son :o really li/5s to :at we are say+1 :o really tries to und]/& our liv$ exp]i5ces ( ! _w & :o asks ! same f u4 ,:5 f\nd1 x br+s ! same exhil>at+ feel+ ( self-affirmation & ! com=t+ feel+ ( well-be+4 ,=1 if z holi/ic be+s we are ! implicate ord] explicat+ itself1 z sugge/$ by ,bohm#d & ,newman#e among o!rs1 !n ! responsibilities ( ^? :o w\ld help 7e4g41 nurses7 include mak+ s5se out ( ! *aos t c occur z illness disrupts pa/ ord] & z ! ev]-pres5t ?reat ( non-be+ disrupts all ord]4 ,:5 we are successful 9 help+ pati5ts & _! lov$ ones make s5se ( _! lives by br++ mean+ to !m1 we make s5se ( & br+ mean+ to our own4 ,& :5 we help create mean+1 x is easi] to rememb] :y we *ose nurs+ & :y we cont9ue to *oose x despite :at an und]paid & und]valu$ job x has become 9 today's m>ketplace4 ,^! are ! mom5ts :5 by a look or a ^w or a t\*1 ! pati5t lets u "k t he und]/&s :at is happ5+ to him1 :at 8 *oices are1 & :at he is go+ to d2 t he kn[s we "k2 & t ea* kn[s t ! o!r kn[s4 ,:5 we get pa/ our sci5ce & !ories1 our te*nical pr[ess1 our titles & positions ( influ5ce1 x is ?is %>$ mom5t ( au!nticity--betwe5 pati5t & nurse--t makes u smile & all[s u to move =w>d 9 our own life projects4 ,nurse educators :o seek su* au!ntic ex*anges ) _! /ud5ts enjoy simil> mom5ts4 ,! same c be said ( deans ( s*ools ( nurs+1 adm9i/rators ( deliv]y sy/ems1 executives & /aff ( nurs+ & pr(essional organizations1 & colleagues on a rese>* project4 ,x is ! au!ntic dialogue betwe5 p t makes any activity wor?:ile reg>dless ( :e!r or n x is call$ successful by o!rs4 ,:5 ,joseph9e ,g4 ,pat]son & ,loretta ,t4 ,zd]ad fir/ publi%$ _! book ,humani/ic ,nurs+ 9 #aigf1 society 0 9 ! mid/ ( ! new wom5's movem5t & nurses 7 go+ ?r\gh ! phase ( ass]tiv5ess tra9+1 dress+ = success1 & le>n+ to play ! games t "m nev] taught u4 ,s9ce !n1 nurses h mov$ into _m sectors ( society & h held p[] z we h nev] held x be=e4 ,we h prov$ ourselves z politicians1 adm9i/rators1 rese>*]s1 & writ]s4 ,we h ref9$ our abilities to assess1 diagnose1 treat1 & evaluate4 ,we've rais$ money & balanc$ budgets4 ,we've network$1 organiz$1 & =m$ coalitions4 ,yet1 individually we are uneasy & collectively we are unable to articulate a vision cle> en\gh s t o!rs w jo9 u4 ,?is re-issue ( ,pat]son & v ,zd]ad's classic "w w help to rem9d u ( ano!r way ( develop+ our p[]4 ,p]haps we c1 once aga91 look = & call = au!ntic dialogue ) our pati5ts1 our /ud5ts1 & our colleagues4 ,pat]son & ,zd]ad are cle> 9 _! me?od3 discuss1 "q1 convey1 cl>ify1 argue1 & reflect4 ,!y rem9d u ( our uniqu5ess & our commonality4 ,!y tell u t x is necess>y to d ) & be ) ea* o!r 9 ord] = any "o ( u to gr[4 ,!y help u celebrate ! p[] ( our *oices4 ,is x ironic & =tunate t ,humani/ic ,nurs+ %\ld be re-issu$ n[ :5 x is ne$$ ev5 m ?an x 0 dur+ ! late #aigjs8 ,!n1 humanit>ianism 0 9 vogue4 ,n[1 x is "u attack z a secul> religion4 ,today1 ! te*nocratic imp]ative infiltrates an ev]-increas+ numb] ( our liv$ exp]i5ces2 & x becomes m difficult to ignore or dismiss ,hab]mas's analysis t all int]e/s h become te*nical r ?an human4#f ,z heal? c>e becomes increas+ly comm]cial ! pr(\nd exp]i5ces ( liv+ & dy+ are discuss$ 9 t]ms ( pr(it & loss4 ,life itself is ! focus ( public debates ab\t :e!r surrogacy involves a :ole baby be+ b\ght & sold or only half ( a baby1 s9ce "o half already belongs to ! natural fa!r & s he _c buy :at he already owns4 ,we h _m *oices be=e u3 to adopt ! values ( comm]ce & r$esign heal? c>e sy/ems accord+ly2 to accept competition z ! modus op]&i or insi/ on o!r measures = p 9 ne$2 to decide :o w be c>$ =1 :o won't1 :o w pay1 & h[ mu*8 ,p]haps x is "t = u to turn away f ! ex*ange betwe5 buy]s & sell]s1 provid]s & consum]s2 & turn back to an ex*ange betwe5 two p try+ to und]/& ! space !y %>e4 ,p]haps x is "t = a %>$ dialogue ) pati5ts = :om ! que/ions are mo/ vital8 ,p]haps we ne$ to he> _! call & respond au!ntically4 ,p]haps !y ne$ to he> ours8 ,= only !n1 z ,pat]son & ,zd]ad h made q cle>1 w our liv$ exp]i5ces 9 heal? c>e h any real mean+4 ,patricia ,moccia ,,phd1 ,,rn ,associate ,pr(essor & ,*air ,dep>tm5t ( ,nurs+ ,education ,tea*]s ,college ,columbia ,univ]sity ,,footnotes3 #a ,azanian ,fre$om ,song4 ,lyrics by ,otis ,williams1 music by ,b]nice ,johnson ,reagon4 ,wa%+ton1 ,,dc3 ,songtalk ,publi%+ ,co41 #aihb4 #b ,frankl1 ,viktor4 ,man's ,se>* ,= ,mean+4 ,bo/on3 ,beacon ,press1 #aiei4 #c ,rukeys]1 ,muriel4 ,ka! ,kollwitz1 9 ,by a ,woman ,writ1 ed4 ,joan ,g\lianos4 ,new ,york3 ,bobbs ,m]rill1 #aigc1 p4 #cgd4 #d ,bohm1 ,david4 ,:ol5ess & ! ,implicate ,ord]4 ,london3 ,ark1 #aihj4 #e ,newman1 ,m>g>et4 ,heal? ,z ,exp&+ ,consci\sness4 ,/4 ,l\is3 ,c4 ,v4 ,mosby ,company1 #aihf4 #f ,hab]mas1 ,jurg54 ,k & ,human ,int]e/1 7trans4 ,j4 ,%apiro47 ,bo/on3 ,beacon ,press1 #aiga4 ,,cont5ts ,,"p ,,"o ,,!oretical ,,roots #a #a ,humani/ic ,nurs+ ,practice ,!ory #c #b ,f\ndations ( ,humani/ic ,nurs+ #aa #c ,humani/ic ,nurs+3 ,a ,liv$ ,dialogue #ba #d ,ph5om5on ( ,community #cg ,,"p ,,two ,,me?odology--,a ,,process ,,( ,,be+ #di #e ,t[>d a ,responsible ,free ,rese>* ,nurse 9 ! ,heal? ,ar5a #ea #f ,! ,logic ( a ,ph5om5ological ,me?odology #fe #g ,a ,ph5om5ological ,approa* to ,humani/ic ,nurs+ ,!ory #gg #h ,humani/ic ,nurs+ & ,art #he #i ,a ,heuri/ic ,culm9ation #ie ,app5dix #aac ,gloss>y #aba ,bibliography #abc ,index #abg #a ,"p #a ,,!oretical ,,roots #b #c #a ,,humani/ic ,,nurs+ ,,practice ,,!ory ,sub/antively ?is *apt] introduces two aspects ( ! humani/ic nurs+ practice !ory3 fir/1 :at ?is !ory proposes &1 second1 h[ ! proposals ( ! !ory evolv$4 ,concisely1 humani/ic nurs+ practice !ory proposes t nurses consci\sly & delib]ately approa* nurs+ z an exi/5tial exp]i5ce4 ,!n1 !y reflect on ! exp]i5ce & ph5om5ologically describe ! calls !y receive1 _! responses1 & :at !y come to "k f _! pres5ce 9 ! nurs+ situation4 ,x is believ$ t compilation & complem5t>y syn!ses ( ^! ph5om5ological descriptions ov] "t w build & make explicit a sci5ce ( nurs+4 ,,humani/ic ,,nurs+3 ,,its ,,mean+ ,nurs+ is an exp]i5ce liv$ betwe5 human be+s4 ,ea* nurs+ situation reciprocally evokes & affects ! expression & manife/ations ( ^! human be+s' capacity = & condition ( exi/5ce4 ,9 a nurse ?is implies a responsibility = ! condition ( h]self or be+4 ,! t]m humani/ic nurs+ 0 select$ ?\ghtfully to designate ?is !oretical pursuit to reaffirm & floodlight ?is responsible *>act]i/ic z fundam5tally inh]5t to all artful-sci5tific nurs+4 ,humani/ic nurs+ embraces m ?an a b5evol5t te*nically compet5t subject-object "o-way relation%ip guid$ by a nurse 9 behalf ( ano!r4 ,r x dictates t nurs+ is a responsible se>*+1 transactional relation%ip ^: mean+fulness dem&s conceptualization f\nd$ on a nurse's exi/5tial aw>5ess ( self & ( ! o!r4 #d ,,exi/5tial ,,exp]i5ce ,uniqu5ess--,o!rness ,exi/5tial exp]i5ce inf]s human aw>5ess ( ! self & ( o!rness4 ,x calls = a recognition ( ea* man z exi/+ s+ul>ly 9-8-situation & /ruggl+ & /riv+ ) 8 fell[s = survival & becom+1 = confirmation ( 8 exi/5ce & und]/&+ ( its mean+4 ,m>t9 ,bub]1 philosophical an?ropologi/ & rabbi1 express$ artfully ?is uniqu5ess1 /ruggle1 & pot5tial ( ea* man4 ,he said3 ,s5t =? f ! natural doma9 ( species into ! haz>d ( ! solit>y category1 man surr\nd$ by ! air ( a *aos :i* came into be+ ) him1 secretly & ba%fully he wat*es = a ,yes :i* all[s him to be & :i* c come to him only f "o human p]son to ano!r4#a ,) su* uniqu5ess ( ea* human be+ z a giv51 an assum$ fact1 only ea* p]son c describe or *oose ! evolvem5t ( ! project :i* is himself-9-8 situation4 ,?is awesome & lonely human capacity = *oice & novel evolvem5t pres5ts bo? hope & fe> z reg>ds ! unfold+ ( human mor5ess4 ,uniqu5ess is a univ]sal capacity ( ! human species4 ,s1 all-at-once1 :ile ea* man is unique2 p>adoxically1 he is also l 8 fell[s4 ,8 v uniqu5ess is a *>act]i/ic ( 8 commonality ) all o!r m54 ,au!nticity--,exp]i5c+ ,9 humani/ic nurs+ exi/5tial aw>5ess calls = an au!nticity ) "o's self4 ,z a vision>y aim1 su* au!nticity1 self-9-t\*ness1 is m ?an :at usually is t]m$ intellectual aw>5ess4 ,auditory1 olfactory1 oral1 visual1 tactile1 k9e/hetic1 & visc]al responses are involv$ & ea* c convey unique mean+ to man's consci\sness4 ,9-t\*ness ) ^! s5sations & our responses in=ms u ab\t our quality ( be+1 our !r5ess1 our degree ( pres5ce ) o!rs4 ,! k9d ( betwe5 we live ) o!rs dep5ds on bo? our degree ( aw>5ess & ! mean+ we attribute to ?is aw>5ess4 ,?is aw>5ess1 reflect$ on1 sometimes %>$ ) a responsible o!r = reality te/+1 (f]s u opportunity = broad5+ our mean+ base1 = becom+ m--m 9 accord ) our pot5tial = humanness4 ,p]haps a /atem5t made by ,dr4 ,g5e ,phillips1 pr(essor ( education at ,bo/on ,univ]sity1 w cl>ify ! importance ,i atta* to ea* nurse becom+ z mu* z %e c be4 ,he said1 ,! m mature we are ! less x is necess>y = u to exclude4 ,pres5tly ,i w\ld p>aphrase ?is /atem5t #e & say1 ! m ( ourselves we d n h to exclude1 ! m ( ! o!r we c be op5 to4 ,our self-aw>5ess1 9-t\*ness1 self-acceptance1 actualization ( our pot5tial all[s u to %>e ) o!rs s !y c become 9 relation%ip ) u4 ,9 ?is k9d ( exi/5tial relat+1 pres5ce ) ano!r1 a nurse is confront$ ) man z s+ul> 9 8 own peculi> angul>1 bias$1 or %ad$ reality4 ,x becomes app>5t t ea* has 8 v own liv$ _w4 ,s "o might describe human exi/5ce z man-_w z "s ref] to man z m9d-body1 us+ a hyph5 r ?an &4 ,man's univ]sal species commonality & peculi> p]plex+ noncommonality1 has ?is manness1 affect & con/antly int]play ) "o ano!r4 ,?is ar5a ( int]play is complicat$ fur!r by man's capacity = nondet]m9$ness1 8 ability = envision+ & consid]+ a v>iety ( alt]natives & *oos+ selectively4 ,(t5 ^! alt]natives are exp]i5c$ z contradictory & inconsi/5t4 ,humani/ic nurs+ calls =? 9 ! nurse ! /ruggle ( recogniz+ ! complexity ( m5's relat+ 9 ! nurs+ _w z j h[ man is & 8 nature1 8 human condition1 z se>*+1 exp]i5c+1 & an unfold+ becom+4 ,mor5ess--,*oice ,h[ c a nurse let h]self "k h] human responses & ! bread? & dep? ( ! possibilities call$ =? by ! o!r8 ,h[ c %e be1 se>*1 exp]i5ce1 become 9 an accord ) ! calls & responses ( h] liv$ nurs+ _w8 ,x is a *os51 delib]ate life-long process4 ,! process itself is g5]ative4 ,"o exp]i5ce op5s ! door = ! next4 ,9 humani/ic nurs+ practice !ory we call ?is k9d ( exp]i5c+ au!ntic1 g5u9e1 or lett+ be :at is4 ,x is man consci\s ( himself1 n necess>ily act+ out1 b aw>e ( 8 human responses to 8 _w & _! mean+s to him4 ,?is quality ( p]sonal au!nticity all[s "o's responsible *os5 actions to be bas$ 9 human k r ?an human def5siv5ess4 ,man is a kn[+ place4 ,f education & liv+ exp]i5ce "o assumes an initial innate =ce 9 human be+ness t moves man to come to "k 8 own & o!rs' angul> views ( ! _w4 ,humani/ic nurs+ is conc]n$ ) ^! angul> views1 ^! diff]5ces be+ view$ by nurses responsibly & z realities t are beyond ! negative-positive1 good-evil /&>d ( judgem5t4 ,or1 = example1 nurs+ is conc]n$ ) h[ ?is p>ticul> man1 ) 8 p>ticul> hi/ory1 exp]i5ces be+ label$ ) ?is g5]al diagnosis & be+ admitt$1 dis*>g$1 & liv+ out 8 life ) 8 condition z he views x 9-8-_w4 ,man has ! inh]5t capacity to respond to o!r man z o!r man4 ,only ea* unique nurse fac$ ) ! *aos ( h] alt]natives 9 a situation c !n *oose ei!r to relate or n to relate & h[ to relate 9-h]-nurs+-_w to o!rs4 ,*oos+ to & h[ to relate or respond _c be sup]impos$ on man f ! outside by ano!r4 ,a p]son1 to a degree1 c be co]c$ to behave outw>dly 9 a c]ta9 way4 ,= example1 physically1 9 a spatial #f s5se1 a nurse c be ord]$ into p>allel exi/5ce ) ano!r4 ,be+ exi/5tially & g5u9ely pres5t ) ano!r is diff]5t4 ,?is human mode ( be+ is *os5 & controll$ by ! self4 ,x takes responsible self-ord]+ t c arise only 9 ! _s ( "o's own discipl9$ be+4 ,value--,nonvalue ,to (f] g5u9e pres5ce to o!rs1 a belief mu/ exi/ )9 a p]son t su* pres5ce is ( value & makes a diff]5ce 9 a situation4 ,if x is a value = a nurse1 x w be (f]$ 9 h] nurs+ situation4 ,libr>ies1 concrete build+s bur/+ ) words ( great ?9k]s1 support ! value ( g5u9e pres5ce & au!ntic dialogue betwe5 p]sons4 ,consid] ! lit]>y works t h convey$ or reflect$ ?is message ?r\gh\t ! exi/5ce ( intellectual man4 ,plato1 ,r\sseau1 ,goe!1 ,pr\/1 ,nietzs*e1 ,:itehead1 ,jung1 ,may1 ,frankl1 ,hesse1 de ,*>d91 ,b]gson1 ,m>cel & ,bub] ef=tlessly come to m9d4 ,_m nurses are g5u9e pres5ces 9 ! nurs+ situation4 ,"s h tri$ to %>e _! exp]i5ces2 "s h n4 ,&1 !re are ^? :o are n g5u9e pres5ces 9 ! nurs+ situation4 ,"o wond]s if ?is has influ5c$ ! di/9ctions nurses h made ov] ! ye>s ) c]ta9ty :5 consid]+ _! nurse contempor>ies4 ,(t5 "o he>s1 %e is a good nurse1 a natural4 ,^! positive critics are (t5 up aga9/ x :5 ask$1 :y1 h[1 :at8 ,descriptive lit]>y conceptualizations ( nurs+ t reflect ?is quality ( nurse-be+ 7pres5ce1 int]subjectiv5ess7 call = nurses will+ to se>* out & br+ to aw>5ess1 ! my/]ies ( _! commonplace1 _! famili>1 & to appreciate ! unique ideas1 values1 & mean+s fundam5tal to _! practice4 ,conceptualization ( ^! qualities by practic+ nurses is basic & necess>y to ! developm5t ( a sci5ce & an actualiz$ pr(ession ( nurs+4 ,,ph5om5ological ,,description ,ph5om5ology directs u to ! /udy ( ! ?+ itself4 ,! exi/5tial lit]ature1 descriptions ( :at man has come to "k & und]/& 9 8 exp]i5ce1 has evolv$ f ! use ( ! ph5om5ological approa*4 ,9 ! humani/ic nurs+ practice !ory ! ?+ itself is ! exi/5tially exp]i5c$ nurs+ situation4 ,bo? ph5om5ology & exi/5tialism value exp]i5ce1 man's capacities = surprise & kn[+1 & honor ! evolv+ ( ! new4 ,:at ,does ,humani/ic ,nurs+ ,practice ,!ory ,ask ! ,nurse to ,describe8 ,nurses exp]i5ce ) o!r human be+s peak life ev5ts3 creation1 bir?1 w9n+1 no?+ness1 los+1 sep>ation1 dea?4 ,_! ,i-,?\ empa!tic #g relations ) p]sons dur+ ^! actual liv$ exp]i5ces & _! own exp]i5tial-educational hi/ories make ! betwe5 ( ! nurs+ situation unique4 ,?r\gh 9-t\*ness ) self1 au!ntic aw>5ess & reflection on su* exp]i5ces ! human nurse comes to "k4 ,humani/ic nurs+ practice !ory asks t ! nurse describe :at %e comes to "k3 7#a7 ! nurse's unique p]spective & responses1 7#b7 ! o!r's kn[able responses1 & 7#c7 ! reciprocal call & response1 ! betwe51 z !y occur 9 ! nurs+ situation4 ,:y ,does ,humani/ic ,nurs+ ,practice ,!ory ,ask ,t ,exi/5tial ,nurs+ ,exp]i5ce ,be ,describ$ ,ph5om5ologically8 ,!re are _m reasons4 ,philosophically & fundam5tally ! reason relates to h[ humani/ic nurs+ p]ceives ! purpose & aim ( nurs+4 ,x views nurs+ z ! ability to /ruggle ) o!r man ?r\gh peak exp]i5ces relat$ to heal? & suff]+ 9 :i* ! p>ticipants 9 ! nurs+ situation are & become 9 accordance ) _! human pot5tial4 ,s1 l ,elie ,wiesel1 ! noveli/1 :o /ates 9 ,"o ,g5]ation ,aft] t he writes to atte/ to ev5ts ( human exi/5ce & to come to und]/&1 humani/ic nurs+ proposes t human =ms ( exi/5ce 9 nurs+ situations ne$ atte/ation & t ?r\gh describ+1 nurses w und]/& bett] & relate to man z man is4 ,?us ! pr(ession ( nurs+'s s]vice contribution to ! community ( man w ev] become m4 ,! reasons = ph5om5ologically describ+ nurs+ are complex1 int]9flu5tial1 & _! ramifications are f> rea*+4 ,sequ5tially1 ! /udy & description ( human ph5om5a pres5t$ 9 nurs+ situations w affect 7#a7 ! quality ( ! nurs+ situation1 7#b7 man's g5]al k ( ! v>iation 9 human capacity = be+ness1 & 7#c7 ! developm5t & =m ( ! evolvem5t ( nurs+ !ory & sci5ce4 ,h[ ,c ,nurses ,beg9 to ,describe ,humani/ic ,nurs+ ,ph5om5ologically8 ,! process ( h[ to describe nurs+ ev5ts entails delib]ate responsible1 consci\s1 aw>e1 nonjudgm5tal exi/5ce ( ! nurse 9 ! nurs+ situation foll[$ by discipl9$ au!ntic reflection & description4 ,!re are obvi\s common liv$ human exp]i5ces :i* if consid]$ & wond]$ ab\t1 c advance a nurse's ability = ph5om5ological description4 ,^! exp]i5ces are easily cit$1 yet n easily plumb$4 ,(t5 exp]i5ces su* z ang]1 fru/ration1 wait+1 apa?y1 confusion1 p]plexity1 que/ion+1 surprise1 conflict1 heada*e1 cry+1 laugh+1 joy are quickly !oretically & analytically int]pret$1 label$1 & dismiss$4 ,exam9+1 reexam9+1 mull+ ov]1 brood+ on1 & fuss+ ) ! situational context ( ^! exp]i5ces z nonlabel$1 raw human liv$ data c yield #h k4 ,k ( ! nurse's & h] o!r's unique human exi/5ce 9 _! on-go+ /ruggle becomes explicit4 ,sup]ficial treatm5t ( su* human clues results 9 nonfulfillm5t ( ! reali/ic human possibilities ( artful-sci5tific pr(essional kn[+ & nurs+4 ,words are ! major tools ( ph5om5ological description4 ,!y are limit$ by our human ability to express1 & yet !y are ! be/ tools we h = express+ ! human condition4 ,! noveli/ ,james ,agee1 9 ,let ,u ,n[ ,praise ,fam\s ,m51 says t ?\gh man or human relat$ness nev] c\ld be describ$ p]fectly x w\ld be ! great] crime n to try4 ,?is1 too1 is a basic premise ( ! humani/ic nurs+ practice !ory4 ,! words we use to describe & discuss ?is !ory are easy words1 ev]yday ,engli% words4 ,we all "k !m4 ,we1 at times1 n>r[ a ^w's mean+ or make x m specific4 ,"s problem is pres5t$ by words we are accu/om$ to us+ & he>+4 ,habit & our human fallibility c promote only sup]ficial compreh5sion4 ,?\ghtful aw>5ess ( ! mean+ ( ^! same sequ5tially express$ words c convey ! complexity ( ! nev] completely fa?omable all-at-onc5ess ( liv$ exi/5ce4 ,?is !ory is express$ 9 t]ms l exi/5ce confirm+1 /riv+1 becom+1 relation1 & reflection4 ,we int5d su* words to express ! grasp ) acceptance & recognition ( human limitations :ile awesomely pond]+ ! op5-end$ scope ( ea* man's pot5tial4 ,9 "t1 ) discipl9$ au!ntic reflective description1 !mes common & significant to nurs+ situations become app>5t4 ,!y are !n available = compilation1 complem5t>y syn!sis1 & on-go+ ref9em5t4 ,a nurs+ res\rce bank accrues3 ,n a bank t (f]s a map ( h[ & :at to d b r "o t fur!r /imulates nurses' exploration & und]/&+4 ,,! ,,evolvem5t ,,( ,,humani/ic ,,nurs+ ,,practice ,,!ory ,s9ce #aifj ,loretta ,t4 ,zd]ad & myself 9 dialogue1 toge!r1 & ) gr\ps ( nurses 9 graduate s*ools & 9 nurs+ s]vice situations h reflect$ on1 explor$1 & que/ion$ our own & o!rs' nurs+ situational exp]i5ces4 ,ov] ?is p]iod we h come to value & appreciate ! mean+fulness ( ^! situations to man's exi/5ce4 ,?is con/antly augm5t$ our feel+s ( responsibility = contribut+ to ^! situations b5eficially4 ,!re=e1 we look$ at !m = _! tractability to rese>* me?odology4 ,_! load$ness ) v>iations1 *anges1 uncontrollables1 & our negative feel+s ab\t ! implications ( view+ human be+s z pr$ictable left ! /rict sci5tism ( positivi/ic me?od want+ at ?is /age ( man's kn[+4 ,we saw objectivity 9 nurs+ situations or our que/ions1 nurs+ que/ions1 9 ! realm ( ne$+ to n[ h[ man exp]i5c$ 8 exi/5ce4 ,?is objectivity1 or man's real liv$ reality p>adoxically is subjectively ridd51 man-_w4 ,! exi/5tial lit]ature dealt ) sub/antive !mes enc\nt]$ 9 nurs+ exp]i5ces4 ,z ,i previ\sly /at$ ?is lit]ature evolves f a ph5om5ological #i approa* to /udy+ be+ & exi/5ce4 ,?is approa* to /udy+1 describ+1 & develop+ an arti/ic sci5ce ( nurs+ became ,dr4 ,zd]ad's & my long-s\ght hav54 ,all along exi/5tialism & ph5om5ology _h be5 ours '& _m nurses' :at & h[4 ,n[ we _h labels t 7 acceptable & reputable to _m--mo/ ( all to ourselves4 ,,footnotes3 #a ,m>t9 ,bub]1 ,di/ance & ,relation1 trans4 ,ronald ,gregor ,smi?1 9 ,! ,k ( ,man1 ed4 ,maurice ,fri$man 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 #aife71 p4 #ga4 #aj #aa #b ,,f\ndations ,,( ,,humani/ic ,,nurs+ ,nurs+ is a response to ! human situation4 ,x comes into be+ "u c]ta9 conditions--"o human be+ ne$s a k9d ( help & ano!r gives x4 ,! mean+ ( nurs+ z a liv+ human act is 9 ! act itself4 ,to und]/& x1 !re=e1 x is necess>y to consid] nurs+ z an exi/5t1 a ph5om5on occurr+ 9 ! real _w4 ,,! ,,ph5om5on ,,( ,,nurs+ ,! ph5om5on ( nurs+ appe>s 9 _m =ms 9 ! real liv$ _w4 ,x v>ies ) ! age ( ! pati5t1 ! pa?ology or disability1 ! k9d & degree ( help ne$$1 ! duration ( ! ne$ = help1 ! pati5t's location & 8 pot5tial = obta9+ & us+ help1 & ! nurse's p]ception ( ! ne$ & h] capacities = respond+ to x4 ,nurs+ v>ies also 9 relation to ! sociocultural context 9 :i* x occurs4 ,be+ "o elem5t 9 an evolv+ complex sy/em ( heal? c>e1 nurs+ is cont9u\sly appe>+ 9 new specializ$ =ms4 ,z pr(essionals1 we are accu/om$ to view+ nurs+ z we practice x )9 ^! specialty contexts--= example1 p$iatric1 m$ical1 rehabilitation1 int5sive c>e1 long-t]m c>e1 community4 ,!re seems to be no end to ! prolif]ation ( div]sifications4 ,ev5 ! attempts ( practition]s to comb9e specialties give rise to new specialties1 su* z1 community m5tal heal? nurs+ & *ild psy*iatric nurs+4 ,s x is difficult to focus on ! ph5om5on ( nurs+ z an entity )\t hav+ "o's view color$ by a p>ticul> cl9ical1 functional1 or societal context4 ,yet1 if we c bracket 7hold 9 abeyance7 ^! adjectival labels & ! preconceiv$ viewpo9ts !y signify1 we c consid] ! ?+ itself1 ! act ( nurs+ 9 its mo/ simple & g5]al appe>ance4 #ab ,well-,be+ & ,m-,be+ ,9 ?is mo/ basic s5se1 !n1 disreg>d+ ! p>ticul> specializ$ =ms 9 :i* x appe>s1 ! nurs+ act always is relat$ to ! heal?-illness quality ( ! human condition1 or fundam5tally1 to a man's p]sonal survival4 ,?is is n to say t all in/ances ( nurs+ are matt]s ( life & dea?1 b r t e nurs+ act has to d ) ! quality ( a p]son's liv+ & dy+4 ,t nurs+ is relat$ to heal? & illness is self-evid5t4 ,h[ x is relat$ is n s app>5t4 ,heal? is valu$ z necess>y = survival & is (t5 propos$ z ! goal ( nurs+4 ,!re are1 9 actuality1 _m in/ances ( nurs+ t c\ld be describ$ z heal? re/or+1 heal? su/a9+1 or heal? promot+4 ,nurses engage 9 heal? tea*+ & heal? sup]vision4 ,on ! o!r h&1 !re are in/ances 9 :i* heal?1 tak5 9 its n>r[e/ mean+ z fre$om f disease1 is n se5 z an atta9able goal1 z evid5c$1 = example1 9 labels giv5 to pati5ts su* z t]m9al1 hopeless1 & *ronic4 ,yet 9 actual practice ^! humans' conditions call =? "s ( ! mo/ complete1 exp]t1 total1 beautiful nurs+ c>e4 ,nurs+1 !n1 z a human response1 implies ! valu+ ( "s human pot5tial beyond ! n>r[ concept ( heal? tak5 z abs5ce ( disease4 ,nurs+'s conc]n is n m]ely ) a p]son's well-be+ b ) 8 m-be+1 ) help+ him become m z humanly possible 9 8 p>ticul> life situation4 ,human ,pot5tial ,s9ce nurs+ involves "o human be+ help+ ano!r1 ! notion ( human5ess has be5 associat$ traditionally ) nurs+4 ,nurs+ practice is criticiz$ ju/ifiably :5 x is n humane & is tak5 = grant$ or prais$ :5 x is4 ,! expectation ( human5ess is s +ra9$ 9 ! concept ( nurs+ t "s nurses are surpris$ :5 x is ackn[l$g$ by pati5ts4 ,if a pati5t ?anks !m = _! k9dness1 pati5ce1 or conc]n1 ^! nurses reply1 9 _! emb>rassm5t1 ,oh1 t's "p ( my job4 ,h[ev]1 to equate nurs+'s humani/ic "* solely ) an ov]fl[+ ( ! milk ( human k9dness is a s]i\s error ( ov]simplification4 ,su* a limit$ view1 9 fact1 is a dehumaniz+ d5ial ( man's pot5tials4 ,z a human transaction1 ! ph5om5on ( nurs+ conta9s all ! human pot5tials & limitations ( ea* unique p>ticipant4 ,= in/ance1 fru/ration1 disc\ragem5t1 ang]1 rejection1 )drawal1 lonel9ess1 aggression1 impati5ce1 envy1 grief1 despair1 pa91 & suff]+ are con/itu5ts ( nurs+1 z well z t5d]ness1 c>+1 c\rage1 tru/1 joy1 hope4 ,9 o!r words1 s9ce nurs+ is liv$ by humans1 ! /uff ( nurs+ includes all possible responses ( man--man ne$+ & man help+--9 8 situation4 ,int]subjective ,transaction ,look+ aga9 at ! ph5om5on ( nurs+ z x occurs 9 ! real liv$ _w1 obvi\sly x is always an int]human ev5t4 ,:5ev] nurs+ takes #ac place two 7or m7 human be+s are relat$ 9 a %>$ situation4 ,ea* p>ticipates accord+ to 8 own mode ( be+ 9 ! situation1 t is1 z a p]son nurs+ or z a p]son beg9 nurs$4 ,s9ce "o is nurs+ & ! o!r is be+ nurs$1 x foll[s t ! ess5tial "* ( ! situation is nurturance4 ,9 o!r words1 ! ph5om5on ( nurs+ involves nurtur+1 be+ nurtur$1 & a relation--! betwe5 9 :i* or ?r\gh :i* ! nurturance occurs4 ,on reflection1 x is obvi\s t nurs+ is an int]subjective transaction4 ,bo? p]sons1 nurse & pati5t 7cli5t1 family1 gr\p71 necess>ily p>ticipate 9 ! proce$+s4 ,9 ?is s5se1 !y are int]dep5d5t4 ,yet1 !y are bo? subjects1 t is1 ea* is ! orig9ator ( human acts & ( human responses to ! o!r4 ,9 ?is s5se1 !y are 9dep5d5t4 ,! int]subjective transactional "* ( nurs+ _c be escap$ :5 "o is exp]i5c+ ! ph5om5on1 ei!r z nurse or z pati5t4 ,consid] = example1 "s ( ! mo/ common nurs+ activities1 su* z1 fe$+ & be+ f$1 com=t+ & be+ com=t$1 giv+ & tak+ m$ications4 ,al?\gh ?is int]subjectivity is unmi/akably kn[n 9 exp]i5ce1 x is extremely difficult to conceptualize & convey x to o!rs4 ,x r>ely is f\nd 9 descriptions ( nurs+1 & to ! un=tunate ext5t t x is miss+1 ! descriptions are n true to life4 ,9 real life1 nurs+ ph5om5a may be exp]i5c$ f ! ref]5ce po9ts ( nurtur+1 ( be+ nurtur$1 or ( ! nurtur+ process 9 ! betwe54 ,= in/ance1 ! nurse may describe com=t z an exp]i5ce ( com=t+ ano!r p]son2 ! pati5t1 z an exp]i5ce ( be+ com=t$4 ,h[ev]1 :ile ea* has exp]i5c$ some?+ )9 himself1 he also has exp]i5c$ some?+ ( ! betwe51 namely1 ! message or mean+ ( ! com=t+-be+ com=t$ process4 ,?is ess5tial int]human dim5sion ( nurs+ is beyond & yet )9 ! te*nical1 proc$ural1 or int]actional elem5ts ( ! ev5t4 ,x is a quality ( be+ t is express$ 9 ! do+4 ,be+ & ,do+ ,z an int]subjective1 transactional exp]i5ce1 nurs+ necess>ily involves bo? a mode ( be+ & a do+ ( some?+4 ,! be+ & do+ are int]relat$ s inextricably t x is difficult1 ev5 di/ort+1 to speak ( "o )\t ! o!r4 ,descriptions ( nurs+1 h[ev]1 (t5 focus prim>ily 7sometimes exclusively7 on ! do+ aspect ( ! process1 on ! nurs+ te*niques or proc$ures4 ,! obs]vable acts are m easily disc]n$ & discuss$4 ,!y c be measur$1 c\nt$1 & *>t$4 ,yet1 9 ! actual int]human exp]i5ce ( nurs+ ! weight ( be+ is felt4 ,pres5ce & ! effect ( "o's pres5ce c be kn[n mu* m vividly ?an !y c be describ$4 ,/ill1 n to attempt to describe !m is to pres5t only a half1 or p]haps less ?an half1 ( ! nurs+ picture4 ,:5 a nurse ref]s to a nurse-pati5t int]action dur+ :i* a *ange 9 ! pati5t's condition or behavior 0 not$1 "o hop+ to get a description ( nurs+ may ask1 ,:at did y d8 ,(t5 ! answ] is a description ( a #ad manual action or a v]bal int]*ange4 ,sometimes ! nurse responds1 ,no?+1 ,i 0 j !re4 ,p]haps x is ! "q t is wrong4 ,! respond5t usually int]prets do+ 9 a limit$ s5se4 ,9 reality1 ev]y?+ ! nurse does is color$ by ! "* ( h] be+ 9 ! situation4 ,! nurs+ act itself is a behavioral expression ( ! nurse's /ate ( be+1 = example1 conc]n$1 fatigu$1 hurri$1 confid5t1 hopeless4 ,fur!rmore1 !re is a k9d ( be+1 a be+ ) or a be+ !re1 t is really a k9d ( do+ = x involves ! nurse's active pres5ce4 ,to be ) 9 ?is full] s5se requires turn+ "o's att5tion t[>d ! pati5t1 be+ aw>e ( & op5 to ! "h & n[ %>$ situation1 & communicat+ "o's availability4 ,:e!r ! nurs+ act is v]bal1 or manual1 or bo?1 a sil5t glance1 or physical pres5ce1 "s degree ( int]subjectivity is involv$ & w>rants recognition4 ,to become m aw>e ( & explore m fully ?is ess5tial con/itu5t ( nurs+ we ne$ to focus on ! p>ticipants' modes ( be+ 9 ! situation4 ,r ?an ask ! nurse1 ,:at did y d 9 ! nurse-pati5t situation8 we ought to ask1 ,:at happ5$ betwe5 y8 ,,humani/ic ,,nurs+ ,:5 ! mean+ ( nurs+ is s\ght by scrut9iz+ ! ph5om5on1 t is1 by exam9+ ! nurs+ ev5t itself z x occurs 9 real life1 "o f9ds nurs+ emb$d$ )9 ! human context4 ,z a nurtur+ response ( "o p]son to ano!r 9 ne$1 x aims at ! developm5t ( human pot5tial1 at well-be+ & m-be+4 ,z some?+ t happ5s betwe5 p1 x reflects all ! human pot5tial & limitations ( ! p]sons involv$4 ,z an int]subjective transaction1 x holds ! possibility = bo? p]sons to effect & be affect$1 ! possibility = bo? to become m4 ,at its v base1 !n1 nurs+ is humani/ic4 ,x is1 at once1 man's expression ( & 8 /riv+ = survival & fur!r developm5t 9 community4 ,9 a way1 to specify nurs+ z humani/ic seems r$undant4 ,9 view ( its s\rce & goals h[ c\ld x be o!rwise8 ,h[ev]1 ! t]m humani/ic nurs+ 0 co9$ ?\ghtfully & us$ purposely "h to designate a p>ticul> nurs+ approa*4 ,n only does ! t]m signify full recognition ( nurs+'s human f\ndation & mean+ b x also po9ts ! direction = nurs+'s necess>y developm5t4 ,:at is propos$ "h is ! enri*m5t ( nurs+ by explor+ & exp&+ its relations to its human context4 ,au!ntic ,commitm5t ,:5 x is g5u9ely humani/ic1 nurs+ is an expression1 a liv+ out1 ( ! nurse's au!ntic commitm5t4 ,x is an exi/5tial engagem5t direct$ t[>d nurtur+ human pot5tial4 ,! humani/ic nurse values nurs+ z a situation 9 :i* ! necess>y conditions = su* human actualization exi/ & is op5 to ! possibilities 9 ! intimately %>$ nurse-pati5t "h & n[4 #ae ,humani/ic nurs+ calls = an exi/5tial involvem5t1 t is1 an active pres5ce ) ! :ole ( ! nurse's be+4 ,?is involv$ pres5ce is p]sonal & pr(essional4 ,x is p]sonal--a live act /emm+ f ?is unique1 individual nurse4 ,x is a *os5 human response freely giv52 x _c be assign$ or programm$4 ,! involvem5t is pr(essional--goal direct$4 ,x is bas$ on an art-sci5ce2 x is held acc\ntable4 ,anyone famili> ) typical hectic nurs+ situations c\ld ju/ifiably "q ! actual atta9ability ( su* an exi/5tial involvem5t4 ,x goes )\t say+ t x w\ld be humanly impossible = a nurse to be :olly pres5t to num]\s pati5ts = eight h\rs a day4 ,b any nurse :o has exp]i5c$ mom5ts ( g5u9e pres5ce 9 ! nurse-pati5t situation w atte/ to _! reality & to ! fact t x is ^! beautiful mom5ts t give mean+ to nurs+4 ,9 t]ms ( actual practice1 !n1 x is m reali/ic to ?9k ( humani/ic nurs+ z occurr+ 9 v>i\s degrees4 ,x may be m useful1 9 fact1 to consid] humani/ic nurs+ a goal wor? /riv+ =2 or an attitude t /r5g!ns "o's p]sev]ance t[>d atta9+ ! difficult goal2 or fundam5tally1 a major value %ap+ "o's nurs+ practice4 ,process--,*oice & ,int]subjectivity ,= ! process ( nurs+ to be truly humani/ic x mu/ be> out1 t is1 be a liv$ expression (1 ! nurse's recognition & valu+ ( nurs+ z an opportunity = ! developm5t ( ! human p]son4 ,to ?is end1 humani/ic nurs+ process e*oes exi/5tial !mes relat$ to a p]son's becom+ ?r\gh *oice & int]subjectivity4 ,exi/5tially speak+1 man is 8 *oices4 ,?is does n mean t a man c be any?+ he *ooses4 ,naturally1 ea* individual is unique1 hav+ 8 own p>ticul> pot5tials & limitations4 ,nor is ?is view a d5ial ( ! =ces ( unconsci\s motivation & habit4 ,x does n imply t all ( a p]son's actions result f totally consci\s delib]ations4 ,by say+1 ,i am my *oices1 ,i mean ,i am ?is "h & n[ p]son because 9 my pa/ life ,i took p>ticul> pa?s 9 pref]5ce to o!rs2 ( ! possibilities op5 to me1 ,i actualiz$ c]ta9 ones4 ,9 ?is s5se1 ,i am my hi/ory1 ,i am :at ,i am1 :at ,i h become4 ,b ,i am also :at ,i am n1 :at ,i h n become4 ,i am a nurse1 ?is unique "h & n[ nurse ) p>ticul> exp]i5ce1 k1 skills1 & values2 )\t o!r exp]i5ce1 k1 skills1 & values4 ,?r\gh self-reflection ,i "k t ,i h *ang$1 ,i h exp]i5c$ gr[? f )94 ,i "k myself z a be+ capable ( becom+ m1 capable ( actualiz+ my possibilities1 my self4 ,s ,i am my *oices n only 9 t]ms ( my pa/ b also 9 reg>d to my future1 my possibilities4 ,man is an individual be+ necess>ily relat$ to o!r m5 9 "t & space4 ,z e man is behold5 to o!r m5 = 8 bir? & developm5t1 int]dep5d5ce is inh]5t 9 ! human situation4 ,9 ?is s5se1 human exi/5ce is coexi/5ce4 ,! deep] significance ( ?is tru? has be5 recogniz$ & elucidat$ by _m ?9k]s1 especially ^? 9 ! exi/5tial /ream4 ,ov] #af & ov]1 _! writ+s reveal ! p>adoxical t5sion ( be+ human3 ea* man is1 at once1 indep5d5t1 a unique individual & int]dep5d5t1 a necess>ily relat$ be+4 ,z ,wilfrid ,desan says1 ref]r+ to man z subsi/5t relation1 ,he is t[>ds-!-o!r b he is n-!-o!r4#a ,fur!rmore1 z ,m>t9 ,bub] & ,gabriel ,m>cel ma9ta91 x is actually ?r\gh 8 relations ) o!r m5 t a man becomes1 t 8 unique individuality is actualiz$4 ,to "k myself z individual is to exp]i5ce myself z ?is p>ticul> unique "h-&-n[ p]son & o!r ?an t !re-&-n[ p]son4 ,or 9 o!r words1 to "k myself z me is to see myself 9 relation to & di/ant f o!r selves4 ,z ,bub] s beautifully /ates1 ,x is f "o man to ano!r t ! heav5ly bread ( self-be+ is pass$4#b ,logically1 x foll[s t ! possibility = self-confirmation exi/s 9 any int]subjective situation4 ,h[ev]1 9 ev]yday life ?is self-confirmation is exp]i5c$ to diff]5t degrees or on diff]5t levels 9 int]human relat+4 ,s9ce bo? p]sons are indep5d5t subjects act+ ) _! human capacity = disclos+ or enclos+ !mselves1 !re is no gu>antee t ! availability & pres5ce necess>y = a g5u9e confirm+ enc\nt] w come =?4 ,pres5ce1 ! gift ( "o's self1 _c be seiz$ or call$ =? by dem&1 x c only be giv5 freely & be invok$ or evok$4 ,s9ce man becomes m ?r\gh 8 *oices & ! aim ( nurs+ is to help man t[>d well-be+ or m-be+1 ! humani/ic nurs+ ef=t is direct$ t[>d increas+ ! possibilities ( mak+ responsible *oices4 ,su* *oice involves1 9 ! fir/ place1 an op5ness to & an aw>5ess ( "o's own situation4 ,a *oice is a response to possibility4 ,!re=e1 "o mu/ fir/ recognize t possibilities or alt]natives exi/4 ,?is op5ness to options is exp]i5c$ z a fre$om to *oose z well z a fre$om f ! bonds ( habit & /]eotyp$ response1 f r\t9e1 f ! veils ( ! obvi\s4 ,x means gett+ 9 t\* ) "o's exp]i5ce1 "o's subjective-objective _w4 ,z "o becomes m acutely aw>e ( 8 p]sonal fre$om ( *oice1 !re arises concurr5tly an aw>5ess ( ! quality ( *oice1 ( ! responsibility t is always impli$ 9 ! fre$om4 ,!n foll[s reflective consid]ation ( "o's unique situation ) its possible alt]natives & an exam9ation ( ! values inh]5t 9 !m4 ,f9ally1 ! act ( *oos+ is express$ 9 a response to ! situation ) a will+ness to accept ! responsibility = its =eseeable consequ5ces4 ,?r\gh ?is exp]i5ce ! p]son becomes aw>e ( himself z an individual4 ,z a subject *oos+ freely & responsibly1 he kn[s himself z di/9ct f & yet relat$ to o!rs4 ,nurs+1 be+ an int]subjective transaction1 pres5ts an occasion = bo? p]sons1 pati5t & nurse1 to exp]i5ce ! process ( mak+ responsible *oices4 ,?r\gh liv+ ?is process 9 nurs+ situations1 ! nurse develops h] own pot5tial = responsible *oos+4 ,! satisfaction1 (t5 9 ! =m #ag ( a s5se ( vitality & /r5g?1 t is felt 9 mak+ responsible compet5t pr(essional judgm5ts re9=ces ! habit4 ,9 p]sonally com+ to exp]i5tially appreciate ! gr[? promot+ "* ( responsible *oos+1 ! nurse may m readily recognize ! value ( su* exp]i5ces = any p]son1 includ+ ! "o curr5tly label$ pati5t4 ,! humani/ic nurse1 !re=e1 is al]t to opportunities = ! pati5t to ex]cise 8 fre$om ( *oice )9 ! limits ( safe & s\nd practice4 ,%e is con/antly assess+ 8 capabilities & ne$s & enc\rages 8 maximum p>ticipation 9 8 own heal? c>e program4 ,?r\gh coexp]i5c+ & support+ ! process 9 ! pati5t's exp]i5ce f 8 po9t ( view1 ! nurse nurtures 8 human pot5tial = responsible *oos+4 ,bo? pati5t & nurse become m ?r\gh mak+ responsible *oices 9 ! int]subjective1 transactional nurs+ situation4 ,!ory & ,practice ,! t]m humani/ic nurs+ ref]s to a k9d ( nurs+ practice & its !oretical f\ndations4 ,! two are s int]relat$ t x is difficult1 9 fact ev5 some:at di/ort+1 to speak exclusively ( ei!r ! practice or ! !ory ( humani/ic nurs+4 ,:51 = ! sake ( cl>ity or emphasis1 discussion is focus$ on ei!r ! practical or ! !oretical realm1 ?\ghts ( ! o!r realm ca/ _! %ad[s on ! fr+es4 ,= 9 our view1 = ! process ( nurs+ to be truly humani/ic means t ! nurse is involv$ z an exp]i5c+1 valu+1 reflect+1 conceptualiz+ human p]son4 ,f ! o!r side1 ! !ory ( humani/ic nurs+ is d]iv$ f actual practice1 t is1 f be+ ) & do+ ) ! pati5t4 ,!ory1 says ,r4 ,d4 ,la+1 is ! articulat$ vision ( exp]i5ce4#c ,humani/ic nurs+ is n a matt] solely ( do+ b also ( be+4 ,! humani/ic nurse is op5 to ! reality ( ! situation 9 ! exi/5tial s5se4 ,%e is available ) h] total be+ 9 ! nurse-pati5t situation4 ,?is involves a liv+ out ( ! nurtur+1 int]subjective transaction ) all ( "o's human capacities :i* include a response to ! exp]i5c$ reality4 ,man is able to set 8 _w at a di/ance z an indep5d5t opposite & ent] into relation ) x4 ,9 fact1 accord+ to ,bub]1 ?is is :at di/+ui%es exi/5ce z human4 ,x is man's special way ( be+4#d ,= nurs+ to be humani/ic 9 ?is full s5se ( ! t]m requires be+ & do+ 9 ! situation & subsequ5tly sett+ ! exp]i5c$ reality at a di/ance 7t is1 objectify+ x7 & ent]+ into relation ) x4 ,! nurse's reflective response to h] liv$ _w may take ! %ape ( any =m ( human dialogue ) reality1 su* z1 sci5ce1 art1 or philosophy4 ,view$ exi/5tially1 e nurs+ ev5t is unique1 a live int]subjective transaction color$ & =m$ by ! individual p>ticipants4 ,al?\gh ! ev5t is ephem]al1 ! resultant exp]i5tial k is la/+ & cumulative4 ,s #ah f ! nurse's daily commonplace gr[s a body ( cl9ical wisdom4 ,! ne$ = describ+ nurs+ ph5om5a1 = express+ & conceptualiz+ liv$ nurs+ worlds1 is basic to ! !oretical & actual developm5t ( humani/ic nurs+4 ,9 summ>y1 we cont5d t humani/ic nurs+ practice necess>ily involves ! conceptualization ( t practice & an exam9ation ( its inh]5t values & t humani/ic nurs+ !ory mu/ be d]iv$ f nurses' liv$ exp]i5ce4 ,! int]wov5 !ory & practice are reciprocally enlight5+4 ,framework--,! ,human ,situation ,x is easy to recognize ! intr9sic int]relat$ness ( humani/ic nurs+ !ory & practice & ! consequ5t necessity = _! concurr5t developm5t4 ,x is ev5 q easy to take ! next /eps ( valu+ su* developm5t & committ+ oneself to ! task4 ,b !n ! "q arises3 ,:]e to beg98 ,humani/ic nurs+ is conc]n$ ) :at is basically nurs+1 t is1 ) ! ph5om5on ( nurs+ :]ev] x occurs reg>dless ( its specializ$ cl9ical1 functional1 or sociocultural =m4 ,s its doma9 includes any or all nurs+ situations4 ,& )9 ?is doma91 s9ce humani/ic nurs+ is an int]subjective transaction aim$ at nurtur+ well-be+ & m-be+1 its /uff includes all possible human & int]human responses4 ,to conceive ( s limitless a univ]se = /udy is at once exhil>at+ & ov]:elm+4 ,h[ c "o get a h&le on ! nurs+ univ]se8 ,is x possible to envision an inclusive frame t w\ld all[ an ord]ly1 sy/ematic1 & hopefully productive approa* to ! developm5t ( humani/ic nurs+8 ,! key is to return aga9 to ! s\rce1 to look at ! ph5om5on ( nurs+ z x occurs 9 real life4 ,f ?is p]spective1 ! human situation sets ! /age :]e nurs+ is liv$4 ,! major dim5sions ( humani/ic nurs+1 !n1 may be d]iv$ f ?is situation4 ,exi/5tially1 man is an inc>nate be+ always becom+ 9 relation ) m5 & ?+s 9 a _w ( "t & space4 ,! nurs+ situation is a p>ticul> k9d ( human situation 9 :i* ! int]human relat+ is purposely direct$ t[>d nurtur+ ! well-be+ or m-be+ ( a p]son ) p]ceiv$ ne$s relat$ to ! heal?-illness quality ( liv+4 ,! elem5ts ( ! frame1 bas$ on ?is view ( humani/ic nurs+1 w\ld include inc>nate m5 7pati5t & nurse7 meet+ 7be+ & becom+7 9 a goal direct$ 7nurtur+ well-be+ & m-be+7 int]subjective transaction 7be+ ) & do+ )7 occurr+ 9 "t & space 7measur$ & z liv$ by pati5t & nurse7 9 a _w ( m5 & ?+s4 ,9 o!r words1 ! inexhau/ible ri*ness ( liv$ nurs+ worlds c\ld be explor$ freely1 imag9atively1 & creatively 9 any direction sugge/$ by ! dim5sions ( ?is op5 framework4 ,x all[s = a v>iety ( angul> views4 ,= example1 9 t]ms ( man z inc>nate1 x is c]ta9ly n new = nurses to focus on man's bodily exi/5ce4 ,naturally1 "o ( nurs+'s basic conc]ns always has be5 c>e ( p's physical ne$s4 ,to view nurs+ f ! p]spective ( ! human situation1 h[ev]1 is to see beyond physical c>e1 #ai beyond ! categorization ( man z a biopsy*osocial organism4 ,! focus is on ! p]son's unique be+ & becom+ 9 8 situation4 ,e man is ins]t$ into ! common _w ( m5 & ?+s ?r\gh 8 own unique body4 ,?r\gh x he affects ! _w & ! _w affects him4 ,?r\gh x he develops 8 own unique p]sonal private _w4 ,:5 a p]son's bodily functions *ange dur+ illness ! _w & 8 _w *ange = him4 ,! nurse ne$s to consid] h[ ! pati5t exp]i5ces 8 liv$ _w4 ,ord9>y ?+s :i* nurses simply take = grant$1 su* z1 hospital noises or odors1 t\*+1 ba?+1 fe$+1 sleep or meal s*$ules1 may h v diff]5t mean+ = individual pati5ts4 ,!y may or may n be exp]i5c$ z nurtur+ 9 a p>ticul> p]son's liv$ _w4 ,9 ! humani/ic p]spective ! nurse also is view$ z a human p]son1 z a be+ 9 a body r ?an m]ely z a function or a do] ( activities4 ,consci\s recognition ( ?is fact op5s _m areas = exploration4 ,obvi\sly1 ! nurse's actions 7h] be+ ) & do+ )71 t affect ! pati5t's _w1 are express$ ?r\gh h] body4 ,h[ is nurturance communicat$ & actually effect$ ?r\gh nurs+ activities8 ,f ! o!r side1 consid] ! nurse z be+ affect$ by ! _w ?r\gh h] body4 ,:at dep?s ( nurs+ cont5t c\ld we fa?om if we accept$ ! exi/5tial dictum t ! body kn[s8 ,w\ld we dismiss s lightly ^? gems ( cl9ical wisdom nurses attribute disp>ag+ly to gut reaction1 unsci5tific intuition1 or ye>s ( exp]i5ce8 ,w\ld we value s]i\s exploration & extraction ( ^! natural res\rces 9 ! nurs+ _w8 ,! framework sugge/s1 fur!r1 ! possibilities ( explor+ ! developm5t ( human pot5tial1 bo? pati5t's & nurse's1 z x occurs 9 ! unique doma9 ( nurs+'s int]subjective transactions4 ,:at human res\rces are call$ =? 9 ! %>$ situations dur+ :i* nurses coexp]i5ce & cose>* ) pati5ts ! v>i$ mean+s ( be+ & becom+ ov] ! entire range ( life f bir? to dea?8 ,h[ does x occur8 ,:at is ! process8 ,:at promotes well-be+ or becom+ m :5 fac+ life1 suff]+1 dea?8 ,= ! pati5t8 ,= ! nurse8 ,:at k ga9$ ?r\gh ! /udy ( nurs+1 a p>ticul> =m ( ! human situation1 c\ld be contribut$ to ! g5]al body ( human sci5ces8 ,f9ally1 )9 ?is framework1 all ! ph5om5a exp]i5c$ 9 ! nurs+ situation c\ld be explor$ 9 relation to _! attributes ( "t & space4 ,m specifically1 f an exi/5tial p]spective1 ! focus w\ld be direct$ t[>d ! significance ( liv$ "t & space1 t is1 "t & space z exp]i5c$ by ! pati5t &_/or ! nurse1 & z %>$ int]subjectively4 ,= example1 wait+1 sil5ce1 *ronicity1 em]g5cy1 position+ a pati5t 9 b$1 mov+ ?r\gh space 9 a :eel*air1 crut*walk+1 pac+1 c\ld be consid]$ f ! /&po9t ( ! pati5t's exp]i5c$ space & "t1 or f ! nurse's1 or z a %>$ ev5t4 ,explorations ( ?is k9d c\ld provide valuable insights into important nurs+ ph5om5a1 su* z1 pres5ce1 empa?y1 com=t1 tim+4 #bj ,! human situation1 !n1 is ! gr\nd )9 :i* nurs+ takes =m4 ,z su*1 x provides a framework = approa*+ ! /udy & developm5t ( humani/ic nurs+4 ,z an angul> view1 x holds ! focus on ! basic "q und]ly+ nurs+ practice3 ,is ?is p>ticul> int]subjective1 transactional nurs+ ev5t humaniz+ or dehumaniz+8 ,,conclusion ,?is *apt] explor$ ! f\ndations ( humani/ic nurs+4 ,! discussion fl[$ naturally1 p]haps unavoidably1 into ! realm ( meta-nurs+4 ,naturally1 = ! humani/ic nurs+ approa* is itself an outgr[? ( ! critical exam9ation ( nurs+ z an exp]i5c$ ph5om5on4 ,f ?is exi/5tial p]spective ( nurs+ z a liv+ human act1 ! mean+ ( nurs+ is f\nd 9 ! act itself1 9 nurs+'s relation to its human context4 ,reflection on nurs+ z x is liv$ 9 ! real _w reveal$ its exi/5tial1 nurtur+1 int]subjective1 transactional "*4 ,! process ( humani/ic nurs+ /emm+ f ! nurse's au!ntic commitm5t is a k9d ( be+ ) & do+ )4 ,x aims at ! developm5t ( human pot5tial ?r\gh int] subjectivity & responsible *oos+4 ,! actualization ( humani/ic nurs+ is dep5d5t on ! concurr5t developm5t ( its practice & !oretical f\ndations by practic+ nurses4 ,an op5 framework d]iv$ f ! human situation 0 (f]$ to sugge/ possible dim5sions ( humani/ic nurs+ practice t c\ld be describ$ & articulat$ into a body ( !ory4 ,nurses :o h consid]$ ?is humani/ic nurs+ approa* 9 t]ms ( _! daily practice h felt at home 9 ! ideas4 ,! conceptualizations fit _! p]sonal nurs+ exp]i5ce4 ,if !re is any /rang5ess 9 ! approa*1 x is p]haps t x does n foll[ ! cont\rs ( ! cl9ical specialties to :i* we h gr[n s accu/om$ t !y may be m ruts ?an roads4 ,?is is n to say t humani/ic nurs+ is oppos$ to cl9ical specialization 9 nurs+4 ,9 fact1 cl9ical nurs+1 z x exi/s 9 any =m1 is its v he>t & base4 ,humani/ic nurs+ is n comp>tm5taliz$ into cl9ical 7or functional1 or sociocultural7 specialties because x applies 9 all cl9ical areas4 ,x is1 9 ! mo/ basic s5se1 cross-cl9ical4 ,?is may be ! great advantage ( humani/ic nurs+4 ,by ori5t+ its explorations ontologically1 x may fo/] g5u9e cross-cl9ical /udies ( nurs+ ph5om5a4 ,if nurses ) highly develop$ abilities 9 p>ticul> =ms ( nurs+ w\ld /ruggle toge!r 9 collaborative cross-cl9ical /udies ( nurs+ ph5om5a1 specialization w\ld s]ve to advance r ?an fragm5t all nurs+4 ,,footnotes3 #a ,wilfr$ ,desan1 ,! ,planet>y ,man1 ,vol4 ,i1 ,a ,noetic ,prelude to a ,unit$ ,_w 7,new ,york3 ,! ,macmillan ,company1 #aigb74 p4 #cg4 #b ,m>t9 ,bub]1 ,di/ance & ,relation1 trans4 ,ronald ,gregor ,smi?1 9 ,! ,k ( ,man1 ed4 ,maurice ,fri$man 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 #aife71 p4 #ga4 #c ,r4 ,d4 ,la+1 ,! ,politics ( ,exp]i5ce 7,new ,york3 ,ballant9e ,books1 #aifg71 p4 #bc4 #d ,bub]1 ,! ,k ( ,man1 p4 #fj4 #ba #c ,,humani/ic ,,nurs+3 ,a ,,liv$ ,,dialogue ,! mean+ ( humani/ic nurs+ is f\nd 9 ! human act itself1 t is1 9 ! ph5om5on ( nurs+ z x is exp]i5c$ 9 ! ev]yday _w4 ,!re=e1 ! int]relat$ practical & !oretical developm5t ( humani/ic nurs+ is dep5d5t on nurses exp]i5c+1 conceptualiz+1 & %>+ _! unique angul> views ( _! unique liv$ nurs+ worlds4 ,an op5 framework sugge/+ dim5sions = su* exploration 0 d]iv$ f a consid]ation ( ! ph5om5on ( nurs+ )9 its basic context1 namely1 ! human situation4 ,! elem5ts ( ?is humani/ic nurs+ framework include inc>nate m5 7pati5t & nurse7 meet+ 7be+ & becom+7 9 a goal-direct$ 7nurtur+ well-be+ & m-be+71 int]subjective transaction 7be+ ) & do+ )7 occurr+ 9 "t & space 7z measur$ & z liv$ by pati5t & nurse7 9 a _w ( m5 & ?+s4 ,! framework (f]s a little security by provid+ "s ref]5ce po9ts = ! exploration4 ,h[ev]1 :at is ga9$ 9 cl>ity by conceptual ab/raction is lo/ f ! flavor ( ! actual exp]i5ce4 ,l a wea!r map t /atically repres5ts major factors & curr5ts 9 _! int]relat$ness1 ! framework discloses a nexus ( elem5ts4 ,b x is z f> f ! real ph5om5on ( nurs+ ) its pa9s & suff]+ & com=t+ & joys & hopes z ! wea!r map is f real wea!r ) its w9d & ra9 & heat & cold4 ,?is *apt] is conc]n$ ) ! same basic framework ( humani/ic nurs+ b se5 9 an enliv5$ =m4 ,to inspirit its con/ructs ! se>* mu/ return aga9 to ! exi/5tial s\rce1 to ! nurs+ situation z x is liv$4 ,:5 ,i reflect on an act ( m9e 7no matt] h[ simple or complex7 t ,i c unhesitat+ly label nurs+1 ,i become aw>e ( x z goal-direct$ 7nurtur+7 be+ ) & do+ ) ano!r4 ,! int]subjective or int]human elem5t1 ! betwe51 runs ?r\gh nurs+ int]actions l an und]gr\nd /ream convey+ ! nutri5ts ( heal+ & gr[?4 ,9 ev]yday practice1 we are usually s involv$ ) ! imm$iate dem&s ( our be+ ) & #bb do+ ) ! pati5t t we d n focus on ! ov]%ad[$ plane ( ! betwe54 ,h[ev]1 occasionally1 9 beautiful mom5ts1 ! int]human curr5ts are s /rong t !y flood our consci\s aw>5ess4 ,su* r>e & rew>d+ mom5ts ( mutual pres5ce rem9d u ( ! elusive ev]-pres5t betwe54 ,f ^! epiphanic episodes 9 our p]sonal nurs+ exp]i5ce1 we h c]ta9 & imm$iate k ( int]subjectivity4 ,?r\gh our exp]i5ce1 too1 we "k t bo? humaniz+ & dehumaniz+ effects c result f human int]actions4 ,!re=e1 x is ess5tial = ! developm5t ( humani/ic nurs+ to explore & describe its int]subjective "*4 ,al?\gh _m nurses h agre$ 9 pr9ciple ab\t ! importance ( ?is "w1 !y also h express$ ! feel+s ( fru/ration & disc\ragem5t att5d+ x4 ,!re are real difficulties involv$ 9 attempt+ to describe some?+ s real yet s nebul\s z ! betwe54 ,! descriptions mu/ be d]iv$ f our own real nurs+ exp]i5ces4 ,?is means t we mu/ develop habits ( consci\s aw>5ess ( exp]i5ce1 ( recall1 & ( reflection4 ,!n we mu/ /ruggle ) our language f9d+ ! words 9 our physically & te*nologically ori5t$ vocabul>ies1 p]haps ev5 creat+ t]ms1 to convey ! sub/ance & flavor ( ! exp]i5ce ( int]subjectivity4 ,fur!rmore1 description ( ! int]subjective quality ( nurs+ is difficult because ( its peculi> p]vasiv5ess4 ,:e!r x is consci\sly recogniz$ or n1 x is "p ( e nurs+ transaction4 ,h[ev]1 to consid] & explore int]subjectivity solely z a compon5t or con/itu5t ( nurs+1 ev5 a necess>ily inh]5t or an ess5tial "o1 w\ld be to see x out ( true p]spective4 ,! betwe5 is m ?an a factor or facet ( nurs+2 x is ! basic relation 9 :i* & ?r\gh :i* nurs+ c occur4 ,s ! "q rema9s4 ,h[ c our exp]i5ces1 our angul> views1 our glimpses ( ?is f\ndation1 ?is necess>y means ( nurs+1 be conceptualiz$ & %>$8 ,once :ile reflect+ on ! nature ( nurs+ aga9/ a backgr\nd ( notions ab\t int]subjectivity drawn f exp]i5ce & lit]ature & te/+ !m aga9/ my own real life exp]i5ces ( nurs+1 ,i sudd5ly saw t nurs+ itself is a p>ticul> =m ( human dialogue4 ,?is insight occurr$ to me ) cl>ity1 conviction1 & all ! =ce ( a br& new idea4 ,x 0 s obvi\s1 s di/9ct1 s simple1 s cle>ly a c5tral intuition t c\ld illum9ate ! ph5om5on ( nurs+ f )94 ,i exp]i5c$ ! idea z fre% & excit+ly full ( promise4 ,yet1 :5 ,i said x out l\d1 ,nurs+ is dialogue1 ! words seem$ too meag] to convey ! true mean+ ( ! idea & its real significance4 ,!re 01 fur!rmore1 an annoy+ %ad[ ( famili>ity lurk+ ab\t x4 ,x 0 almo/ z if ,i _h express$ some?+ simil> previ\sly4 ,at fir/1 ,i hesitat$ to %>e ?is insight ) o!rs = fe> !y w\ld ext+ui% x by say+1 ( c\rse1 ev]yone kn[s t1 or ,i've he>d y say some?+ l t be=e4 ,/ill1 ,i exp]i5c$ x z an idea ,i _h to express4 ,mov$ by ! pressure ( feel+s ( responsibility & desire to %>e1 9 #aigc ,i wrote a pap]1 ,! ,dialogue ,call$ ,nurs+4 #bc ,9 retrospect1 t pap] has ! m>ks ( a hesitant beg9n+1 re/ra9$ by cauti\s /atem5ts & suppos$ly protective ref]5ces to exi/5tial lit]ature4 ,dissatisfaction ) x prompt$ fur!r re?9k+ & revision4 ,se>*+ ?r\gh my files dur+ ?is process1 ,i f\nd1 to my great surprise1 "s notes on ! dialogic nature ( nurs+ writt5 by myself ?ree & six ye>s previ\sly4 ,9 fact1 a ?ree-ye>-old note conta9$ ! v title1 ,dialogue ,call$ ,nurs+6 ,n[1 h[ is x possible to grasp a tru? & !n =get t "o kn[s x & lat] meet & grasp ! old tru? aga9 z new8 ,! diff]5ce 9 ^! exp]i5ces ( kn[+1 = me at lea/ 9 ?is case1 is t n[ ,i "k z if f ! inside out t nurs+ is dialogical4 ,! idea seems to h spr\t$ out ( ! liv$ ph5om5on1 to h brok5 =? f ! gr\nd ( exp]i5ce1 z oppos$ to hav+ be5 conclud$ 9 my e>li] intellectual1 !oretical1 or philosophical pond]+s4 ,b h[ did ! e>li] idea1 ! conclusion t nurs+ is dialogical1 become a live option = me8 ,:y did x appeal to me8 ,h[ did x come to make s5se 9 ! fir/ place if n because ( my exp]i5ce8 ,! concept & ! actual exp]i5ce revitalize ea* o!r4 ,p]haps ?is is ! value ( an exi/5tially gr\nd$ insight2 x has a k9d ( durability result+ f its cont9u\s rejuv5ation by ! int]play ( exp]i5c+ & conceptualiz+4 ,"s old ideas are always new4 ,9 ?is _s1 ?is *apt] looks aga9 at humani/ic nurs+ z liv$ dialogue4 ,,liv$ ,,dialogue ,! c5tral insight 7intuition or idea7 f :i* ?is exploration gr[s is ?is3 nurs+ itself is a =m ( human dialogue4 ,i mean t ! ph5om5on ( nurs+1 t is1 ! nurtur+1 int]subjective transaction1 ! ev5t liv$ or exp]i5c$ by ! p>ticipants 9 ! ev]yday _w1 is a dialogue4 ,mu* has be5 writt5 ab\t dialogue &1 z ! ^w is n[ 9 vogue1 x is be+ us$ 9 diff]5t ways4 ,"h1 ! t]m dialogue is us$ to d5ote a broad] concept ?an ! typical diction>y def9ition ( dialogue z a conv]sation betwe5 two or m p]sons or betwe5 *>act]s 9 a drama or novel4 ,x is us$ 9 ! exi/5tial s5se4 ,x implies an ontological sph]e1 9 ,bub]'s t]ms1 or ! realm ( be+ to :i* ,m>cel ref]s4 ,"h x ref]s to a liv$ dialogue1 t is1 to a p>ticul> =m ( int]subjective relat+4 ,?is may be und]/ood 9 t]ms ( see+ ! o!r p]son z a di/9ct unique individual & ent]+ into relation ) him4 ,9 o!r words1 nurs+ is a dialogical mode ( be+ 9 an int]subjective situation4 ,z 9 common usage1 "h also1 ! t]m dialogue implies communication1 b 9 a mu* m g5]al s5se4 ,x is n re/rict$ to ! notion ( s5d+ & receiv+ messages v]bally & nonv]bally4 ,r1 dialogue is view$ z communication 9 t]ms ( call & response4 #bd ,nurs+ implies a special k9d ( meet+ ( human p]sons4 ,x occurs 9 response to a p]ceiv$ ne$ relat$ to ! heal?-illness quality ( ! human condition4 ,)9 t doma91 :i* is %>$ by o!r heal? pr(essions1 nurs+ is direct$ t[>d ! goal ( nurtur+ well-be+ & m-be+ 7human pot5tial74 ,nurs+1 !re=e1 does n involve a m]ely =tuit\s enc\nt] b r "o 9 :i* !re is purposeful call & response4 ,9 ?is ve91 humani/ic nurs+ may be consid]$ z a special k9d ( liv$ dialogue4 ,,nurs+ ,,view$ ,,z ,,dialogue ,^! consid]ations ( ! dialogical "* ( nurs+ w be m fruitful if !y are relat$ to "s concrete nurs+ exp]i5ce4 ,reflect = a mom5t on y\r daily nurs+ practice4 ,recall an enc\nt]1 a specific int]action ) a pati5t 7cli5t74 ,try to rememb] ! details4 ,:]e 7 y8 ,:at "t ( day 0 x8 ,:o 0 pres5t8 ,:at 0 y\r /ate ( be+--:at 7 y feel+1 ?9k+1 do+8 ,h[ did ! int]action beg98 ,:at happ5$ betwe5 y8 ,:at 0 felt1 said1 done8 ,:at 0 left unsaid1 undone8 ,h[ did ! int]action end or close8 ,h[ long did ! flavor la/8 ,n[ keep ?is concrete in/ance ( y\r liv$ nurs+ reality 9 m9d & let x raise its que/ions 9 ! foll[+ exploration4 ,meet+ ,! act ( nurs+ involves a meet+ ( human p]sons4 ,z 0 not$ above1 x is a special or p>ticul> k9d ( meet+ because x is purposeful4 ,bo? pati5t & nurse h a goal or expectation 9 m9d4 ,! int] subjective transaction1 !re=e1 has mean+ = !m2 ! ev5t is exp]i5c$ 9 light ( _! goal7s74 ,or 9 o!r words1 ! liv+ human act ( nurs+ is =m$ by its purpose4 ,its goal-direct$ness colors ! attributes & process ( ! nurs+ dialogue4 ,:5 a nurse & pati5t come toge!r 9 a nurs+ situation1 _! meet+ may be expect$ or plann$ by "o or bo? or x may be unexpect$ by "o or bo?4 ,9 any case1 ! goal or purpose ( nurs+ holds4 ,ev5 9 a spontane\s int]action :]e !y h met only by *ance1 9 a heal? c>e facility or any place :]e "o is id5tifi$ z pati5t & ! o!r z nurse1 !re is an implicit expectation t ! nurse w ext5d h]self 9 a helpful way if ! pati5t ne$s assi/ance4 ,if ! meet+ is plann$ or expect$1 ?is factor influ5ces ! dialogue4 ,ea* comes ) feel+s ar\s$ by anticipation ( ! ev5t1 = example anxiety1 fe>1 dread1 hope1 pleasure1 wait+1 impati5ce1 dep5d5ce1 ho/ility1 responsibility4 ,ano!r factor exp]i5c$ 9 _! meet+ is ! am\nt ( *oice or control ei!r nurse or pati5t _h ov] _! com+ toge!r4 ,9 today's complex heal? c>e sy/ems1 a nurse may be assign$ to c>e = a p>ticul> pati5t1 or = p]sons 9 an area or unit1 or may be call$ into s]vice ?r\gh a regi/ry1 #be or may be approa*$ directly by a pati5t4 ,f ! o!r side1 ! pati5t also exp]i5ces v>y+ degrees ( control ov] 8 meet+s ) nurses dep5d+ on ! sy/em 9 :i* ! heal? c>e is (f]$1 8 location1 8 f9ancial means1 & s =?4 ,s :5 a pati5t & nurse d meet 9 a giv5 in/ance1 ea* comes to ! situation be>+ remnants ( feel+ ( hav+ caus$ or n hav+ caus$ ?is enc\nt] ) ?is p>ticul> individual4 7,( c\rse1 ev5 9 ! mo/ de-individualiz$ sy/ems ! nurse &_/or pati5t c /ill control _! meet+s to "s ext5t1 = example1 avoidance by ! nurse be+ too busy or avoidance by ! pati5t feign+ sleep47 ,! pati5t & ! nurse are two unique individuals meet+ = a purpose4 ,9 ! exi/5tial s5se1 ea* ( ^! p]sons is 8 *oice1 ea* is 8 hi/ory4 ,ea* comes to meet ! o!r ) all t he is & all t he is n at ?is mom5t 9 ?is place4 ,ea* comes z a p>ticul> inc>nate be+4 ,ea* is a specific be+ 9 a specific body ?r\gh :i* he affects ! o!r & ! _w & ?r\gh :i* he is affect$ by !m4 ,?is nurse :o uses h] eyes1 e>s1 nose1 h&s1 h] body1 ?is way "h & n[ meets ?is pati5t ^: body 9 ?is condition s]ves him ?is way "h & n[4 ,fur!rmore1 bo? ! pati5t & ! nurse h ! human capacity = disclos+ or enclos+ !mselves4 ,s !y h "s control ov] ! quality ( _! meet+ by *oos+ h[ & h[ mu* to be op5 ) & to be op5 to ! o!r4 ,_! op5ness is influ5c$ by _! views ( ! purpose ( ! meet+4 ,9 g5]al1 ! pati5t expects to receive help & ! nurse expects to give x4 ,h[ev]1 _! views may diff] on ! precise ne$ & ! k9d ( help to be giv54 ,also1 al?\gh ! nurse & ! pati5t h ! same goal1 t is1 well-be+ & m-be+1 !y h diff]5t modes ( be+ 9 ! %>$ situation4 ,"o's purpose is to nurture2 ! o!r's is to be nurtur$4 ,?is diff]5ce 9 ! p]spectives f :i* !y approa* ! meet+ is reflect$ 9 ! k9d & degree ( _! op5ness to ea* o!r4 ,9 describ+ _! exp]i5ces nurses (t5 h reveal$ t !y are op5 to pati5ts 9 a c]ta9 way4 ,?is is evid5t :5 nurse & pati5t meet4 ,! nurse may h prior k ( ! pati5t1 p]haps ev5 an image ( him drawn f case hi/ory1 *>ts1 t\r ( duty reports1 & s =?2 or %e may meet him z a total /rang]4 ,b :5 !y come toge!r1 ! nurse sees ! pati5t z a :ole4 ,?is global appreh5sion is n exp]i5c$ z an additive summation b r z a ge/alt4 ,x may result 9 a v cle> picture ( ! pati5t's condition ) nurs+ action initiat$ almo/ be=e ! picture regi/]s 9 full consci\s aw>5ess4 ,or ! p]ception may be imprecise yet /rong t some?+ is wrong4 ,f ^! exp]i5ces "o may inf] t a nurse's op5ness involves be+ op5 to :at is & to :at is n 9 ! pati5t's /ate ( be+ z weigh$ aga9/ "s notion 7or /&>d7 ( :at ought to be1 ) ! int5tion ( do+ some?+ ab\t ! diff]5ce4 ,?us1 ! nurse is op5-z-a-help] to ! pati5t4 ,?is k9d ( op5ness is a quality t *>act]izes ! humani/ic nurs+ dialogue4 ,( c\rse1 e nurse-pati5t meet+ diff]s1 = ea* p>ticipant comes to ! situation z ! #bf unique individual he is1 ) 8 own expectations & capacities = giv+ & tak+ help4 ,:5 ^! factors are consid]$ 9 t]ms ( an actual p]sonal nurs+ exp]i5ce 7= in/ance1 ! example recall$ above by ! read]71 !y highlight a t5sion 9 ! liv$ nurs+ _w4 ,! meet+ ?r\gh :i* ! nurs+ dialogue is initiat$ & consequ5tly is possible is1 to a c]ta9 ext5t1 out ( ! nurse's control4 ,%e is assign$ to approa* or %e approa*es ! pati5t 9 t]ms ( h] function4 ,9 ?is s5se1 ! nurse is synonym\s ) ! function nurs+4 ,yet %e exp]i5ces ea* meet+ z h]self--a unique individual p]son1 ?is "h-&-n[ be+ 9 ?is body respond+ 9 ?is situation4 ,%e is at once a replaceable cog 9 a :eel ( an incompreh5sibly complex sy/em & a unique human be+ %>+ mo/ intimately 9 ano!r's se>* = ! mean+s ( suff]+1 liv+1 dy+4 ,c ^! two _w views be reconcil$8 ,h[ c !y be liv$ 9 ! nurs+ dialogue8 ,relat+ ,z a human response to a p]son 9 ne$1 ! nurs+ act is necess>ily an int]subjective transaction4 ,or to put x 9 o!r words1 reg>dless ( ! complexity ( ne$ &_/or response1 :5 nurse & pati5t meet 9 ! ev5t ( nurs+ bo? h to d ) ea* o!r4 ,s9ce bo? are human1 _! do+ ) means be+ )4 7,reflect = a mom5t on ! p]sonally exp]i5c$ pati5t enc\nt] y recall$ at ! beg9n+ ( ?is exploration4 ,relive x & see cle>ly aga9 t ! nurs+ dialogue involves be+ ) & do+ ) ! pati5t47 ,m5 c d ) & be ) ea* o!r because !y are able to see o!rs & ?+s z di/9ct f !mselves & ent] into relation ) !m4 ,:at di/+ui%es ! human situation is t m5 c ent] into a dialogue ) reality4 ,!y h a capacity = = int]nal relation%ips1 = kn[+ !mselves & _! worlds )9 !mselves1 !y c relate z subject to object 7= example1 z kn[] to ?+ kn[n7 & z subject to subject1 t is1 z p]son to p]son4 ,bo? types ( relation%ips are ess5tial = g5u9e human exi/5ce4 ,x is natural1 9 fact unavoidable1 = man to relate to 8 _w z subject to object4 ,h[ c\ld a p]son survive ev5 "o day )\t kn[+ & us+ objects8 ,!re=e1 man's abilities to ab/ract1 objectify1 conceptualize1 categorize1 & s =?1 are necess>y = ev]yday liv+4 ,ev5 beyond ?is1 ! human capacity = relat+ to ! o!r z object is basic to ! advancem5t ( mank9d = x und]lies sci5ce1 art1 & philosophy4 ,x is simply "o way ( be+ human4 ,ano!r mode ( relat+ is op5 to m54 ,:5ev] two p]sons are pres5t to ea* o!r z human be+s1 ! possibility ( int]subjective dialogue exi/s4 ,s9ce bo? are subjects ) ! capabilities = int]nal relation%ips1 !y c be op51 available1 & kn[able to ea* o!r4 ,!y c "k ea* o!r )9 !mselves4 ,fur!rmore1 !y c be truly ) ea* o!r 9 ! #bg int]subjective realm because :ile ma9ta9+ _! own unique id5tities1 !y c p>ticipate 9 an int]ior union4 ,int]subjective relat+ is also necess>y = human exi/5ce4 ,= x is ?r\gh 8 relation%ips ) o!r m5 t a p]son develops 8 human pot5tial & becomes a unique individual4 ,nurs+1 be+ an int]human ev5t1 has )9 x possibilities = v>i\s types & degrees ( relation%ips4 ,bo? nurse & pati5t c view !mselves & ! o!r z objects & z subjects or 9 any v>iation or comb9ation ( ^! ways4 ,a p]son c view & relate to ano!r p]son z an object1 = in/ance z a m]e function 7pati5t1 nurse1 sup]visor1 m$ic9e nurse1 admitt+ nurse1 adm9i/ration7 or z a case or type 7s*izophr5ic1 c>diac1 outpati5t1 readmission1 b$ pati5t1 :eel*air pati5t1 total c>e pati5t1 t]m9al pati5t74 ,su* subject-object or ,i-,x relation%ips diff] ess5tially f subject-subject or ,i-,?\ relation%ips4 ,z ! d]ivation ( ! t]m indicates1 an object is some?+ plac$ be=e or opposite2 x is any?+ t c be appreh5d$ intellectually4 ,?r\gh objectification ! object is de-individualiz$ & !re=e made replaceable = ! purpose ( /udy by any o!r object ) ! same prop]ties4 ,x is indiff]5t to ! act by :i* x is ?\ght &1 !re=e1 ! subject /udy+ ! object may also be replac$ by a simil> subject4 ,al?\gh x is possible to view a p]son z an object1 p]sons & ?+s are necess>ily diff]5t k9ds ( objects4 ,a ?+1 z object1 is op5 to a subject's scrut9y1 :ile a p]son1 z object1 c make himself kn[able or set up b>ri]s to objectification4 ,he c keep 8 ?\ghts to himself1 rema9 sil5t1 or delib]ately conceal "s ( 8 qualities4 ,?r\gh ! sci5tific objective approa*1 t is1 subject-object relat+1 x is possible to ga9 c]ta9 k ab\t a p]son2 ?r\gh int]subjective1 t is1 subject-subject relat+1 x is possible to "k a p]son 9 8 unique individuality4 ,?us1 bo? subject-subject & subject-object relation%ips are ess5tial to ! cl9ical nurs+ process4 ,bo? are integral elem5ts ( humani/ic nurs+4 ,pres5ce ,9 ! nurs+ _w1 z 9 ! _w at l>ge1 human enc\nt]s may range f ! trivial to ! extremely significant4 ,)9 a day's "w1 ! nurse may exp]i5ce _m levels ( int]subjectivity f ! l[e/ level ( be+ call$ on z a function or be+ us$ z an object1 to ! o!r end ( ! scale ( be+ recogniz$ z a pres5ce or a ?\ 9 g5u9e dialogue4 ,nurs+ activities br+ a nurse & pati5t into close physical proximity1 b ?is 9 itself does n gu>antee g5u9e int]subjectivity 9 :i* a man relates to ano!r p]son z a pres5ce r ?an an object4 ,a pres5ce _c be grasp$ or seiz$ l an object4 ,x _c be dem&$ or #bh comm&$2 x only c be welcom$ or reject$4 ,9 a s5se1 x lies beyond compreh5sion & c only be invok$ or evok$4 ,!re is a quality ( unpr$ictabl5ess or spontaneity ab\t g5u9e dialogue4 ,a nurse may be go+ ?r\gh h] daily activities1 function+ effectively1 relat+ humanely1 :5 sudd5ly %e is /opp$ by some?+ 9 ! pati5t1 p]haps a look ( fe>1 a tug at h] sleeve1 a moan1 a rea*+ = h] h&1 a "q1 empt9ess4 ,9 a susp5seful pause two p]sons hov] betwe5 _! private worlds & ! realm ( int]subjectivity4 ,two humans /& on ! br9k ( ! betwe5 = a preci\s mom5t fill$ ) promise & fe>4 ,) my h& on ! doorknob to op5 myself f )91 ,i hesitate--%\ld ,i1 w ,i let me out1 let him 98 ,"t is susp5d$1 !n moves aga9 z ,i move ) resolve to recognize1 to give te/imony to ! o!r pres5ce4 ,?us1 = g5u9e dialogue to occur !re mu/ be a c]ta9 op5ness1 a receptivity1 read9ess1 or availability4 ,! op5 or available p]son reveals himself z pres5t4 ,?is is n ! same z be+ att5tive2 a li/5] may be att5tive & /ill refuse to give himself4 ,visible actions d n necess>ily signify pres5ce s x _c be prov54 ,b x c be reveal$ directly & unmi/akably 9 a glance1 a t\*1 a tone ( voice4 7,i c only ask y to sub/antiate ?is /atem5t ) y\r own exp]i5ce47 ,availability implies1 !re=e1 n only be+ at ! o!r's disposal b also be+ ) him ) ! :ole ( oneself4 ,fur!rmore1 x involves a reciprocity4 ,! o!r is also se5 z a pres5ce1 z a p]son r ?an an object1 su* z a function or a case4 ,z 0 discuss$ e>li]1 ! nurs+ dialogue occurs )9 ! doma9 ( heal? & illness & has a purpose 9 ! m9ds ( ! p>ticipants4 ,nurs+ is a liv$ dialogue 7a be+ ) & do+ )7 aim$ at nurtur+ well-be+ & m-be+4 ,?is fact ( goal-direct$ness modifies or *>act]izes dialogical pres5ce4 ,z a nurse ,i try to be op5 to ! o!r z a p]son1 a pres5ce1 & to be available to ! o!r4 ,yet1 :5 ,i reflect ^u my pres5ce1 ,i realize t my op5ness is an op5ness to a p]son-)-ne$s & my availability is an availability-9-a-help+-way4 ,by comp>ison1 my exp]i5ces ( op5ness & availability 9 social1 family1 or fri5d relation%ips & 9 nurse-pati5t relation%ips diff]4 ,9 ! lat]1 ,i f9d myself respond+ ) a k9d ( pr(essional res]ve4 ,:ile x is true t :at ,i conceive ( z pr(essional & ! degree ( res]ve has v>i$ ov] ! ye>s & f pati5t to pati5t1 nev]!less1 x is always a factor influ5c+ ! tone ( my liv$ dialogue ( nurs+4 ,x is ! qualitative diff]5ces 9 ! v>i\s exp]i5ces ( pres5ce t des]ve1 yet almo/ defy1 description4 ,= in/ance1 ! pres5ce seems to h a diff]5t quality ( intimacy4 ,x is n exp]i5c$ z less int5se or less deep 9 ! nurse-pati5t relation%ip1 b z someh[ color$ by a s5se ( responsibility or reg>d = :at is se5 z ! pati5t's vuln]ability4 ,at times ,i am aw>e ( a %ad[ ( hold+ back 9 t]ms ( :at ,i consid] nurtur+ #bi or !rapeutically appropriate at a giv5 mom5t4 ,z a nurse1 ,i f9d my pres5ce fl[s ?r\gh a filt] ( !rapeutic tact4 ,or aga91 ! mutuality ( pres5ce may be exp]i5c$ 9 ! nurse-pati5t situation4 ,at times ,i become consci\sly & acutely aw>e ( ! reciprocal fl[ ( op5ness 9 ! dialogue4 ,x is z /rong1 def9ite1 imm$iate1 & total z 9 o!r dialogical relation%ips & yet x is someh[ diff]5t4 ,x is felt z a fl[ betwe5 two p]sons ) diff]5t modes ( be+ 9 ! %>$ situation4 ,my reason = be+ !re1 to nurture1 & 81 to be nurtur$1 bob into my consci\sness l buoys m>k+ ! *annel ( op5ness4 ,(t5 9 nurs+ x is necess>y to focus my att5tion on "s aspect ( ! pati5t's body or behavior4 ,! pati5t may or may n h ! same focus ( att5tion4 ,at lea/ mom5t>ily !n1 or ev5 = a prolong$ p]iod1 ,i place "s aspect ( ! pati5t be=e or opposite myself 7t is1 objectify x74 ,& to ! ext5t t ?is detail absorbs my att5tion1 ,i lose my sight ( & my relat$ness to ! :ole p]son :o happ5s to be ! pati5t4 ,:ile ,i "k ?is focus+ on details to be a necess>y /ep 9 ! nurs+ process1 sometimes ,i f9d myself abruptly refocus+ my att5tion on ! :ole p]son ) almo/ a tw+e ( guilt = hav+ ab&on$ him4 7,pati5ts h describ$ ?is uncom=table int]subjective exp]i5ce z feel+ look$ at or wat*$ by /aff47 ,at o!r times1 on reflection1 ,i f9d my att5tion 0 oscillat+ betwe5 ! detail & ! p]son1 or focus+ on bo? relat+ "o to ! o!r4 ,f ^! exp]i5ces x is evid5t t dialogical pres5ce is complicat$ 9 ! nurs+ situation4 ,x is inhibit$ :5 ! focus ( att5tion 7( "o or bo? p>ticipants7 is on ! pati5t's body itself or on 8 behavior4 ,yet ! body is an integral "p ( ! p]son & 8 behavior is an expression ( 8 mode ( exi/5ce or 8 way ( be+ 9 ! _w4 ,man is an embodi$ be+1 & ! nurse1 9 nurtur+ ! pati5t's well-be+ & m-be+1 mu/ relate to him & 8 body 9 _! my/]i\s int]relat$ness4 ,call & ,response ,! dialogical "* ( nurs+ may be explor$ fur!r by consid]+ x 9 ! g5]al s5se ( a call & response4 ,nurs+ is a purposeful call & response1 t is1 x is relat$ to "s p>ticul> k9d ( help 9 ! doma9 ( heal? & illness4 ,a pati5t calls = a nurse ) ! expectation ( be+ c>$ =1 ( hav+ 8 ne$ met4 ,he is ask+ = some?+4 ,a nurse responds to a pati5t = ! purpose ( meet+ 8 ne$1 ( c>+ = him4 ,! nurse expects to be ne$$4 ,9 reflect+ on nurs+ exp]i5ces1 x becomes obvi\s t ! call & response 9 ! nurs+ dialogue goes bo? ways = nurs+ is transactional4 ,bo? pati5t & nurse call & respond4 ,! patt]n ( ! dialogue is complex4 ,x cont9ues ov] "t1 f mom5ts to ye>s1 9 an ongo+ sequ5ce t ei!r pati5t or nurse may beg91 int]rupt1 resume1 or end4 ,= in/ance1 #cj ! pati5t turns on 8 call light to ask = some?+4 ,?is is n only a call b also a response to ! nurse's previ\sly /at$ sugge/ion t he use ! signal if he ne$s h] help4 ,or aga91 a nurse may /op & talk ) a pati5t dur+ a *ance meet+ recall+ t he previ\sly _h express$ feel+s ( lonel9ess1 bor$om1 pa91 or joy4 ,also1 o!r p]sons or ev5ts may int]rupt or end a nurs+ dialogue4 ,= in/ance1 ! nurse is call$ away to help 9 ano!r situation1 ! pati5t is dis*>g$ on ! nurse's day (f1 ! pati5t expires4 ,fur!rmore1 ! call & response are n only sequ5tial b also simultane\s4 ,9 ?is live dialogue bo? pati5t & nurse are call+ & respond+ all at once4 ,! pati5t's reque/1 = in/ance1 is a call = help & at ! same "t a response to ! nurse's availability or (f] to be ( help4 ,f ! o!r side1 ! way a nurse responds to a pati5t's call is1 itself1 a call to him = a p>ticul> k9d ( response1 a call = 8 p>ticipation 9 ! dialogue4 ,reflect = a mom5t on y\r own example4 ,0 y\r response to ! pati5t influ5c$ by ! value y plac$ on su* factors z 8 indep5d5ce1 motivation1 rehabilitation1 gr[?1 /r5g?s1 pa?ology2 on "t1 on place2 on ag5cy policy8 ,"h aga9 goal-direct$ness affects nurs+ dialogue4 ,our int]pretation ( ! pati5t's calls z well z our responses are color$ by ! aim ( our practice4 ,our values are l calls )9 ! calls4 ,or to /ate x diff]5tly1 ! values und]ly+ our practice give mean+ to ! calls4 ,view+ dialogical nurs+ z a p>ticul> =m ( call & response highlights its complexity4 ,x reveals ! intricacy n only ( its patt]ns ( fl[ b also ( its means ( expression4 ,nurs+ is a liv$ call & response reflective ( e mode ( human communication4 ,mu* has be5 /udi$ & writt5 ab\t v]bal dialogue betwe5 pati5t & nurse4 ,exam9+ v]bal ex*anges f ! p]spective ( call & response c\ld uncov] ev5 m ab\t ?is aspect ( ! nurs+ dialogue4 ,x is m difficult to f9d writt5 descriptions ( nonv]bal nurse-pati5t communication1 al?\gh ?is aspect is g5]ally recogniz$ to be ( equal significance4 ,"h aga9 ! call & response framework c\ld be a useful aid4 ,= in/ance1 :at does a nurse's m]e physical pres5ce mean to a pati5t ei!r z a call or response8 ,or f ! nurse's /&po9t1 "u :at circum/ances is a pati5t's pres5ce exp]i5c$ z a call &1 ev5 m1 z a call = a p>ticul> nurs+ response8 ,:at prompts u to respond 9 t]ms ( 8 po/ure1 8 color1 8 facial expression1 8 behavior1 ! appe>ance ( 8 clo!s8 ,are we almo/ unconsci\sly *eck+ "s k9d ( vital signs 9 ! int] subjective realm8 ,nurs+ dialogue is *>act]iz$ by ! unique feature ( occurr+ ?r\gh nurs+ acts4 ,! dialogue is exp]i5c$ 9 :at ! nurse does ) ! pati5t4 ,a call & response ( c>+ is liv$ ?r\gh 9 nurse-pati5t transactions 7nurs+ c>e activities7 f ! simple/1 mo/ basic acts ( ba?+ & fe$+ to ! mo/ dramatic resuscitation4 #ca ,! nurs+ act itself conta9s a mean+ = ea* p]son 9 ! dialogue & ! mean+s may diff] 7= example1 t\*+ & be+ t\*$1 fe$+ & be+ f$1 ba?+ & be+ ba!d74 ,9 addition1 z a behavioral expression1 ! nurs+ act conveys a message1 a reflection ( ! nurse's /ate ( be+ 7= example1 anxi\s1 hurri$1 tr\bl$1 abs5t1 pres5t1 fully pres5t74 ,fur!rmore1 a nurs+ act may s]ve z an occasion1 or ev5 a cataly/1 = op5+ or mov+ ! dialogue 9 "s direction on a v]bal level 7= example1 ba?+ a pati5t may prompt 8 discussion ( 8 body image or ( 8 fe> ( disfigurem5t74 ,! complexity ( possibilities 9 ?is unique feature ( nurs+ dialogue 7occurr+ ?r\gh nurs+ acts7 is /agg]+1 especially s :5 "o consid]s ! additional factors associat$ ) ! effects ( te*nological advances 9 nurs+4 ,?9k1 = in/ance1 ( ! influ5ce on y\r nurs+ dialogue ( any te*nical nurs+ proc$ure4 ,:at happ5s betwe5 y & ! pati5t :5 y place a !rmomet] into 8 m\?8 ,take 8 blood pressure8 ,give him an injection8 ,aspirate him8 ,d any =m ( monitor+1 f ! simple/ to ! mo/ complex8 ,are ! te*nical proc$ures & in/rum5ts bridges or b>ri]s 9 ! betwe58 ,,dialogical ,,nurs+ ,,9 ,,! ,,real ,,_w ,x is necess>y n[ to look aga9 at dialogical nurs+ 9 a broad] p]spective1 = by limit+ ! exploration to ! nurse1 ! pati5t1 & _! betwe51 ! previ\s discussion grossly ov]simplifi$ ! way ! dialogue actually evolves 9 real life4 ,9 ! above1 x 0 z if nurs+ 7 a drama act$ out by two *>act]s on a specially design$ /age :]e precisely plac$ props lay ready to s]ve ! actors & ! passage ( "t is controll$ by ! *im+ ( a clock or ! dimm+ ( lights4 ,z x is actually liv$1 ! nurs+ dialogue is subject$ to all ! *aotic =ces ( real life4 ,nurs+ takes place 9 a real _w ( m5 & ?+s 9 "t & space4 ,9 _m cases1 x is a special _w1 a heal? sy/em _w1 )9 ! ev]yday _w4 ,o!r ,human ,be+s ,! dialogue liv$ betwe5 nurse & pati5t is affect$ by _! num]\s o!r int]human relation%ips4 ,= a nurse to be g5u9ely ) a pati5t involves h] coexp]i5c+ 8 _w ) him4 ,8 family1 fri5ds1 & significant o!rs are a v real "p ( ?is _w :e!r !y are physically pres5t or di/ant4 ,s to be op5 to ! pati5t is to be op5 to him z a p]son necess>ily relat$ to o!r m54 ,fur!rmore1 9 c>+ = a pati5t ! nurse relates to him n only z an individual pati5t b also z "o 9 a gr\p ( pati5ts4 ,! gr\p may be physically pres5t 7= example1 9 a w>d1 9 an int5sive c>e unit1 9 a #cb wait+ room1 9 a d9+ room1 9 a !rapeutic gr\p7 or !y may be pres5t 9 ! nurse's m9d 7= example1 :ile c>+ = "o %e may ?9k ,i h ?ree m pati5ts to visit1 s & s ne$s 8 m$ication 9 five m9utes1 ,i promis$ s & s ,i'd get back to him1 ?ree o!r pati5ts are wait+ to be f$74 ,ev5 :5 ! nurse is responsible = only "o pati5t1 %e (t5 views him 9 relation to o!r pati5ts %e has nurs$4 ,! nurse h]self also functions )9 complex networks ( int]human relation%ips t affect ! nurs+ dialogue4 ,z heal? c>e becomes m specializ$1 m gr\ps ( heal? c>e work]s arise & ! v>i\s gr\ps become m div]sifi$4 ,s ! nurse's int]subjective transactions ) h] pati5ts occur )9 an intra- & int]discipl9>y milieu ( con/antly *ang+ p]sonnel1 functions1 & roles4 ,:ile h] own role is exp&+1 ext5d+1 deep5+1 broad5+1 becom+ m specializ$1 %e mu/ relate ) o!rs und]go+ simil> *ange4 ,& "h aga91 z ) ! pati5ts s ) h] colleagues1 ! nurse is con/antly fac$ ) ! possibility & necessity ( relat+ to o!rs 9 t]ms ( _! functions & z p]sons4 ,f9ally1 x %\ld be recogniz$ t :ile x is easy & common to ?9k ( ! nurse z synonym\s ) ! function nurs+1 9 real life ! nurse is a human be+ necess>ily relat$ to o!rs4 ,%e le>ns to focus on ^? pres5t 9 h] "h & n[ "w situation4 ,b %e too is h] hi/ory & br+s to h] "w _w all t %e is & all t %e is n includ+ h] pa/ exp]i5c$ & future anticipat$ int]human relation%ips4 ,s ea* nurse affects h] peopl$ nurs+ _w & is affect$ by x 9 h] own unique way4 ,f ! o!r side1 ! pati5t also ent]s into ! nurs+ dialogue ) 8 v>i\s networks ( int]human relation%ips4 ,h[ he exp]i5ces 8 relation%ips ) 8 family & significant o!rs1 ) ! pati5t gr\ps ( :i* he becomes a "p 9 diff]5t degrees1 ) memb]s ( v>i\s discipl9es & heal? s]vices gr\ps1 ) ! nurse & 8 nurse1 all influ5ce ! liv$ nurs+ dialogue4 ,x is always color$ by ! pati5t's curr5t mode ( int]p]sonal relat+4 ,( c\rse1 ! curr5t mode reflects 8 pa/1 = example1 le>n$ habits ( response1 & 8 future1 = example1 conc]ns ab\t anticipat$ *anges 9 int]p]sonal relation%ips due to ! effects ( 8 illness4 ,9 "s cases1 ! int]subjective behavior itself becomes ! focus ( ! nurs+ dialogue z ! area ( ! pati5t's greate/ ne$s 9 atta9+ well-be+ & m-be+4 ,?+s ,! nurs+ dialogue takes place 9 a real _w ( ?+s1 ord9>y ?+s ( ev]yday liv+ & all =ms ( heal? c>e equipm5t4 ,bo? types ( objects affect ! nurse-pati5t transactions & _! influ5ce v>ies = !y may be exp]i5c$ diff]5tly by nurse & pati5t4 ,ord9>y objects us$ ev]yday--eat+ ut5sils1 clo!s1 furniture1 books1 television sets--are s famili> t "o usually takes _! use = grant$4 #cc ,h[ev] due to illness a p]son may be unable to manipulate a knife & =k1 = example4 ,!y become fru/rat+ objects4 ,8 tools are no long] ext5sions ( himself b imp$im5ts & b>ri]s4 ,he feels h&icapp$4 ,8 _w ( ?+s *anges4 ,on ent]+ a heal? c>e facility1 ! pati5t f9ds himself 9 a =eign _w ( /range objects4 ,9 place ( 8 famili> possessions he is surr\nd$ by equipm5t1 ma*9es1 in/rum5ts1 solutions1 & s =?4 ,he may exp]i5ce ^! z bewild]+1 fright5+1 pa9ful1 supportive1 soo?+1 life-su/a9+4 ,! nurse1 on ! o!r h&1 may exp]i5ce ^! same objects q diff]5tly4 ,to h] !y may be famili> tools1 useful aids1 complex ma*9es1 annoy+ly defective equipm5t4 ,ev5 9 a situation t does n h special equipm5t1 = in/ance 9 a home1 ! pati5t's _w ( ?+s *anges z ! nurse conv]ts ord9>y objects into tools4 ,?us1 :ile nurse & pati5t %>e a situation1 ! ?+s 9 _! %>$ _w h diff]5t mean+s = ea*4 ,! ?+s !mselves z well z ! p]sons' relations to !m c s]ve to enhance or inhibit ! int]subjective transaction ( nurs+4 ,"t ,to view dialogical nurs+ z x is actually exp]i5c$ 9 ! real _w1 "o mu/ conceive ( x z occurr+ 9 "t1 n simply measur$ "t b also "t z liv$ by pati5t & nurse4 ,c]ta9ly bo? p>ticipants are caught up 9 measur$ "t & ?is influ5ces _! %>$ _w1 = example1 eight-h\r t\rs ( duty1 a day (f1 surg]y s*$ul$ at #h3jj a4m41 dis*>ge 9 two days1 visit ?ree times a week1 cl9ic appo9tm5t 9 #cj days4 ,?us1 to an ext5t1 bo? pati5t & nurse mu/ live by ! clock & cal5d>4 ,h[ev]1 equally important1 or p]haps ev5 m important1 9 ! liv$ dialogue ( nurs+ is ! p>ticipants' exp]i5ce ( "t4 ,"s ref]5ces 7 made to liv$ "t 9 ! section on call & response :]e x 0 not$ h[ ! nurs+ dialogue unfolds ov] "t f mom5ts to ye>s4 ,h[ ! involv$ p]sons exp]i5ce ?is cont9uity is an individual matt]4 ,! nurse may conceive ( h]self z "o ( _m p]sons contribut+ to a cont9u\s /ream ( c>+ = ! pati5t4 ,s %e w give & he> & write & read reports1 note obs]vations1 keep records4 ,%e w c>ry an image ( ! pati5t 9 h] m9d cont9ually add+ to x or *ang+ x ) ea* int]action or report4 ,sometimes1 aft] n see+ ! pati5t = a "t1 on meet+ him aga9 %e w pick up :]e %e left (f1 treat+ him z if he 7 ! same p]son1 z if days1 mon?s1 ye>s ( liv+ _h n int]v5$4 ,oh1 x's him aga94 ,or %e may be />tl$ by ! visible *anges & resume ! dialogue f t po9t4 ,or ev5 if *ange is n visible1 %e may be aw>e t x may h occurr$ & try to fill 9 ! gap4 ,^! possibilities may be mirror$ f ! pati5t's /&po9t1 = he likewise exp]i5ces cont9uity or lack ( x 9 8 c>e4 ,& yet1 ! exp]i5ce mu/ be diff]5t = him4 ,= in/ance1 nurses may ?9k ( cont9uity ( c>e 9 t]ms ( cov]age = a plann$ program ( c>e4 ,s x has (t5 be5 #cd claim$ t ! nurse is ) ! pati5t #bd h\rs a day4 ,f ! pati5t's po9t ( view ?is is n true4 ,a nurse may be ) him b ea* nurse is diff]5t4 ,! function ( nurs+ may be cont9u\s1 b individual nurses come & g2 ! day nurse1 ! ev5+ nurse1 ! night nurse are ea* unique individuals4 ,& ! nurs+ dialogue z liv$1 int]subjective transaction occurs betwe5 a p>ticul> nurse & a p>ticul> pati5t4 ,:5 we speak ( a nurse & a hospitaliz$ pati5t sp5d+ a day toge!r1 we usually are ref]r+ to eight h\rs out ( a #bd-;h\r day4 ,!y may bo? exp]i5ce ! spac+ ( ?is "t by functions or activities su* z meal "t1 m$ic9e "t1 visit+ "t4 ,yet ! measur$ m9utes & h\rs are exp]i5c$ diff]5tly by ea* 9 _! diff]5t modes ( be+ 9 ! situation4 ,nurses (t5 express feel+s ( n hav+ en\gh "t to give ! c>e !y want to give2 ( hav+ too _m dem&s on _! "t2 ( try+ to make "t = pati5ts :o ask d y h a m9ute8 ,pati5ts live _! "t 9 relation to bor$om1 pa91 lonel9ess1 sep>ation1 wait+4 ,! nurs+ dialogue runs its c\rse 9 clock "t b bo? nurse & pati5t live x 9 _! private times4 ,:5 ! nurs+ dialogue is g5u9ely int]subjective1 x has a k9d ( syn*ronicity t is evid5t 9 ! nurse's be+ ) & do+ ) ! pati5t4 ,?is k9d ( tim+ is relat$ to ! transactional "* ( nurs+ & to its goal ( nurtur+ ! developm5t ( human pot5tial4 ,x is exp]i5c$ 9 op5ness1 availability1 & pres5ce1 z well z 9 nurs+ c>e activities4 ,! nurse feels 9 h>mony ) ! rhy?m ( ! dialogue &1 s5s+ ! tim+ ( its fl[1 %e paces h] call & response to pati5t's ability to call & respond 9 t mom5t4 ,s1 z a nurse1 y may f9d y\rself almo/ unconsci\sly or intuitively wait+1 hold+ back1 anticipat+1 urg+ ! pati5t4 ,?is k9d ( syn*ronization or tim+ is int]subjective = ! clues or reasons = enc\rag+ or wait+ are n f\nd solely 9 ! pati5t's behavior nor only 9 ! nurse's k or exp]i5ce4 ,good or "r tim+ someh[ involves ! betwe54 ,x implies t nurse & pati5t %>e n only clock "t b private1 liv$ "t4 ,space ,by explor+ ! dialogue ( nurs+ z x is liv$ 9 ! real _w ! factor ( space becomes app>5t4 ,"h aga9 ! dialogue is influ5c$ by space z x is measur$ & space z x is exp]i5c$ by nurse & pati5t4 ,:5 ?9k+ ( heal? c>e facilities1 space may be synonym\s ) su* ?+s z b$s1 wait+ rooms1 int]view rooms1 treatm5t areas1 size ( pati5t's room1 visit+ areas1 a quiet place1 a private place4 ,naturally1 ! physical sett+1 :e!r 9 a hospital1 home1 any:]e 9 ! community1 c s]ve to enhance or imp$e ! nurs+ dialogue4 ,h[ev]1 ! p]son's exp]i5ce ( ! space may be ev5 m important4 ,space is liv$ 9 t]ms ( l>ge & small1 f> & ne>1 long & %ort1 high & deep1 above & bel[1 be=e & beh9d1 left & "r1 across1 all #ce ar\nd1 empty1 cr[d$4 ,^! p]ceptions & exp]i5ces ( space may be influ5c$ by ! effects ( illness1 = example1 *anges 9 vision or locomotor ability4 ,?us1 a pati5t's spatial _w may *ange1 exp& or dim9i%1 become unmanageable or manageable day by day4 ,fur!rmore1 a pati5t's attitude t[>d & exp]i5ce ( a p>ticul> place may be affect$ by 8 m5tal association to x 7= example1 oncology w>d1 psy*iatric unit71 8 previ\s exp]i5ce 9 x 7= example1 em]g5cy room1 op]at+ room71 or a desire to be some:]e else 7= example1 ,?is is a nice hospital b ,i'd r be home74 ,place is a k9d ( liv$ space4 ,x is p]sonaliz$ space4 ,"o says1 = example1 ,come to my place mean+ to my home4 ,or ev5 m p]sonally1 x relates to :]e ,i feel ,i belong or am1 = in/ance1 he put me 9 my place2 ,i felt put d[n4 ,! pati5t may feel out ( place 9 ! heal? c>e sett+1 :ile x may be commonplace to ! nurse4 ,!re may be areas 9 ! sett+ t ! pati5t exp]i5ces z 8 t]ritory1 = example1 8 b$1 8 room1 8 w>d2 :ile o!r areas are !irs or re/rict$ to au?oriz$ p]sonnel4 ,s a nurse & a pati5t may be 9 a place toge!r1 yet "o feels at home & ! o!r does n4 ,= ! nurse to be really ) ! pati5t involves h] kn[+ him 9 8 liv$ space1 9 8 "h & n[4 ,liv$ space is int]relat$ ) liv$ "t4 ,pati5ts hospitaliz$ = a long "t (t5 express a propriet>y attitude t[>d ! hospital4 ,! same holds true = p]sonnel4 ,) "t & famili>ity a feel+ ( reciprocal belong+ness gr[s4 ,! p]son belongs 9 ! place & ! place belongs to ! p]son4 ,on ! o!r h&1 :5 a p]son f9ds himself 9 a new place he may feel ! discom=t ( n belong+4 ,?is is z true = ! nurse 9 an unfamili> sett+ z = ! pati5t4 ,aga9 9 ?is reg>d1 ! liv$ nurs+ dialogue is enhanc$ by ! nurse's aw>5ess ( n only h] own exp]i5ce ( space b ! pati5t's z well4 ,,conclusion ,?is *apt] explor$ ! basic view ( humani/ic nurs+ z a ph5om5on 9 :i* human p]sons meet 9 a nurtur+1 int]subjective transaction4 ,beg9n+ ) ! c5tral intuition t nurs+ is liv$ dialogue1 ! exam9ation turn$ to its exi/5tial s\rce1 ! nurs+ situation z x is liv$4 ,reflection on actual exp]i5ce cl>ifi$ ! ph5om5a ( meet+1 relat+1 pres5ce1 & call & response z !y occur 9 humani/ic nurs+4 ,dialogical nurs+ 0 !n reconsid]$ 9 broad] p]spective z x actually evolves 9 ! real _w ( m5 & ?+s 9 "t & space4 ,z sci5tific advances multiply 9 ! heal? field1 nurs+ is swept along 9 ! tide4 ,cont9u\s te*nological *anges1 ev] increas+ specialization1 emphasis 9 nurs+ education & rese>* on sci5tific me?odology all h m>k$ influ5ce on ! developm5t ( nurs+4 ,sci5ce 7) a capital ,s7 colors ! nurs+ _w4 ,at e turn x p]meates ! nurse's be+ ) & #cf do+ ) ! pati5t4 ,x (f]s a c]ta9 security by provid+ a consi/5t & effective approa* to "s problems & que/ions1 &1 9 "s cases1 results 9 g5]al laws to guide practice4 ,at ! same "t1 9 ! liv$ nurs+ _w ! nurse exp]i5ces a reality t is n op5 to ! sci5tific approa*1 a reality n always v]ifiable ?r\gh s5se p]ception1 a reality ( individuality4 ,! uniqu5ess ( individuality 7h] own z well z ! pati5t's7 p]vades ! nurs+ dialogue4 ,! ev]-pres5t individual diff]5ces may be reg>d$ z intractable elem5ts to be conqu]$ = ! sake ( ! effici5cy ( ! sy/em 7= example1 fit ! pati5t to ! treatm5t program74 ,or !y may be valu$ z indicators ( ! inexhau/ible ri*ness ( human pot5tial to be develop$4 ,9 _! daily practice1 nurses are drawn t[>d ! two realities--! reality ( ! objective sci5tific _w & ! reality ( ! subjective-objective liv$ _w4 ,?is t5sion is liv$ out 9 ! nurs+ act4 ,do+ ) & be+ ) ! pati5t calls = a complem5t>y syn!sis by ! nurse ( ^! two =ms ( human dialogue1 ,i-,x & ,i-,?\4 ,bo? are inh]5t 9 humani/ic nurs+ = x is a dialogue liv$ 9 ! objective & int]subjective realms ( ! real _w4 ,9 ! highly complex heal? c>e sy/em nurses exp]i5ce _m dem&s f _m directions4 ,_! cl9ical judgm5ts 9 daily practice mu/ be made )9 a cont9u\s /ream ( decisions ab\t priorities ( inve/m5t ( _! "t & ef=ts4 ,sometimes1 survival 9 ! sy/em r$uces ! nurse to foll[+ ! l9e ( lea/ resi/ance1 t is1 respond+ to ! imm$iate or to ! l\de/ dem&s4 ,h[ev]1 ev5 ) _! total commitm5t ?is c\rse ( response does n gu>antee t nurses are mak+ _! greate/ possible contribution to heal? c>e4 ,?is c happ5 only if we are able to see dem&s & opportunities 9 relation to our reason = be+--nurtur+ ! well-be+ & m-be+ ( p]sons 9 ne$4 ,humani/ic nurs+1 view$ z a liv$ dialogue1 (f]s a frame ( ori5tation t places ! c5t] ( our univ]se at ! nurse-pati5t int] subjective transaction4 ,insightful recognition ( ! liv$ nurs+ act z ! po9t ar\nd :i* all our functions revolve1 c\ld require a ,cop]nican revolution ( ori5tation ( "s nurses4 ,x does provide1 = all nurses1 a true s5se ( direction t c be actualiz$ by ea* unique nurse ?r\gh creative human dialogue4 #cg #d ,,ph5om5on ,,( ,,community ,humani/ic nurs+ creates1 happ5s )91 & is affect$ by community4 ,?is *apt] w discuss ! ab/ract t]m community4 ,to /imulate ?\ght on a nurse's influ5ce on community1 consid]ation w be giv5 to ?ree po9ts3 7#a7 my angul> view ( community & its evolvem5t1 7#b7 h[ man has consid]$ community ov] "t1 7#c7 h[ a human be+ comes to be ?r\gh community4 ,,my ,,angul> ,,view ,"o c view memb]s ( a family1 a /ud5t class1 a hospital unit1 a hospital /aff1 sev]al relat$ hospital /affs1 heal? s]vices organizations )9 a geographic area1 a pr(ession1 a t[n to a _w or univ]se z community4 ,man's m9d1 my m9d1 det]m9es :]e ,i sup]impose ! limits or lift ! limits or relate compon5ts4 ,9 ,! ,republic ,plato depict$ a community z a macrocosm4#a ,its nature 0 condition$ by ! k9ds ( m51 ! microcosms1 t compos$ x4 ,! macrocosm 0 a reflection ( its microcosms4 ,s ea* human p]son1 ea* nurse1 z a microcosm1 c\ld make a diff]5ce4 ,reflect+ on ! liv$ worlds ( nurses1 _! communities1 if we use ,plato's philosophical analogy ( macrocosm-microcosm1 despite ! v>ieties ( situation1 we c make mean+ful a basic concept ( community4 ,su* a concept utiliz$ by a nurse to view h] p>ticul> ongo+ *ang+ _w c help h] to und]/& m reali/ically1 survive )91 & /ruggl+ly p>ticipate z a quality =ce4 ,to be a quality =ce )9 community a nurse mu/ op5 h] be+ to ! endless innovative possibilities & unattempt$ *oices available to h]4 #ch ,! ability to ?us op5 "o's self requires our expos+ our biases1 ! %ades ?r\gh :i* we reg>d ! _w1 to ! sunlight4 ,9 nurs+ our %ades (t5 are clos$ categories1 labels1 diagnoses1 trite sup]ficial hackney$ expressions le>n$ by u1 taught to u z fact1 tak5 9 unexam9$1 & left unreexam9$ despite o!r *anges 9 ourselves & our situations4 ,socrates said1 & x /ill holds1 t ! unexam9$ life is n wor? liv+4 ,our %ades c be *]i%$ concepts1 beliefs t guide u automatically r ?an ?\ghtfully4 ,:e!r !y are entirely my? or p>tial tru?s1 !y c cause u agoniz+ dilemma because !y obscure ! obvi\sly relevant & ! possibilities beyond4 ,a concept ( community1 if grasp$ & if a nurse is truly consci\sly aw>e1 c help h] to und]/& h[ h] nurs+ _w has evolv$1 is pres5tly1 & h[ %e c be1 to %ape its future 9 accordance ) h] values4 ,z nurses "o ( our %ades is (t5 ! conf9+ labels we give to ourselves z do]s 9 s]vice giv+ pr(ession4 ,i w\ld l to g on record z mo/ respectful ( ?is aspect ( my _w4 ,i regret1 none!less1 t we h n always simil>ly cry/alliz$ & floodlight$ ! discov]y & creative possibilities 9 our communities4 ,9 our v p]sonal1 intimate1 involv$ pr(essional nurs+ relations ) o!r man we are privileg$ to be includ$ 9 human happ5+s op5 to no o!r gr\p4 ,z nurses1 we h _h & are hav+ emphasiz$ to u ! importance ( facts h&$ to u4 ,c we actuate ! importance ( ! k ( man t becomes "p ( u ?r\gh our nurs+ worlds8 ,x is h>d to honor ! significance ( ! ev]yday1 ! commonplace1 ! intimately kn[n8 ,x has be5 said t "o c\ld "k ( ! :ole univ]se if "o c\ld make e possible relation%ip />t+ f a piece ( bread4 ,?9k ( a simple or r\t9e nurs+ situation4 ,?9k ( its true complexity & h[ x c trigg] puzzlem5t1 wond]m5t1 & ?9k+4 ,z le>n+ situations1 nurses' situations are exi/5tially priceless4 ,return+ n[ to ,plato's conception ( community und]/ood ?r\gh ! t]ms macrocosm & microcosm1 :at c ! nurs+ _w situation reveal to u ( community8 ,:at are ! qualities ( ! p>ticipants1 ! microcosms1 & h[ are ^! qualities reflect$ 9 our nurs+ communities8 ,,hi/ory3 ,,! ,,%ades ,,( ,,my ,,_w1 ,,bracket$ ,9 ye>s pa/ z a public heal? m5tal heal? psy*iatric nurse ,i h /ructur$ facts ab\t man1 family1 & community precisely = pres5tation4 ,approa*+ ! data sociopsy*ologically ,i fram$ x 9 ! public heal? model ( promotion ( heal?1 prev5tion ( illness1 treatm5t1 rehabilitation1 & ma9t5ance4 ,i ?\ght ( family sociologically z nucle>1 procreative1 & ext5d$4 ,9 accordance ) ! psy*oanalytic model1 family memb]s 7 oral1 anal1 o$ipal1 lat5t1 homosexual1 adolesc5t1 het]osexual1 &_/or mature4 ,community1 l p]son & family1 0 consid]$ accord+ to a #ci clos$ p>adigm1 rang+ f ideal to abysmal1 f ! smalle/ to ! l>ge/ unit 9 :i* p]sons congregat$ = common purposes4 ,i select$ f exp]i5ce nurs+ examples to make ^! sociopsy*ological public heal? con/ructs mean+ful4 ,i did n />t f nurs+ exp]i5ces to come up ) nurs+ concepts ( man1 family1 & community4 ,i d5i$ my p>ticul> self z a s\rce ( k ( ^! areas4 ,_h education programm$ me to value only o!rs' ideas glean$ 9 ! classroom or f books8 ,i project$ ?is devaluation ( my own ideas onto my colleagues & until ,i really knew !m gave !m :at ,i ?\ght !y want$1 o!rs' ideas4 ,pres5tly ,i prize my unc]ta9ty ab\t ! nature ( man 9 family & community & my /riv+ t[>d an ev] explorative process ( be+ & becom+1 available = surprise4 ,p>adoxically1 ,i believe x 0 ^! v same capacities1 unc]ta9ty & /riv+1 t compell$ my sup]impos+ on my colleagues ) c]ta9ty o!r p]sons' & o!r pr(essions' views4 ,actually1 my c]ta9ty ab\t ! conundrums3 man1 family1 community come only 9 p>ticul>s & only 9 fits & />ts1 & my c]ta9ty is at once a tru? & a nontru?4 ,i see my aim z ev] /riv+ t[>d c]ta9ty :ile con/antly wre/l+ ) ! discom=t ( unc]ta9ty4 ,,ea* ,,nurse3 ,a ,,noetic ,,locus#b ,ea* nurse is a kn[+ place4 ,x feels z if my greate/ tal5ts1 z a human nurse p]son1 await$ my acceptance t came ?r\gh z ,i relat$ to ! exi/5tiali/ ?9k+ ( p]sons l ,m>t9 ,bub]1 ,teilh>d de ,*>d91 ,fr$]ick ,nietzs*e1 ,k>l ,popp]1 ,h]mann ,hesse1 ,wilfrid ,desan1 & ,norman ,c\s9s4 ,n[ :5 ,i ?9k ( ! ph5om5a--man1 family1 community--,!resa ,g4 ,mull]1 nurse educator & cl9ician1 :o quot$ ,h]sey f 8 novel1 ,a ,s+le ,pebble1 comes to m9d4#c ,he said1 ,i approa*$ ! riv] z a dry sci5tific problem2 ,i f\nd x in/ead an av5ue along :i* human be+s mov$ :om ,i _h n ! insight1 ev5 ?\gh ,i _h ! vocabul>y1 to und]/&4 ,i consid] my greate/ gifts z a human be+ nurse my ability to relate to o!r man1 to wond]1 se>*1 & imag9e ab\t my exp]i5ce1 & to create out ( :at ,i come to "k4 ,my ev] develop+ int]naliz$ community ( _w ?9k]s dynamically int]relat$ ) my consci\s aw>5ess ( my exp]i5c$ nurs+ realm all[s my appreciation ( my human gifts & ! ev] enri*m5t ( myself z a kn[+ place4 ,,nurse3 ,,exp]i5ce ,,int]naliz$ ,nurs+ exp]i5ce taught me t ea* man1 ea* family1 ea* community 0 at once alike & diff]5t4 ,hesse1 an exi/5tial noveli/1 9 ,/epp5wolf1 #dj describes ea* man :o has become 9 family & community z l an onion ) hundr$s ( integum5ts or a texture ) _m ?reads4#d ,!n man's diff]5ces w\ld be 9 ! quality ( 8 integum5ts & _! developm5t or 9 8 ?reads 9 _! prepond]ance4 ,contemplat+ ! /ruggles 9 community reg>d+ mutual und]/&+1 ,i exp&$ ,hesse's conception ( man & f\nd my vision ( community to be a salad toss+ or a pat*work quilt tumble dry+4 ,valu+ ! complexity ( ?is conception ( man & !re=e ( community ,i f9d myself smil+ at ! naivety ( ! e>li] m /atic frames ( ord] ,i sup]impos$ on ^! ph5om5a4 ,^! ov]simplifications ma9ta9$ ! %ade ?r\gh :i* ,i view$ my _w4 ,! %ade 03 o!rs are kn[+ places1 !y are responsible2 !re=e if ,i quote au?ority f outside ( myself1 ,i c speak ) c]ta9ty ab\t :at ,i "k & believe & no "o c attack me4 ,& yet1 my unique k 0 n giv5 & s my def5se1 my clut*+ at security foil$ my human ne$ = conceptualization ( & expression ( my own nurse vision ( reality4 ,?is defeat$ ! developm5t by me ( nurs+ !ory4 ,n[ ,i realize h[ ,i und]e/imat$ ! pot5tialities ( my nurs+ effect1 ( ! diff]5ce ,i made1 & c\ld make4 ,j consid] ! giv5 human uniqu5ess ( ea* p>ticipant 9 ! nurs+ situation ^: familial pot5tial goes back to an orig9 ( ?9k+ be+ or consci\sness1 & =w>d to 8 anticipation ( ! future1 8 et]nity4 ,9 ! nurs+ lit]ature1 x is r infrequ5t t we philosophically %>e our inn]mo/ ?\ghts1 dreams1 ideals1 & /riv+s )\t a /rong ov]lay ( indoctr9ation or conv]sion4 ,nietzs*e pres5ts philosophy z autobiographical1 su* %>+ does n (f] maps4 ,x c\ld (f] relevant res\rces & /imulate o!r nurses to influ5ce ! %ape & becom+ ( ! pr(ession4 ,?is *apt] attempts to discuss ideas ( community1 ! macrocosm1 by consid]+ man1 ! microcosm1 z he develops 9 family & community4 ,! ideas repres5t my "h & n[ z x reflects my pa/ & anticipat$ nurs+ _w1 includ+ my hopes & expectations4 ,man's ,exp]i5ce ,ea* human be+ c>ries a view ( p]sons1 families1 & communities %ad$ by ! views ( 8 nucle> family4 ,! pa/ usually is correct$2 x is nev] eras$4 ,s 9 8 family ( orig9 man int]nalizes ideas ( "r-wrong1 appropriate-inappropriate1 expect$-unexpect$4 ,ea* family's %ad$ _w e*oes its procreators' familial1 psy*osocialeconomic1 religi\s & exp]i5tial bread?1 closely resembl$ or di/ort$4 ,two p]sons1 p]haps m1 usually husb& & wife1 br+ %ad$ views toge!r 9 "s comb9ation or balance t becomes ! /uff1 ! au?ority1 ( #da _! *ildr5's worlds4 ,?us1 *ildr5 see _! e>ly worlds ?r\gh ! complem5t>9ess & conflict ( ?is initial home view1 act+ at times ) x2 at times aga9/ x4 ,adults1 9 response to & ?r\gh "o ano!r1 procreate new s5sitive be+s :om !y want &_/or d n want & :om !y may &_/or may n exp]i5ce z _! responsibility 9 v>y+ degrees4 ,m>cel1 a ,fr5* exi/5tiali/ philosoph]1 views procreation & responsible p>5?ood z q diff]5t4 ,my pa/ nurs+ exp]i5ce sub/antiates ?is4 ,m>cel expresses my bias ab\t responsible p>5?ood1 & ?is /atem5t is also wor?y ( consid]ation by nurses 9 positions ( au?ority to o!rs4 ,he says1 ,we h to lay d[n ! pr9ciple t our *ildr5 7or ^? = :om we c>e7 are de/9$1 z we are ourselves1 to r5d] a special s]vice1 to %>e 9 a "w1 we h humbly to ackn[l$ge t we _c conceive ( ?is "w 9 its entirety & t a =tiori we are incapable ( kn[+ or imag9+ h[ x is de/9$ to %ape itself = ! "y w1 x is our prov9ce to awak5 to a consci\sness ( itself4#e ,?9k ( ?is /atem5t ( responsible au?ority4 ,h[ has x be5 evid5c$ 9 families & nurs+ situations ( y\r nurs+ _w8 ,:at are y\r expectations ( y\r pati5ts or nurses ) :om y "w8 ,teilh>d de ,*>d91 paleontologi/1 biologi/1 & philosoph]1 l ,nietzs*e1 depicts man z lack+ a fix$ nature ) 8 own mode ( be+ z 8 fundam5tal project4#f ,initially1 ea* p]son takes on a mode ( be+ 9 8 _w dep5d5t ^u 8 degree ( fre$om & ! h[ & :at ( ! _w z pres5t$ by 8 family & p]ceiv$ by him4 ,! _w z pres5t$ is reflective ( ! family's culture1 _! prov9cial _w view1 _! unique exp]i5c$ "h & n[1 & ! times4 ,metaphorically1 ! family's liv$ _w1 h[ !y exp]i5ce at ?is p>ticul> cross-section ( _! lives1 c be symbolically describ$ z a kaleidoscopic telescop+ ( its pa/ & anticipat$ future4 ,n[1 ?is w\ld be :at 0 pres5t$ at any p>ticul> "t4 ,:at w\ld a *ild's p]ception d to ?is metaphorical symbol8 ,! *ild's curr5t human developm5t & 8 n>r[ exp]i5ce w\ld be l a circus h\se mirror t w\ld int]pret ! metaphorical symbol di/ort$ly4 ,witness a ?ree-ye>-old speak+ que/ion+ly & compla9+ly ab\t h] t5sion heada*e to h] mute1 nonp]ceptive doll1 & ask+ h] to please1 please /op mak+ su* a mess & racket4 ,! e>lie/ *ildhood views ( family & community are influ5c$ ov] "t1 gradually & abruptly1 & gr[ 9 complexity4 ,! *ild's puzzlem5t is ar\s$ by o!rs' com+s & go+s1 happ5+s )9 ! family1 imm$iate neighborhood1 & adjac5t community1 & ! _w pres5t$ ?r\gh books & te*nologically1 on radio1 television1 & tape record]4 ,ea* *ild att5ds ^! pres5tations ) v>y+ measures ( complac5cy1 que/ion+1 bafflem5t1 & involvem5t4 #db ,= in/ance1 = myself1 z a *ild !re 0 ! excitem5t ( ! con/ruction ( a new h\se 9 ! woods next door & meet+ new neighbors4 ,initially my p>5ts express$ _! diff]5ces f ourselves4 ,! diff]5ces !y p]ceiv$ 7 foll[$ by negative projections on ^! unkn[n folk4 ,7 ^! o!rs really humanly diff]5t8 ,i inve/igat$2 my family inve/igat$4 ,! folk became p]sons4 ,!y express$ !mselves diff]5tly 9 volume & sometimes 9 language4 ,!y look$ diff]5t4 ,yet !y 7 n fe>some4 ,!y felt1 c>$1 respond$1 & worri$ mu* z we did4 ,mutual k all[$ increas+ clos5ess & lik+4 ,=bidd56 ,?is 0 ! neighborhood across ! tracks4 ,i cri$ :5 an uncle teas+ly proclaim$ "o day t my miss+ "m 0 ov] !re4 ,lat] ,i att5d$ s*ool ) bo? :ite & black *ildr5 :o liv$ ov] !re4 ,& aga91 ea* 0 diff]5t1 yet n diff]5t2 ea* 0 kn[able1 likeable1 & loveable4 ,adult family memb]s :isp]$ ab\t a neighbor woman f across ! /reet4 ,%e 0 app>5tly hospitaliz$ p]man5tly4 ,:5 ,i inquir$ z to :y1 eyebr[s 7 rais$ & /range looks 7 ex*ang$4 ,i 0 told 9 a n believable way1 ,%e broke h] leg fall+ (f ! back por*4 ,a neighbor husb& & wife frequ5tly c\ld be he>d fight+ bo? v]bally & physically4 ,family talk at our h\se depict$ ! husb& z evil1 ! wife z a poor s\l4 ,i did n enjoy be+ 9 ^! peoples' h\se4 ,p]haps ! viol5ce fright5$ me2 p]haps ,i 0 unc]ta9 :5 x might erupt8 ,p]haps ,i 0 conc]n$ t ,i might "o day someh[ become "p ( su* a situation8 ,n[1 look+ back ov] ! ye>s1 ,i w\ld guess t bo? ?is husb& & wife 7 poor s\ls /ruggl+ ) _! humanness z be/ !y c\ld4 ,an adolesc5t girl liv$ d[n ! block4 ,%e 0 label$ z /range1 peculi>1 odd1 crazy4 ,(t5 "o saw h] talk+ to h]self1 skipp+ & rotat+ z %e mov$ along 9 h] always solit>y & my/]i\s way4 ,all express$ great sorr[ = h] always solit>y & my/]i\s way4 ,all express$ great sorr[ = h] eld]ly "m & fa!r on h] admission to ! ,/ate ,hospital4 ,ye>s lat] ,i wond]$1 & /ill wond] :at happ5$ to t girl1 h]self8 ,:at k9d ( an exi/5ce has %e exp]i5c$8 ,dur+ ^! e>ly ye>s !re 0 also sep>ation f & loss ( close lov$ family memb]s4 ,:5 ,i 0 ?ree & a half a great aunt :o always appreciat$ my side ( ?+s mov$ out ( our home due to a family argum5t4 ,p]haps mo/ confus+ ( all dur+ ^! pres*ool ye>s1 at f\r & a half1 my fa!r di$ sudd5ly4 ,!y said t he w5t to heav51 t ,god call$ him4 ,:y did he g8 ,:y w\ld he leave u8 ,mo/ important h[ c\ld he leave me8 ,:at _h ,i done wrong8 ,0 x t ,i _h n lov$ him en\gh8 ,be5 good en\gh to him8 ,0 he angry8 ,:at k9d ( ,god is ,god1 anyway8 ,is he b5evol5t1 malevol5t1 indiff]5t8 ,is he real3 is he believable8 ,:at c "o expect & h[ %\ld "o act t[>d au?ority & p[]8 ,! _w didn't feel l a v safe place nor did p]sons appe> to be dep5dable4 ,!n !re 0 s*ool4 ,) additional au?orities & pe]s !re arose new wond]m5t & expectation4 ,! way "o 0 to be 9 s*ool 0 #dc diff]5t f at home4 ,& :at 0 happ5+ at home :ile ,i 0 at s*ool8 ,c\ld ,i dep5d on ?+s be+ safe8 ,9 k9d]g>t5 ,i made an a% tray ( clay = my already dead fa!r4 ,9 my *ild _w !re 7 books1 radio1 & ! movies4 ,today *ildr5 exp]i5ce ^!1 z well z television & record play]s4 ,= me1 books1 radio1 & ! movies br\ght into my _w new aspects ( fe>1 excitem5t1 joy1 love1 horror1 viol5ce1 imag9ation1 & susp5se4 ,!y depict$ at times ! ideal & at times ! abysmal4 ,sometimes1 despite ev]y?+1 good triumph$4 ,at o!r times reg>dless ( ! ef=t inve/$ all 0 lo/4 ,:]e 0 ! h>mony ( logical reason8 ,is our _w absurd8 ,are we absurd to respond to x ) an expectation ( reason8 ,= ea* *ild !re are v special1 long-rememb]$ ev5ts3 be+ taught to swim by "o's fa!r1 family picnics1 trips into ! _w beyond city or c\ntry1 go+ to ! circus1 a _w's fair1 a zoo or a fantasy l&4 ,!re1 also are ! ev5ts ( be+ lov$ & lov+ deeply1 l9k$ someh[ ) times ( feel+ unlov$ & unlov+4 ,m ?an e>li]1 today !re are multiple community gr\ps = *ildr5 :]e activities are guid$ & sup]vis$4 ,)9 ^! situations & 9 ! free play ( neighborhood *ildr51 !re is always ! confus+1 enlight5+1 & frequ5tly di/ort$ in=mation ga9$ ?r\gh discov]+ y\r relation%ip ) bo? boys & girls4 ,exploration by *ildr5 into _! sexual simil>ities & diff]5ces1 a heal?y pursuit1 9 ! pa/ m ?an today (t5 ar\s$ p>5tal furor4 ,furor & diff]5t reactions f diff]5t involv$ p>5ts lead to fur!r *ild confusion & focus4 ,)9 *ildhood pe] relations !re are games1 play1 & s*oolwork t all[ ! *ild to come to "k p]sonally ! mean+s & feel+s ( compet+1 collaborat+1 fight+1 w9n+1 los+1 de/roy+1 build+1 aggression1 passivity1 con/riction1 fre$om1 & *oice4 ,!n !re is adolesc5ce ) all its mood9ess1 que/ions1 fe>s1 & exp]im5t+ relat$ to adult modes ( be+4 ,! moods are a my/]y & ! que/ions (t5 unansw]able or ! answ]s contradictory4 ,norman ,kiell 9 ,! ,univ]sal ,exp]i5ce ( ,adolesc5ce says t z adults we =get ! int5sity1 turmoil1 & concretes ( ?is p]iod & t p]haps we h to4#g ,yet1 x is n possible t ! in/ability & discom=t ( _s liv$ 9 adolesc5ce does n leave its +ra9$ trac+ z "p ( our et]nal pres5ts4 ,:5 ! focus ( our responsibility %ifts f play to "w1 dur+ ^! e>ly ye>s ( becom+1 dep5ds on our p>ticul> circum/ances & abilities4 ,= mo/ p]sons !re is a tipp+ ( ! balance betwe5 ^!4 ,hopefully nei!r extreme is ! ma/]4 ,=tunately1 9 _m in/ances1 z ! *ild's "w z be5 to play2 ! adult's "w _w1 8 _w ( responsibility is liv$1 exp]i5c$ by him1 to an ext5t z play--x gives satisfaction & pleasure4 #dd ,"s adults select ano!r & are *os5 by ?is o!r = a %>+ ( _! worlds4 ,"s g x alone4 ,"s procreate new be+s2 "s create 9 o!r ways2 "s give-take & exi/2 "s j lean4 ,^! la/ appe> to be1 & yet to n be1 all-at-once4 ,,man ,,becomes ,,ev] ,,m ,bub] p]ceives man becom+ m ?r\gh 8 human capacity to relate to o!r be+ 9 all =ms f ! mat]iali/ic to ! spiritual 9 ,i-,?\1 ,i-,x1 & ,we ways4#h ,ge/ation1 ) ! clos5ess ( "m & *ild1 has left man ) an +ra9$ kn[+ ( ! exp]i5ce ( clos5ess4 ,?us1 ?r\gh\t man's life 8 condition ( exi/5ce is affect$ by & desires relation%ip ) & clos5ess to o!r be+4 ,! clos5ess ( ! conditions ( ge/ation is nev] aga9 possible1 h5ce exi/5tial lonel9ess4 ,yet because ( ?is pr5atal exp]i5ce ,bub] conceives ( man z born ) a ,?\--ano!r--be=e he is consci\s ( himself1 8 ,i4 ,) gr[+ consci\sness he sorts out 8 ,i f 8 ,?\4 ,y c see ! late infant do+1 act+ ?r\gh1 ?is sep>ation4 ,dur+ ?is gr[+ phase1 (t5 to ! c>e-tak+ adult's fru/ration1 he repeat$ly1 int5sely1 & excit$ly ?r[s 8 toys or bottle out ( ! crib1 c>riage1 or playp54 ,(t5 he runs away f 8 ,?\1 8 p>5tal security s\rce1 to a safe di/ance ) int5se aw>5ess ( :at he is do+4 ,:ile int]naliz+ ^! & subsequ5t ,?\s z "p ( 8 ,i1 8 kn[+ place1 p>adoxically1 he sorts out :o he is1 & :o & :at is o!r ?an himself4 ,s ) ev] m relation%ip1 ev] m exp]i5ce1 he becomes ev] m ! p]son he has ! human capacity to be4 ,he becomes m ?r\gh 8 relations ) o!rs1 nev] ! same z ^! o!rs1 ?\gh he does int]nalize ^! o!rs z "p ( himself4 ,bub] describes ,i-,?\ relat+1 man m]g+ ) o!rness1 z always necessitat+ an ,i1 a man1 capable ( recogniz+ self z at a di/ance1 ap>t f o!rness4 ,!re=e1 8 ,i-,?\ relat+1 a m]g+ ( be+s1 is n l ! psy*ological def5se1 unconsci\s id5tification4 ,bub]'s ,i-,?\ relat+ emphasizes aw>5ess ( ea* be+'s uniqu5ess )\t a sup]impos+1 or a decid+ ab\t ! o!r )\t a kn[+4 ,su* relat+ is a turn+ to ! o!r1 (f]+ ! o!r au!ntic pres5ce1 all[+ ! au!ntic pres5ce ( ! o!r ) ! self1 & ma9ta9+ "o's capacity to "q4 ,x is n !n id5tification or an idealization ( ! o!r4 ,)9 ?is my/]i\s happ5+ ( ,i-,?\ relat+1 :5 bo? p>ticipants are human1 ea* becomes m4 ,bub] ref]s to ! ev5t ( ?is m]g+ ( o!rness1 ( man ) o!r be+1 z ! betwe54 ,humani/ic nurs+ is conc]n$ ) ! betwe5 ( nurses & _! o!rs4 ,_! o!rs1 ! #de microcosms ( _! communities1 w\ld be pati5ts1 pati5ts' families1 pr(essional colleagues1 & o!r heal? s]vice p]sonnel4 ,bub] describes man's ability to come to "k & relate 9 ,i-,x z man look+ back1 reflect+ on 8 pa/ ,i-,?\ relations4 ,look+ back ^! ,i-,?\ relations are view$ z an object to be kn[n1 z ,x4 ,i-,x relat+ all[s man to int]pret1 categorize1 & accrue sci5tific k4 ,f9ally man relates ) o!rs z ,we4 ,?is p]mits ! ph5om5on ( community & ( adult unique contribution4 ,s man becomes ?r\gh relat+ ) family1 o!rs1 & community1 l ,hesse's onion or a be+ :o actively moves t[>d ev] m integum5ts1 qualities1 ?reads1 & complexity4#i ,_m unique contradictory type be+s1 !n1 h influ5c$ ! becom+ ( ea* individual human p]son4 ,9 a s5se ea* unique p]son might be view$ z a community ( ! be+s ) :om he has mean+fully relat$ 9 /ruggle &_/or complem5t>9ess4 ,9 fact ,bub] talks ( ?9k+ man z a dialogue ( int]naliz$ ,?\s4 ,,community3 ,,nurs+ ,if ea* man c be lik5$ to a community ( 8 int]naliz$ ,?\s1 logically ?9k ( ! outcome ( _m m5 /ruggl+ toge!r suppos$ly = a common purpose4 ,s9ce "t began1 man 9 community has be5 exp]i5c$ by man z *aotic4 ,?us ,plato wrote ,! ,republic4#aj ,?is pres5tation depict$ an impossible s*eme = develop+ an ideal community4 ,z a classic1 ,! ,republic cont9ues to be a ?\ght provok+ !sis4 ,its antiquity makes "o realize t ?is desire to control1 our cont9u$ conc]n ) g5etic plann+1 is a "p ( ! v nature ( man4 ,& yet1 consid]+ man's ev] exi/+ recognition ( ! *aos ( community h[ naive we (t5 behave1 = example1 enrag$ at exp]i5c+ ano!r communication break4 ,plato envision$ regulat+ & controll+ almo/ e dim5sion ( ! individual's exi/5ce 9 accordance ) 8 p>ticul> pot5tial = developm5t to fulfill ! ne$s ( 8 ideally conceptualiz$ community4 ,today ,he9le91 a sci5ce fiction noveli/1 /ill writes ( bre$+ = longevity 9 man1 z we bre$ animal /ock = ! greate/ am\nt ( meat & pr(it4#aa ,giv+ ,plato 8 due1 he recogniz$ at ! end ( 8 book conc]n & d\bt z to :e!r m5 s c>efully mat$ & re>$ w\ld fulfill _! designat$ responsibilities4 ,he wond]$ if ?+s c\ld1 w\ld1 or w\ld n g 9 accordance ) 8 plan4 ,he !n logically indicat$ ! process & k9ds ( community det]iorations :i* c\ld ensue4 ,plato _h a concept ( an ideal community1 ( ideal types ( necess>y m51 & ( ideal male-female bre$+ relation%ips4 ,he view$ our pres5t-/yle family z "o t saps ! #df /r5g? ( community & does n support ?is concept4 ,he conceiv$ ( communal liv+ m l ! communal liv+ ( our pres5t-day communes4 ,h[ev]1 ,plato's communes w\ld h be5 regulat$ by ! plan z he conceiv$ x4 ,exi/5ce 9 ^! communes 0 to be pr$et]m9$ & v det]m9$4 ,nurs+1 ?\gh n g5]ally ! rul+ =ce ( ?is type ( plann+1 c]ta9ly is involv$ 9 control measures analog\s to ,plato's4 ,nurses d influ5ce :o gets ! hospital b$ & :o does n1 :o gets ! specializ$ treatm5t & equipm5t1 :o is dis*>g$ & :51 & :at goes into ! education & plann+ = po/-hospital heal? c>e4 ,also1 h[ d our biases influ5ce our tea*+ reg>d+ family8 ,innu5does are frequ5t 9 ! areas ( bir? control1 abortion1 & family size4 ,s nurses c make a diff]5ce reg>d+ community ?\ght1 purpose1 & action4 ,nietzs*e put =? a concept ( community ( a m indef9ite nature ?an ,plato's4#ab ,two major !mes dom9at$ ! nature ( community 9 8 conception3 7#a7 ! legitimate purpose ( community 0 ! total support ( its elite m5 & 7#b7 ! crit]ion = det]m9+ ! elite 0 to be bas$ on ^? :o select$ _! own values ) a w to say1 yes to life4 ,he ref]r$ to 8 elite z sup]m54 ,he que/ion$ ! realization ( su* a community because ( ! prepond]ance ( con=m+ nonque/ion+ m$iocre m54 ,?is complac5t majority fe>ful ( ! diff]5t or /range w\ld subdue ! possibility ( 8 sup]m54 ,nietzs*e did n seem to tru/ man2 he spoke ( him z human1 all too human4 ,unlike ,plato1 ,nietzs*e view$ good & evil z aris+ f a common s\rce4 ,man 9 8 humanness1 ,nietzs*e felt1 d5i$ 8 animal h]itage & animal qualities4 ,recognition ( ^!1 ( "o's ,dionysian nature1 z a s\rce ( bo? good & evil 0 necess>y = becom+ sup]man4 ,to me x is wondr\s to pond] my own consci\s purposefulness & unconsci\s purposelessness1 my quality ( =ce z a memb] ( ! nurs+ & heal? communities1 view$ ?r\gh ! deep ext5sive conceptualiz$ ?\ght ,nietzs*e bequea!d4 ,i (fh& consid] our communities z egalit>ian1 "p ( a l>g] egalit>ian society4 ,are !y really8 ,does ! citiz5 affect ! quality ( organizational /ructure 9 accordance ) 8 exi/5tial ne$s :ile 9 our commonplace--! heal?-nurs+ _w8 ,^: values set & direct on ?is /age ( life8 ,d ,i1 nurse1 se>* out ! values on :i* ,i want to base my nurs+ practice8 ,d ,i look = direction & values f o!rs8 ,did ,i take on values dur+ my initial nurs+ exp]i5ce--values nev] to be reexam9$8 ,)9 ! nurs+ community are !re nurses eag]ly noncomplac5t & desir\s ( look+ at1 ( %>+ _! explorations1 & ( det]m9+ & *oos+ ! values t !y want to und]lie _! nurs+ practice8 #dg ,w\ld sup]nurses be all[$ to be ! m$iocre _m8 ,:o w\ld det]m9e ! elite ( ! nurs+ community8 ,c\ld sup]nurses survive )\t approval ( _! be+ diff]5t8 ,w\ld !y be /r5g!n$ by ! fruits ( suff]+ 9 _! /ruggle )9 ! pr(ession8 ,w\ld ^! fruits ( suff]+ contribute con/ructively to ! /r5g!n+ ( ! nurs+ community8 ,bub]1 l ,nietzs*e1 sees man-9-community ) possibilities = evolv+1 be+1 & becom+ m4 ,bub] tru/s ea* man z a unique pot5tial involv$ 9 an ongo+ /ruggle ) 8 fell[s direct$ t[>d a c5t]4#ac ,8 non/atic1 nonselect$ community :]e m5 become 9 & ?r\gh ongo+ /ruggle ) ea* o!r expresses ! reality ( my nurs+ _w4 ,:o w\ld expect a community )\t /ruggle if !y accept$ ea* man z 8 hi/ory inclusive ( antec$5ts t g back to beg9n+s ( man's consci\sness & ( anticipations t g =? into ?is man's notions ( et]nity8 ,consid]+ ! complexity ( ea* man's be+ & becom+1 x is surpris+ t we come to und]/& ea* o!r 9 community at all1 r ?an ! rev]se4 ,h[ c we hope = a su/a9$ !r5ess1 pres5ces ( nurses ) o!r man 7pati5ts1 pati5ts' families1 pr(essional colleagues1 & o!r heal? s]vice p]sonnel7 z ,we 9 an ongo+ /ruggle ( community consid]+ _! multitud9\s diff]5ces8 ,norman ,c\s9s1 9 ,:o ,speaks = ,man1 comm5ts on man's inability to respond affirmatively to ^? he exp]i5ces z diff]5t f himself4#ad ,= ! human community to progress he sugge/s f$]ation4 ,a unity 9 :i* diff]5ces w\ld be valu$ z promot+ ?\ght1 human evolvem5t1 & community advancem5t4 ,c\s9s gives examples ( man's inhumanity to man bas$ on diff]5ces view$ z nonvalues4 ,! preval5ce ( ?is latt] view ( diff]5ces is v evid5t 9 our commonplace heal?-nurs+ _w4 ,c nurses & o!r heal? c>e ma9ta9]s look at ! ways !y respond to diff]5ces consci\sly1 & c !y delib]ately *oose to be op5 to respond+ to !m z valuable8 ,c we conceive ( !re be+ value 9 t :i* we see z n "r1 untrue1 wrong8 ,! ability to be !re1 to /ay involv$ 9 community ) my fell[s1 is a problem wor?y ( conc]n to me z a nurse4 ,h[ d ,i /ay 9 an exi/5tial way ) my contempor>ies1 pati5ts1 pati5ts' families :5 _! values 9 reality are s diff]5t f my own8 ,h[ d ,i g beyond a negative judgm5tal to a priz+ attitude t w\ld op5 ! possibility ( see+ /r5g?s 9 o!rs' views p]haps lo/1 disc>d$1 or nev] previ\sly exi/5t 9 my own8 ,nonsup]impos+ ( my own value sy/em ?r\gh recogniz+ & bracket+ x is a difficult pr(essional goal4 ,& yet1 a goal t if c\pl$ ) ! c\rage = p]sonal exi/5ce1 c\ld su/a9 me 9 ! heal?-nurs+ community4 #dh ,s = a heal?-nurs+ community to truly be actualiz$ ea* nurse w\ld prep>e to be all x 0 possible = h] to be z a nurse4 ,!n1 ?r\gh exploration !re w\ld be a recognition ( ! reality ( ! exi/5t community4 ,ov] "t a m]g] ( ! values ( ! nurse & ( ! exi/+ community w\ld be reflect$ z mor5ess 9 ea*4 ,! nurse w\ld be m ?r\gh h] relation ) ! community2 ! community w\ld be m ?r\gh its relation ) ! nurse4 ,ea* w\ld make an important diff]5ce 9 ! o!r4 ,! macrocosm1 ! community1 w\ld reflect ! nurse's quality ( pres5ce4 ,! microcosm1 ! nurse1 w\ld reflect ! pres5ce ( ! community ) h]4 ,ea* unique man becomes 9 community ?r\gh communication ) o!r uniquely diff]5t m54 ,,footnotes3 #a ,plato1 ,! ,republic1 trans4 ,francis ,mac,donald ,corn=d 7,new ,york3 ,ox=d ,univ]sity ,press1 #aide74 #b ,wilfrid ,desan1 ,planet>y ,man 7,new ,york3 ,! ,macmillan ,company1 #aigb74 #c ,john ,h]sey1 ,a ,s+le ,pebble 7,new ,york3 ,alfr$ ,a4 ,knopf1 #aief71 p4 #ah4 #d ,h]mann ,hesse1 ,/epp5wolf 7,new ,york3 ,holt1 ,r9eh>t & ,w9/on1 #aiff71 p4 #fj4 #e ,gabriel ,m>cel1 ,homo ,viator 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 ,h>p] ,tor*books1 #aifb71 p4 #aba4 #f ,teilh>d de ,*>d91 ,! ,ph5om5on ( ,man 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 #aifa74 #g ,norman ,kiell1 ,! ,univ]sal ,exp]i5ce ( ,adolesc5ce 7,new ,york3 ,int]national ,univ]sities ,press1 #aifd71 pp4 #bb-dd4 #h ,m>t9 ,bub]1 ,i & ,?\1 #bnd ed41 trans4 ,ronald ,gregor ,smi? 7,new ,york3 ,*>les ,s*ribn]'s ,sons1 #aieh74 #i ,hesse1 ,/epp5wolf1 p4 #fj4 #aj ,plato1 ,! ,republic4 #aa ,rob]t ,a4 ,he9le91 ,"t ,en\gh = ,love 7,new ,york3 ,g4 ,p4 ,putnam's ,sons4 #aigc74 #ab ,fr$]i* ,nietzs*e1 ,beyond ,good & ,evil1 trans4 ,hel5 ,zimm]n1 9 ,! ,philosophy ( ,nietzs*e 7,new ,york3 ,r&om ,h\se1 #aibg7 & ,?us ,spoke ,z>a?u/ra4 trans4 ,?omas ,common1 9 ! ,philosophy ( ,nietzs*e 7,new ,york3 ,r&om ,h\se1 #aibg74 #ac ,m>t9 ,bub]1 ,betwe5 ,man & ,man1 trans4 ,ronald ,gregor ,smi? 7,bo/on3 ,beacon ,press1 #aiee74 #ad ,norman ,c\s9s1 ,:o ,speaks = ,man8 7,new ,york3 ,! ,macmillan ,company1 #aiec74 #di ,"p #b ,,me?odology--,a ,,process ,,( ,,be+ #ej #ea #e ,,t[>d ,a ,,responsible ,,free ,,rese>* ,,nurse ,,9 ,,! ,,heal? ,,ar5a ,,angul> ,,view ,rese>* is an inh]5t compon5t ( humani/ic nurs+4 ,:at condition ( humanness is necess>y 9 ! nurse = ! actualization ( nurs+'s rese>* pot5tial8 ,?is *apt] w attempt to %>e "s brood+ & mull+ on ?is problem4 ,nurses practice )9 ev]-mov+1 *ang+ sett+s :]e =mulat$ plans frequ5tly & sudd5ly g awry4 ,unexpect$ pati5t ne$s arise4 ,p[]ful o!rs make bo? reasonable & unreasonable dem&s4 ,dep5d$ on o!rs fail u due to human frailty or lack ( dep5dability4 ,! nurse's sett+1 h] rese>*able area1 is ! extreme opposite ( h] colleague's1 ! laboratory inve/igator's4 ,h] area is beyond rese>* control measures4 ,too1 x lacks ! quiet isolat$ atmosph]e conducive to contemplation & creative ?9k+ associat$ ) rese>*4 ,conv]sely1 x is ov]saturat$ ) ! /uff ( mean+ful exi/5ce4 ,x c /imulate que/ions to ! fr5zy ( immobilization4 ,! human nurse's sy/em c become ov]load$4 ,su* ov]load+ reflects ! humanness ( ! nurse2 l all man %e c envision possibilities beyond any human be+'s ability ( fulfillm5t4 ,nurses "k !re are ev5ts 9 _! commonplace worlds t scream = human int]pretation1 und]/&+1 & atte/ation4 ,! "q becomes h[4 ,?is h[ dep5ds on m ?an concretes & ev5ts 9 ! nurse's sett+4 ,?is h[ dep5ds on relevant ifs4 ,! mean+fulness ( ! nurs+ _w w be actualiz$ conceptually if ?is is support$ by in/itutional economic & adm9i/rative plann]s1 o!r nurses1 & intradiscipl9>y colleagues4 ,= k available & visible to nurses 9 ! heal? sett+ to be pres]v$1 conceptualiz$ = durability1 x ne$s to be valu$ by ! in/itutional heal? community4 ,/ill1 mo/ necess>y to its duration is ! appreciat+ ( ?is k by ! nurse1 h]self4 #eb ,,human ,,condition ,,( ,,be+3 ,,nurse ,,rese>*] ,initiation ( a ,nurse ,rese>*] ,! nurse /ud5t1 rec5tly arriv$ 9 h] exp]i5tial _w1 is aw$ ) ! ne$ to be cognizant ( multitud9\s factors4 ,at ?is initial introductory phase "o c\ld say h] be+ z a nurse is programm$ or impr9t$ )3 ,x is y\r responsibility to report & att5d all ! ?+s t influ5ce ! response & com=t ( ^? = :om y c>e4 ,?is programm+ supports & is support$ by any already exi/+ t5d5cies )9 ! nurse /ud5t t[>d unreali/ic1 p]fectioni/ic expectations ( self4 ,!n 9 rese>* c\rses1 usually positivi/ically ge>$1 h] programm+ jams4 ,h] sy/em is f$3 ,select out1 isolate1 focus d[n on a s+le "q1 limit y\r v>iables1 e/abli% a protocol ( op]ation1 control = reliability & validity1 tunnel y\r vision1 & safegu>d objectivity4 ,! jamm+ is ! result ( ! human nurse's capacity to see relation%ips betwe5 ! "p & ! :ole4 ,human intellig5ce1 z a condition ( humanness1 dem&s ?is relat+ ( "o ?+ to ano!r4 ,(t5 su* relat+ is intuitive1 human1 bas$ on mu* ?9k+ = purposes ( und]/&+ & solution4 ,yet1 (t5 x _c be sub/antiat$ fully & conceptualiz$ logically at specific times1 !re=e x is subjective4 ,to highlight ! obvi\s 9 ! above ,i attempt$ faceti\sness4 ,_m nurses acutely aw>e ( ! complexities1 contradictions1 & inconsi/5cies ( _! nurs+ worlds h /ruggl$ & us$ ! positivi/ic me?od 9 rese>* /udies4 ,h5ce1 !y h isolat$ a rese>*able "q1 /at$ _! basic assumptions1 hypo!siz$ outcomes1 select$ samples1 e/abli%$ exp]im5tal & control gr\ps1 =mulat$ me?odologies1 se>*$ out & utiliz$ appropriate f9d+s1 & h made recomm5dations4 ,usually ^! rese>* ef=ts h advanc$ sci5tific kn[+ & k ( exi/5ts )9 ! heal?-nurs+ situation4 ,& yet1 (t5 ^! ef=ts h disc\rag$ ! rese>* wond]m5t ( ! nurse int]e/$ 9 ! nature & mean+ ( ! nurs+ act & h[ ! ev5t ( nurs+ is liv$1 exp]i5c$1 & respond$ to by ! p>ticipants4 ,^! positivi/ic rese>* me?ods h made available answ]s4 ,/ill1 !y h n answ]$ ! que/ions mo/ relevant to nurs+ practice & to nurses4 ,^! nurses 7 c]ta9 t man g5]ally c\ld n be prescrib$ = int]p]sonally2 he 0 n pr$ictable1 n yet an automaton4 ,fac$ ) alt]natives m5 (t5 surpris$4 ,consequ5tly ^! positivi/ic approa*es to /udy+ human ev5ts1 unless "o =c$ "o's data cr[b> /yle1 always t]m9at$ ) a k9d ( miscellane\s category4 ,man's undet]m9$ness makes him all-at-once fru/rat+ to /udy1 impossible to di/9ctly categorize1 & excit+ly my/]i\s & ! mo/ wor?y focus ( nurs+ rese>*4 #ec ,a ,nurse ,rese>*]'s ,pres5ce 9 ! ,nurs+-,heal? ,sett+ ,! exi/5t1 a nurse label$ rese>*]1 9 ! heal? _w br+s a disquiet t has to be und]/ood & endur$4 ,necessities = sci5tific /udy 9 ! nurse's _w ( ! nurs+ ev5t or situation are wond]m5t1 conc]n1 & responsibility4 ,op5 adh]5ce to su* qualities frequ5tly />tles o!rs into speculat+ ab\t ! rese>*]4 ,%e1 h]self1 becomes an oddity4 ,p]sons pond] ! possibility ( h] /udy's hav+ a hidd5 ag5da t involves !m4 ,ov] "t ^! p]sons g5]ally accept or reject ! se>*]'s ef=ts4 ,if reject$ ! se>*] is (t5 label$ a wor?less nosey tr\blemak]4 ,subtly x is convey$ among ^? involv$ t %e is to be int]f]$ ) (t5 by me*anisms ( ignor+ or =gett+ or righte\sly sett+ pati5t's ne$s above con=m+ to ! /udy plan4 ,= in/ance1 h[ (t5 h rese>* nurses met ) responses f /aff at ! "t ( _! plann$ arrival on a unit to "w ) a pati5t1 ,oh1 he seem$ to ne$ activity1 he 0 re/less1 ,i =got y 7 com+1 ,i s5t him to ! gym1 or ,oh1 7surprise7 did y want to give ! pati5t 8 morn+ c>e8 ,t 0 done a :ile ago2 we give c>e e>ly4 ,if accept$ ! se>*] is (t5 label$ an int]e/$1 int]e/+ p]son ^: ef=ts are to be fo/]$ because h] f9d+s w enhance situation nurs+4 ,! di/9ction frequ5tly is bas$ 9 /affs' responses to ! se>*]'s p]sonality m ?an 9 ! value ( ! issues ( ! inve/igation4 ,significant to negative /aff responses t[>d a nurse se>*] is ! necessity = h] to )hold in=mation4 ,?is )hold+ may be necess>y to protect ! /udy results4 ,= example1 x is necess>y :5 a special type ( pati5t c>e is be+ te/$ aga9/ usual pati5t c>e or :5 confid5tiality is an issue4 ,confid5tiality requires a nurse1 se>*] or n1 to c5sor communications :5 p]sonal k ( individuals make !m id5tifiable4 ,! ne$ = confid5tiality c be det]m9$ by ! nurse's consid]+ ! k ga9$ 9 view ( :e!r x w or w n influ5ce ! ov]-all treatm5t plan4 ,if x w affect ! plan1 !re is reason to reveal x2 !n x mu/ be relat$ 9 a mann] t insures ! pati5t's cont9u$ protection &1 if possible1 ) 8 p]mission4 ,if ov]-all treatm5t is n influ5c$1 "o mu/ c5sor ! k ga9$ to *eck "o's own free communications4 ,w\ld ! pati5t want x reveal$2 is x k ( a quality t br+s ridicule1 is look$ at negatively or nonacceptably 9 our p>ticul> culture g5]ally8 ,is x ( a s5sitive nature & !re=e k we d n j reveal to anyone8 ,o!r pati5t c>e giv]s may s5se ?is )hold+ by ! nurse se>*]4 ,!y may reasonably accept x or unreasonably n accept x4 ,! rese>*] may or may n be aw>e ( or conc]n h]self ) h] colleagues' s5sitivity4 ,?is w\ld dep5d on ! se>*]'s usual modus op]&i & on ! importance %e associates ) h] colleagues' sway 9 h] inve/igation4 ,! latt] c be mu* great] ?an is obvi\s4 #ed ,confid5tiality--,description3 ,humani/ic ,nurs+ ,humani/ic nurs+ practice !ory proposes ph5om5ology1 a descriptive approa* to p>ticipants 9 ! nurs+ situation z a me?od = /udy+1 int]pret+1 & atte/+ ! nature & mean+ ( ! liv$ ev5ts4 ,humane nurs+ is n humani/ic nurs+ )9 ?is !ory unless t :i* becomes visible to ! nurse 9 ! nurs+ situation is %>$ 9 a durable =m ) colleagues4 ,confid5tiality1 !n1 becomes an important issue 9 humani/ic nurs+4 ,no sci5tific me?odology ( rese>* is affix$ ) ought or %\ld virtues reg>d+ k ga9$4 ,9 nurs+1 a pr(essional help+ realm1 a practition] or rese>*] is w$ to ought & %\ld virtues4 ,! k ga9$ ought to be disp]s$ to colleagues = _! increas$ und]/&+4 ,x %\ld enhance ! con/ructive =ce ( ! pr(ession4 ,to s enhance x mu/ be communicat$ 9 a mann] t all[s und]/&+ :ile protect+ di/9ct individuals & gr\ps4 ,words & conceptualiz$ ideas are ! tools ( ph5om5ology4 ,protection ( di/9ct p]sons & mean+ful communication c be augm5t$ ?r\gh ! utilization ( ab/ractions1 metaphors1 analogies1 & p>ables4 ,s humani/ic nurses1 z practition]s & rese>*]s1 are inh]5tly responsible = _! mann] ( be+1 respond+1 & consci\sly sculptur+ k into words4 ,responsibility ,:5 ,%>+3 ,und]/&+ ( ,man ,h[ does a nurse se>*]1 :o wond]s1 notices1 relates1 & comes to "k1 become humanly responsible8 ,nietzs*e's philosophical works w\ld direct a nurse se>*] to look at h] values4 ,! values kn[n ?r\gh look+ at :at det]m9es h] actual behavior consid]+ h[ ^! values correlate ) h] privilege ( call+ h]self1 nurse4 ,empa?y1 kn[+ h[ ano!r exp]i5ces1 :5 c\pl$ ) ! title1 nurse1 dictates a p]=mance t encompasses no h>m to o!rs & hopefully b5efits !m4 ,despite ! human excitem5t ( discov]y1 discipl9$ ef=t & rigor\s evaluation ent] into prep>+ k ( man = disp]sal4 ,revelation %\ld n m]ely %ock2 r1 pr(essionally we use %ock to awak5 surprise1 a fundam5tal1 = human con/ructive movem5t t[>d mor5ess4 ,! =m]1 m]e %ock1 ne$s to be gu>d$ aga9/4 ,! latt]1 %ock to awak5 surprise ne$s to be exact+ly1 uncompromis+ly att5d$ = ! communicability ( k & ! actualization ( ! ph5om5on1 nurs+4 ,9 consid]+ confid5tiality & ! quality ( k ( man available to me1 z nurse1 my consci\sness is confront$ ) my =m] m5tor1 & int]naliz$ ,?\1 ,paul ,v4 ,lemkau1 ,m4,d41 psy*iatri/4 ,he #ee emphasiz$ repeat$ly t ! pr(essional p]son1 z he increas+ly und]/&s man1 %\ld take on increas+ responsibility to man1 "o's self & "o's o!rs4 ,bub] says1 ,z we become free 444 our responsibility mu/ become p]sonal & solit>y4#a ,"o c ext5d ?is & say t to help o!rs /ruggle = fre$om "o mu/ realize t o!rs mu/ responsibly decide & t al?\gh !y d ?is ?r\gh & 9 ! au!ntic pres5ce ( a nurse1 ^! o!rs are alone 9 decid+4 ,& nurses 9 decid+ :at & h[ to convey ( _! kn[+ mu/ decide freely1 responsibly1 p]sonally1 & alone4 ,! nurse 9 decid+ :at & h[ to convey1 consid]+ ! pr(essional necessities ( bo? confid5tiality & disp]sion ( k1 c be guid$ by a conception ( ! nature ( man-9-8-_w4 ,man 9 humani/ic nurs+ practice !ory is view$ z a conflictual1 contradictory1 inconsi/5t dilemma4 ,"o horn ( ! dilemma is ideal spirituality t wre/les aga9/ ! o!r horn1 protective mat]iali/ic animalism4 ,?is all-at-once /ruggl+1 /ret*$1 mix$ nature ( man ne$s recognition4 ,recognition ( man's nature1 z su*1 supports great] self-acceptance4 ,self-acceptance & ?is view ( man-9-8-_w1 l a magnify+ glass1 unmasks = a nurse h] possible responses1 motivations1 & alt]natives4 ,cognizant ( ^!1 %e c responsibly select :at k to disp]se to protect individuals & to cont9ually %ape & conceptually actualize ! nurs+ pr(ession4 ,utiliz+ ?is magnify+ glass on self 9 humani/ic nurs+ practice !ory to let "o's exi/+ mix$1 v>i$1 /ruggl+ responses1 motives1 & alt]natives into self-aw>5ess is an axiom ref]r$ to z au!nticity ) self4 ,acceptance ( ! o!rs' human nature or human condition ( be+ is usually easi] ?an acceptance ( our own4 ,usually ea* man is 8 own sev]e/ judge4 ,lilyan ,weym\?1 ,r4,n41 cl9ical speciali/1 my pa/ tea*] & pres5t fri5d1 9 sympa!tic mom5ts1 speak+ ( suff]+ o!rs1 (t5 says1 ! poor devils4 ,once1 feel+ anxi\s & annoy$1 ,i respond$1 we are all poor devils4 ,%e retort$1 ,i am glad y recognize t4 ,/opp$ %ort1 ,i f\nd myself cont9u+ to pond] ! phrase1 poor devils4 ,man's dilemma is t he is nei!r sa9t nor devil4 ,he is a poor sa9t & a poor devil1 & by 8 nature he is pu%$ & pull$ 9 bo? directions1 all-at-once4 ,our human exi/5ce 9 ! _w calls = an endur+ ) our virtues & vices1 our en]gy & our laz9ess1 our altruism & our selfi%ness1 9 a ^w ) our humanness4 ,:at mean+ does ?is conception ( man h = humani/ic nurs+ practice !ory8 ,?is !ory necessitates a nurse :o accepts & believes 9 ! *aos ( exi/5ce z liv$ & exp]i5c$ by ea* man despite ! %ad[s he ca/s int]pret$ z poise1 control1 ord]1 & joy4 ,label$ m5tal pati5ts 9 !rapeutic situation1 9 ! sun beyond ! %ad[s1 express h[ !y set !mselves ap>t f ! re/ ( ! community #ef ( man4 ,!y express h[ !y exp]i5ce !mselves4 ,!y view !mselves z ! wor/1 ! noble/1 ! unhappie/1 ! mo/ malign$1 & ! mo/ afraid4 ,x comes out z if ^! sup]lative di/9ctions are _! only claims to fame4 ,9 my humanness ,i appreciate ! awesome dreads !y live4 ,!y ne$ to "k t !y exi/ 9 _! unique di/9ctness4 ,& yet1 ! sep>ation & lonel9ess ) :i* !y adorn !mselves & :i* pr(essionally we h fo/]$ ) fe> eng5d]+ diagno/ic labels seem a heavi] ?an necess>y burd54 ,9 ! light ( exi/5tial lonel9ess1 a "p ( ea* human exi/5ce1 (t5 ,i invite !m to see !mselves z n s unlike o!r m5 & z suff]+ ! turmoil ( exi/5ce z "p ( ! human community1 su* z x is4 ,"o usually c note _! surprise & disbelief ( my view4 ,!n1 mom5t>ily at lea/1 t5sion seems to visibly fall f _! faces & =ms4 ,:5 ?is idea ( !m is he>d by !m1 its effect corresponds to h[ ,i exp]i5c$ ! te*nique 9 s5sitivity gr\p ( lit]ally be+ all[$ to dance into :at felt l ! circle ( man1 our gr\p4 ,to he> opportunities = humani/ic nurs+ acceptance & support nurses1 too1 ne$ to "q _! self-nurse-image )9 ! nurs+ & heal? community4 ,d !y "k t !y make & h real pot5tial = mak+ a diff]5ce1 an important diff]5ce8 ,d !y accept !mselves z nurse8 ,to me1 a nurse is a be+1 becom+ ?r\gh int]subjectively call+ & respond+ 9 h] suff]+1 joy\s1 /ruggl+1 *aotic humanness1 always try+ beyond ! possible :ile nev] completely free f ignoble p]sonal human wants4 ,&1 ?r\gh h] pres5ce x is possible = o!r p]sons to be all !y c be 9 crisis situations ( _! worlds4 ,= ! nurse to be humani/ic x is necess>y = h] to live h] human condition-9-h]-nurs+-_w pr\dly ) all its vuln]ability & all its wond]s4 ,z man1 ! nurse c recall & reflect on h] ,i1 on h] pa/ ,i-,o!r exp]i5ces1 & %e c come to "k & accept m & m ( h]self1 z %e becomes m4 ,9 humani/ically recall+ & reflect+ a nurse w und]/& & respond empa!tically & sympa!tically to bo? h] own humanness & ! o!r's4 ,%e w recognize bo? self & o!r z poor devil & poor sa9t1 all-at-once4 ,on ! o!r h&1 if a nurse d5ies h] own /ruggl+ humanness1 %e self-righte\sly w be apt to accuse ei!r self or h] o!r4 ,?is way ( be+ d5ies1 suppresses1 & represses "o's own & ! o!r's ability to be1 to be z mu* z pot5tially possible4 ,und]/&+ man ?r\gh ?is conception ( him is important to ! possibility ( augm5t+ ! implem5tation ( humani/ic nurs+ practice !ory4 ,au!nticity ,) ,! ,self3 ,= ,actualization ( ,nurs+'s ,pot5tial ,huss]l1 ! fa!r ( ph5om5ology1 sugge/$ ! /udy ( our liv$ worlds1 our exp]i5ce1 a return to ! /udy ( ! ?+ itself4 ,look+ at ! liv$ worlds ( nurses "o is confront$ ) conflicts & multiple #eg values4 ,9 _! nurs+ worlds nurses (t5 risk !mselves 9 _! commitm5t to good = _! pati5ts4 ,!y come to "k aspects ( _! own & o!rs' unique natures4 ,^! are (t5 diff]5t f & frequ5tly 9 conflict ) g5]ally accept$ cultural values &_/or in/itutional policies & rules4 ,if confid5tiality is an issue1 does ?is dictate a suppression ( nurses' complete kn[+8 ,or does ?is call = a recognition ( z complete a kn[+ z possible foll[$ by responsible selection & revelation ( t kn[+ :i* w advance k & und]/&+ ( man8 ,und]/&+ ( man c *ange a p]son's way ( be+ ) o!r man & 8 way ( exi/+ 9 & respond+ to 8 _w4 ,i sugge/ ! latt]1 z complete kn[+ z possible foll[$ by responsible selection & revelation1 ) occasional risk tak+ to deep5 ! level ( accept$ cultural k ( man4 ,always1 ! nurse w\ld protect an individual o!r man4 ,?is disp]sion ( k1 !n1 requires n only responsible be+ 9 ! nurs+ situation b also mull+1 pond]+1 assess+1 & judg+ prior to disclosure4 ,z complete a kn[+ z possible1 9 humani/ic nurs+ ref]s to its axiom1 au!nticity ) ! self4 ,:5 ,i1 nurse1 respond 9 ! ar5a ( my liv$ nurs+ _w1 ,i respond to a p>ticul> p]son 9 ?is "h & n[ ) all my backgr\nd & all my anticipation ( ! future4 ,by respond1 ,i d n mean to indicate t ,i ov]tly delib]ately communicate or v]balize my total response4 ,r ,i mean t ,i /rive = aw>5ess ( my total response )9 myself to a p>ticul> p]son 9 a p>ticul> "h & n[ view$ ?r\gh my p>ticul> pa/ & anticipat$ future4 ,x is a /ruggle to grasp h[ ,i p]ceive & respond )9 all my capacity ( human be+ness4 ,to atta9 ! highe/ possible level ( au!nticity ) ! self requires lat] recollection ( ongo+ p]ceptions ( ! o!r & reciprocal responses1 select$ communications1 & actions by ! self4 ,^! recollections n[ become raw data available = analyz+1 que/ion+1 relat+1 syn!siz+1 hypo!tically consid]+1 & ongo+ correct+4 ,sometimes %>+ su* recollections ) a tru/wor?y confidant 7cl9ical speciali/1 consultant7 = purposes ( reality te/+ is helpful4 ,(t5 ?is c broad5 ! pr(essional mean+ base ,i attribute to bo? my p]ceptions & my responses4 ,on return to ! ar5a ( my nurs+ _w ,i !n v]ify my p]ceptions4 ,i c let ! o!r "k h[ ,i p]ceiv$ 8 actions & be op5 to 8 fur!r expression ( h[ ?is _w is = him4 ,9 pr(essional nurs+ ?is k9d ( exp]i5c+1 se>*+1 validat+1 utiliz+ ( "o's human pot5tial capacity mu/ be bas$ 9 ! ideals on :i* nurs+ re/s4 ,prim>ily = me1 ,i see myself1 nurse1 z com=t] or be+ nurse 9 su* a way t my o!r is help$ to be all t he c humanly be 9 ?is p>ticul> "h & n[ consid]+ 8 unique pot5tial4 ,s1 be+ au!ntic ) ! self1 is n an act+ out ( a non?\ght ?r\gh response or m]ely a do+ ( :at "o feels l do+4 ,r x is ! v opposite ( ?is4 ,x is a ?\ght ?r\gh responsible *oos+ ( ov]t response bas$ 9 k & on nurs+ values4 ,x mu/ correspond positively ) "o's belief t se>*+ & %>+ 9 "o's nurs+ _w w promote bo? ! nurs$ & ! nurse to be m4 ,if x is m]ely a #eh peek+ 9 on1 an exploitation ( ! o!r1 = selfi% le>n+ purposes1 x desecrates ! v concept ( nurs+4 ,"o has ! broad human pot5tial ( feel+ l do+ _m ?+s1 all-at-once1 t ext5d into all k9ds ( liv+4 ,& ?is is true 91 z well z outside1 a nurse _w4 ,9 recollect+ & reflect+ on p]ceptions & responses 9 all ^! extremes "o becomes fre] to select f )9 "o's self ! values to be *os51 actualiz$1 & pot5tiat$ 9 "o's nurs+ practice4 ,au!nticity ) ! self calls =? confrontation ( ! self ) "o's motivations & alt]natives4 ,?is p]mits a purposeful selection & an aw>e actualiz$ ov]t response bas$ on "o's nurs+ value crit]ia artfully tailor$ to a p>ticul> situation4 ,i consid] ea* nurse a sci5tific-arti/3 classical1 mod]n1 primitive1 cubic1 or int]pretive4 ,my inf]5ce "h is t we express artfully 9 accordance ) our uniqu5ess4 ,_m nurses giv5 ! same data w\ld accompli% ) ! same or a simil> degree ( adequacy ?r\gh use ( _! p>ticul> di/9ct selves4 ,!re=e1 ?\gh ! function call$ = might be ! same1 ea* nurse w\ld approa* ! function & ! pati5t diff]5tly4 ,h[ "o actualizes ! result ( ?9k+1 & be+ au!ntic ) "o's self recalls :at ,jung said ab\t art4 ,art is a k9d ( innate drive t seizes a human be+ & makes him its in/rum5t4 ,! arti/ is n a p]son end[$ ) free w t seeks 8 own ends1 b "o :o all[s art to realize its purpose ?r\gh him4 ,z a human be+ he may h moods & a w & p]sonal aims1 b z an arti/ he is man 9 a high] s5se--he is collective man--"o :o c>ries & %apes ! unconsci\s1 psy*ic life ( mank9d4#b ,?r\gh ! ye>s1 ov] & ov]1 ,i h met nurses s driv51 motivat$1 & expressive 9 _! nurs+ worlds4 ,i call$ ?is section au!nticity ) ! self3 = actualization ( nurs+'s pot5tial4 ,9 x ,i h be5 try+ to say1 ! m ( ourselves we are able to aw>ely include1 ! m ( ! o!r we c be op5 to & )4 ,a capacity = pres5ce ) o!rs all[s u to %>e ourselves4 ,?r\gh ?is %>+ o!rs become m4 ,!y are able to int]nalize u z ,?\4 ,?is happ5+ occurs 9 ! rev]se1 too1 & we become m4 ,9 a nurs+ situation ! quality ( be+ au!ntic ) ! self is to be /riv5 =4 ,x is a tak+ advantage ( & appreciat+ ( our human ability & _s4 ,x fo/]s our pursuit ( inquiry1 improves our c>+ = o!rs1 ! contribut+ ( our unique kn[+1 & x all[s u to %ape ev] fur!r a sci5tific-arti/ic pr(ession ( nurs+4 ,au!nticity ,) ! ,self3 ,pot5tiat$ 9 ,liv$ ,exp]i5ce ,?is example is (f]$ to support ! claims = au!nticity ) ! self made 9 ! la/ p>agraph ( ! prior section4 #ei ,z cl9ical sup]visor & !sis advisor to a "y graduate nurs+ /ud5t 9 h] tw5ties ! b5efits ( au!nticity ) ! self 7 aga9 br\ght home to me4 ,%e 0 tap+ h] !rapy sessions ) two pati5ts4 ,^! tap$ mat]ials 7 to become h] !sis data4 ,"o ( h] pati5ts 0 n mu* y\ng] ?an h]self4 ,! o!r 0 a divorc$ woman 9 h] =ties1 ar\nd my age4 ,?is "y graduate nurs+ /ud5t 0 receiv+ cl9ical nurs+ sup]vision z a necessity 9 h] p>ticul> situation n by p]sonal *oice or aw>5ess ( ne$4 ,f ! onset ( h] cl9ical sup]vision ) me ,i 0 aw>e t x ar\s$ h] feel+s ab\t dep5d5ce4 ,at h] age ?is _h mean+ s9ce %e 0 /ill /ruggl+ = indep5d5ce & int]dep5d5ce4 ,?is is a difficult "t4 ,h] response to me 0 respectful1 sweetly & unaw>ely ho/ile1 & %e made x app>5t t ,i 0 ano!r nurse au?ority to be appeas$1 manipulat$1 & outsm>t$4 ,?is behavior _h be5 successful = h] ) pa/ au?orities4 ,%e 0 bright & _h be5 able to complete intellectual reque/s & assignm5ts at ! la/ m9ute ) little ef=t4 ,dur+ ! initial phase ( our relation%ip aw>5ess ( h] /ruggle1 h] difficulties & h] assets1 all[$ me to ma9ta9 a supportive k9d ( be+ ) h]4 ,9 li/5+ to h] !rapy tapes ,i realiz$ t ano!r cl9ical sup]visory approa* 0 call$ =4 ,%e 0 def5d+ aga9/ relat+ to h] old] pati5t by behav+ t[>d h] z %e probably felt t[>d h] own "m1 & (t5 t[>d me4 ,also1 %e 0 defeat+ h] !rapeutic purpose ) h] y\ng] pati5t by view+ h] z if ! pati5t 7 h]self4 ,! old] suicidal1 depress$ pati5t 0 begg+ h] = an und]/&+ !rapeutic relation%ip4 ,%e ne$$ t]ribly to %>e h] suff]+4 ,?is woman did n ne$ a reject+ daught] work+ h>d to outwit h]4 ,! y\ng] pati5t ne$$ to %>e h] angry feel+s & s5se ( wor?lessness4 ,?r\gh ! tapes & ?r\gh weekly sessions ) ! graduate /ud5t1 ,i came to "k & und]/& h] exi/+ nurs+ situations4 ,at ?is "t nei!r ! /ud5t's ne$ to und]/& nor ! pati5ts' !rapeutic ne$s 7 be+ met4 ,! /ud5t1 too1 0 aw>e ( ?is 9 a sort ( suppress$ way4 ,indirectly1 9 respond+ to h] pati5ts1 kn[+ ,i w\ld be li/5+ to ! tape %e w\ld take a sweet swipe at me :i* plac$ ! responsibility ( all our ef=ts on my %\ld]s4 ,s if !re 7 no b5eficial outcomes1 obvi\sly ! blame c\ld be plac$4 ,dur+ ! initial phase ( my relation%ip ) ! graduate /ud5t & dur+ ! initial phases ( h] relation%ip ) h] pati5ts ,i came to und]/&4 ,i li/5$1 got into ! rhy?m ( ^! o!r spirits1 reflect$ on :at ,i _h come to "k1 & out ( ?is exp]i5ce assess$ & plann$4 ,lat]1 tak+ :at ,i _h come to "k1 z j h[ x 0 = all ( u1 ,i %>$ my kn[+ ) ! graduate /ud5t & budd+ fir/-rate !rapi/4 ,toge!r we explor$ ! implications ( ! above4 ,%e became inve/$1 involv$1 & excit$ ab\t h]self becom+ m4 ,we1 myself & ea* ( h] pati5ts1 become = h] m :om we ess5tially 74 ,mo/ important to h] & to me1 ?is graduate /ud5t grew 9 h] recognition & acceptance #fj ( h]self & h] ability z an adult nurse !rapi/4 ,! ?anks & mean+ful praise %e receiv$ f bo? h] pati5ts on t]m9ation ( !rapy made ?is app>5t4 ,x br\ght te>s to bo? h] eyes & m9e4 ,i felt joy 9 be+ ) a n[-respect$ colleague1 z oppos$ to ! e>li] be+ ) a p]son :o felt l an unask$ = awe /ruck def5sive daught]4 ,au!nticity ) myself1 & ?is graduate /ud5t's ability = au!nticity ) h]self all[$ ^! pati5ts' progress to occur4 ,x all[$ a reali/ic articulation 9 ?is /ud5t's ph5om5ological ma/]'s !sis ( h] liv$ nurse exp]i5ce4 ,f su* articulation w a !ory & sci5tific-arti/ic pr(ession ( nurs+ ev] mold1 fl[1 & =m4 ,,words ,,di/9ctly ,,human3 ,,limit+1 ,,yet ,,humaniz+ ,?r\gh words we humanly %>e ! mean+ to u ( our behavior1 exp]i5ce1 & pr(ession4 ,words atte/ to & endure4 ,?us1 a pr(essional hi/ory is possible1 accrues1 & has la/+ duration4 ,! /udy ( ! nurs+ ev5t itself & its conceptualization z propos$ 9 humani/ic nurs+ practice !ory is an application ( ph5om5ology4 ,articulation ( our p]spective1 exp]i5ce1 & ideas is ! human way ( ph5om5ology4 ,words are symbols to :i* man gives mean+ z an outgr[? ( 8 civilization )9 8 culture4 ,?r\gh words man attempts to communicatively describe 8 exp]i5c$ /ates ( be+-9-8-_w4 ,9 describ+1 ( necessity1 he relegates 8 uniquely kn[n exp]i5ces to already kn[n ^w symbols or categories4 ,?us1 ! conceptualiz$ exp]i5ce is limit$1 or less real ?an ! liv$ unique exp]i5ce4 ,s1 :ile words prev5t ! loss ( ! wisdom ( liv$ exp]i5ce1 !y are bo? a wond] ( humanness & a limitation ( humanness4 ,9 describ+ human exp]i5ces !re are ef=ts t c cut back ?is limitation4 ,if we truly wi% to convey mean+ to o!rs1 really want to %>e :at we h exp]i5c$ 9 liv+1 we w put =? ! ef=t4 ,to put =? su* ef=t requires go+ beyond ,i mu/ publi% to publi%4 ,x takes writ+1 /ructur+1 rewrit+1 & re/ructur+ (t5 to a po9t :]e = a p]iod "o comes to hate mat]ials he once held de>4 ,?r\gh ! ye>s _m ( u come to use words z a means ( pass+ a c\rse1 or we view words z a mode = self-explosion1 expression1 & self-und]/&+4 ,9 ^! ways !y hold mu* purpose4 ,! requirem5t t words convey unique exp]i5ces ( be+ to o!rs dem&s mu* m4 ,?is necessitates "o select+ words t depict "o's p]spective1 8 unique human angul> view2 or depict = ano!r1 ?is p>ticul> man z he p]ceives & responds to 8 unique exp]i5ce4 ,su* a depiction has to be unkn[n to ! o!r2 ea* "o's vantage po9t1 giv5 8 hi/ory z an exi/5t 9 ?is "t & place1 is s+ul>4 ,!n x requires f9d+ words & putt+ !m #fa toge!r 9 a way t be/ conveys ! mean+ ! nurs+ ev5t _h to ! nurse4 ,an adequate diction>y & !saurus c be useful4 ,! actual pres5tation ( exp]i5ce = an audi5ce dem&s an ord]+ ( data 9 a sequ5ce t w be s5sibly logical = !m4 ,we live exp]i5ce 9 an ord] t fl[s f our be+ & hi/ory )9 a multiplicity ( calls & responses4 ,pres5tly human expression is limit$ to sequ5tiality4 ,s aga9 we see t ! conceptualiz$ exp]i5ce is diff]5t f & lacks ! reality ( ! uniquely liv$ ev5t4 ,/ructur+ a logical sequ5tial pres5tation ( data1 decid+ on ^? aspects t influ5c$ mean+1 & hav+ x con=m z closely z possible to ! real is difficult4 ,(t51 :5 x seems t "o has done 8 v be/1 x is wise to h a tru/$ o!r react to conceptualizations4 ,ano!r's que/ions c br+ to ! conceptualiz]'s aw>5ess ?\ght connections t mov$ him along & t he has fail$ to convey4 ,also1 su* a read] c indicate aspects ( ?\ght trips ! writ] took t add no?+ to ! issue at /ake & weak5 8 message4 ,too1 ano!r's response c make app>5t to a writ] ! ne$ to cl>ify mean+4 ,?is cl>ification may m]ely entail a bett] *oice ( words or phrases1 or x may sugge/ ! use ( a mean+ful metaphor1 analogy1 or p>able4 ,^! la/ imag9ative =ms ( expression we frequ5tly use mean+fully1 sometimes l a %or?&1 ) our intimates4 ,a phrase1 metaphor1 or analogy conveys ) an imm$iacy ! quality or _s ( an ev5t4 ,= example1 a nurse work+ 9 a psy*iatric hospital unit speak+ ( a pati5t said1 ,he came d[n ! hall look+ l an accid5t ab\t to happ54 ,a page ( te*nical description c\ld n h giv5 me z mu* feel+ = :at %e & ! pati5t 7 exp]i5c+ at t mom5t4 ,9 nurses' ef=ts to express objectively1 sci5tifically1 & eruditely su* modes ( expression are (t5 delet$ f our writt5 pr(essional works4 ,x is z if we en=ce ! rules ( m$ical record *>t+ ( precision1 concis5ess1 & use ( weasel words onto all our writt5 works to ! detrim5t ( a !oretical & pr(essional endur+ body ( nurs+ k be+ actualiz$4 ,x takes consid]able pa9 & endeavor to f9d egress f su* human programm+4 ,) x we h purifi$1 equaliz$1 we>i$1 & dehumaniz$ supreme exp]i5ces ( human exi/5ce4 ,&1 we h negat$ ! mean+ & importance ( ourselves & nurs+4 ,h[ (t5 h y he>d1 ,i am j a nurse8 ,ph5om5ology requires rigor\s inve/m5t into respectfully1 appreciatively1 & accept+ly mak+ evid5t our liv$ worlds & _! ramifications = ! n[1 ! pa/1 & ! anticipat$ future4 ,nurs+ lit]ature ( ?is calib] w\ld call & inspire ^? :o att5d$ x to fur!r nurs+ practice & responsibly %>e ! mean+ !y attribute to _! area ( specializ$ d$ication4 ,! raw data ( our liv$ nurs+ worlds d n easily reveal _! mean+s or messages4 ,_m see _! worlds only sup]ficially1 & !mselves z m]e functions4 ,h[ (t5 a nurse is surpris$1 conf\nd$1 on he>+ a relative or fri5d speak ( a nurs+ ev5t 9 _! lives t may h occurr$ #fb f #aj to #dj ye>s previ\sly4 ,frequ5tly p]sons express appreciation = ! mean+ ^! ev5ts h _h = !m ?r\gh ! ye>s4 ,!y rememb] ! pleasure1 ang]1 pa91 fe>1 &_/or joy !y exp]i5c$4 ,x is n loose p]=mance t all[s raw data to convey its message to a nurse4 ,new data are suck$ easily & imm$iately into old1 worn out1 kn[n !oretical frames & networks ( words4 ,sev]e self-discipl9e ent]s into describ+ nurs+ exp]i5ce ) ! vigor ( h[ x 0 liv$4 ,too easily ! description is let fall to m$iocre common =ms4 ,prop] gramm> & pla9 ,engli% %\ld suffice4 ,?is w\ld c>ry ! nurs+ message1 z j>gon borr[$ f o!r discipl9es 9 :i* ! nurse always speaks z an ali51 nev] w4 ,humani/ic nurs+ practice !ory 9 ask+ = description does n ask "o to =get or d5y kn[n t]ms & k4 ,r x asks = a bracket+ or hold+ ( ?is k to ! side4 ,! nurs+ exp]i5ce %\ld be giv5 an opportunity to be se5 9 its pure =m1 r ?an =c+ x to con=m to =eign pre/igi\s t]ms borr[$ f o!r areas ( specialization1 :i* beg ! mean+ ( ! nurs+ ev5t4 ,prior to disp]sion1 ( c\rse1 "o %\ld weigh "o's expression 9 ,engli% aga9/ "o's expression 9 "o's kn[n =eign j>gon4 ,!n "o w be op5 to *oose h[ "o wants to express & %>e ! mean+ ( h] nurs+ _w4 ,ph5om5ology accepts categorization z a necessity ( communicat+4 ,x holds1 nev]!less1 t ?is is second>y to initial aw>e exp]i5c+4 ,?is /udy me?od ackn[l$ges ! unfa?omable complexity ( exi/+ & kn[+4 ,x /rives = z adequate conceptualization ( ! exi/5tial exp]i5ce z possible4 ,x honors ! kn[+ p]son's cont9u$ capacity = surprise & wond]m5t4 ,ph5om5ology asks u to g beyond ! common labels to ! surprise ( our own & o!r's unique exi/5ces-9-!-_w4 ,a nurse :o _h be5 /ruggl+ ov] _m mon?s ) a family 9 _! home1 on ! day %e fir/ exp]i5c$ an ,i-,?\ relation%ip ) !m said1 ,x 0 z if ,i _h gone beyond ! uncoop]ativ5ess & dirt9ess ( ! situation4 ,imm$iacy 9 label+ (f]s u ! complac5cy & security ( a wrapp$ up problem4 ,h[ c\ld a nurse be held responsible = :at happ5$ to a dirty1 uncoop]ative family4 ,! _m commonly he>d labels humans attribute inhumanely to o!rs r>ely relate to answ]s 9 situations or to ! dreadful human suff]+ problems g5]ate4 ,ph5om5ology seeks atte/ation ( ! mean+ ( a situation to a p>ticipant4 ,positivism seeks g5]al objective categories )9 ! univ]sal4 ,ph5om5ology prizes diff]5ces1 v>iations1 & /ruggles = _! repres5tation z p>ts ( ! :ole4 ,r ?an emphasize ! majority z hold+ sway1 x recognizes t ! unique contribution c possibly be ! weightie/ 9 mean+4 #fc ,,! ,,process3 ,,becom+ ,a ,,free ,,responsible ,,rese>* ,,nurse ,= a nurse to become a free responsible rese>* nurse 9 ! heal? ar5a %e accepts h] liv$ nurs+ _w z beyond ! controls valu$ 9 positivi/ic sci5ce4 ,%e appreciates h] liv$ nurs+ _w z saturat$ ) k to be extract$ or wrung4 ,!n %e mu/ exam9e1 recognize1 appreciate1 & unfold h] hi/ory1 h] angul> view1 & h] human nurse pot5tial4 ,9 priz+ h] view1 z nurse1 %e w ask relevant nurs+ que/ions4 ,to atta9 h] pot5tial z nurse %e w discipl9e h]self rigor\sly = au!nticity ) ! self4 ,) ! self-acceptance t comes ) self-au!nticity %e w "k ! importance ( ! diff]5ce %e & ! nurs+ pr(ession make & c make 9 ! community ( man4 ,!n out ( h] own human social ne$ & = ! survival ( nurs+ %e w describe to propel k1 nurs+ !ory1 & practice =w>d4 ,9 ?is process & 9 its effects %e w become m human z %e contributes to man's humanization4 ,,footnotes3 #a ,m>t9 ,bub]1 ,betwe5 ,man & ,man1 trans4 ,ronald ,gregor ,smi? 7,bo/on3 ,beacon ,press1 #aiee71 p4 #ic4 #b ,c>l ,g4 ,jung1 ,mod]n ,man 9 ,se>* ( a ,s\l1 trans4 ,w4 ,s4 ,dell & ,c>y ,f4 ,baynes 7,new ,york3 ,h>c\rt1 ,brace & ,_w1 #aicc71 p4 #afi4 #fd #fe #f ,,! ,,logic ,,( ,a ,,ph5om5ological ,,me?odology ,,p]spective3 ,,angul> ,,view ,9 humani/ic nurs+ practice !ory we1 ,dr4 ,zd]ad & myself1 propose t nurs+ practice :5 /udi$1 l any o!r area /udi$1 w only become available = human conceptualization if ! /udy me?ods are appropriate to its nature4 ,!re=e1 ! me?odology pres5t$ 9 ?is *apt] is relevant to humani/ic nurs+ practice !ory4 ,embrac$ )9 ?is *apt] is a me?odology = /udy+ nurs+ t evolv$ out ( ! process ( my nurs+ practice4 ,! logic ( ?is me?od & ( my process ( nurs+ are "o4 ,x is n a me?od ( ano!r discipl9e sup]impos$ on nurs+4 ,s ?is me?od did n =ce nurs+ or *ange nurs+ to h x mold or con=m4 ,z ?is me?od unfold$ x arose f & 9 accord ) nurs+ process4 ,?is me?odology came into be+ only aft] ye>s 9 :i* v>i\s attempts 7 made to get positivi/ic me?odology to answ] relevant nurs+ que/ions & to develop a pr(essional sci5tific !ory ( nurs+4 ,! me?od pres5t$ "h 0 us$ initially to creatively conceptualize nurs+ con/ructs 9 #aifg-fh4 ,! data = ! developm5t ( ! con/ructs com=t & cl9ical 7 ga!r$ f my cl9ical nurs+ practice & :ile ,i 0 deeply engross$ 9 exi/5tial read+s4 ,! process or me?od us$ 0 n conceptualiz$ until x 0 call$ = :ile writ+ my doctoral diss]tation 9 #aifh4 ,x _h !n be5 us$ to /udy ! cl9ical lit]>y works ( two psy*iatric m5tal heal? nurses1 ,!resa ,g4 ,mull] & ,ru? ,gilb]t4#a ,its conceptualization at t "t 0 rudim5t>y4 ,gradually x has be5 fur!r conceptualiz$4 ,f a ,philosophy ( ,nurs+ to a ,me?od ( #ff ,nursology1 an article publi%$ 9 ,nurs+ ,rese>* 9 #aigb1 0 my next attempt4#b ,graduate nurs+ /ud5ts /udi$ ?is article & repeat$ ! process ( ! me?odology 9 _! /udies ( _! cl9ical nurs+ data4 ,reflect+ on ?is article & realiz+ h[ o!rs _h to /udy & /ruggle ) x4 ,i became aw>e t /ill only ! b>e bones ( my ?9k+ 7 pres5t$4 ,fur!r elaboration ( ?is me?odology 0 call$ =? to %>e x ) ! humani/ic nurs+ practice !ory c\rse p>ticipants4 ,s9ce #aigj ,i h delv$ into ph5om5ologi/s' writ+s & at ?is "t c say t ?is process ( /udy+ nurs+ is a ph5om5ological me?od ( nursology4 ,int]e/+ to me is t ! initiation ( ?is me?od came :5 ,i fir/ began to read ! exi/5tiali/ lit]ature4 ,exi/5tialism c be view$ z ! fruits ( ph5om5ological /udy4 ,! process ( ?is me?od has become cle>] & cle>] to me ov] "t4 ,ph5om5ologically ! process or me?od has gr[n out ( ! reality ( ! ?+ itself to be /udi$1 9 ?is case1 cl9ical nurs+ practice4 ,?is *apt] !n is ! result ( reflect+ on ^! pa/ ef=ts & is a conceptualization ( ?is me?od z ,i und]/& x n[4 ,! foll[+ quote is (f]$ to support & validate ! ef=ts put into conceptualiz+ ?is me?od4 ,! philosoph] ( sci5ce ,abraham ,kaplan says ( me?odology3 ,! aim ( me?odology 444 is to invite speculation f sci5ce & practicality f philosophy 444 to help u und]/& 9 ! broade/ possible t]ms1 n ! products ( sci5tific inquiry1 b ! process itself4#c ,! above quotation expresses ! _s 9 :i* ?is pres5tation is (f]$4 ,positivi/ic sci5ce aims at objectivity & its results are view$ z sci5tific facts4 ,nurs+ practice has be5 und]/ood by _m z an implem5tation ( su* !oretical facts4 ,consid]+ my & o!r nurses' implem5tation ( su* facts x is app>5t t 9 ^! endeavors nurses come to "k mu* ab\t human exi/5ce4 ,philosophy is (t5 view$ z man's contemplations1 autobiographical revelations1 & ! values & belief sy/ems t und]lie man's actions1 ,c an explicit philosophy ( nurs+ all[ = m mean+ful quality practice1 be a res\rce = nurses1 improve s]vice1 be available = reexam9ation1 correction1 & ! =w>d+ ( k8 ,if nurs+ practice is view$ z ! implem5tation ( sci5tific facts & :at !y call =? 9 ! nurs+ situation relat$ to man's condition ( exi/5ce1 is a heuri/ic sci5ce ( nurs+ develop$ f ?is situation1 by nurses1 an appropriate practical pr(essional aim8 #fg ,?is pres5tation is my answ]1 a committ$ ,yes4 ,! me?od (f]$ "h1 a ph5om5ological me?od ( nursology1 aims at ! reality ( man1 h[ he exp]i5ces 8 _w1 or x aims at a subjective-objective /ate4 ,x aims at description ( ! pr(essional cl9ical nurs+ situation :i* 9 reality is subjective-objective _w t occurs betwe5 subjective-objective be+s4 ,! description focuses on ?is betwe5 & pres]ves ! complex mobile fl[ ( ! riv] ( nurs+ to make app>5t t sup]ficial precise portrayals are only an ov]lay ( its riv] b$1 c\rse1 & ev5tual de/9ations4 ,! relevance ( ph5om5ological nursology ranges f ! =mulation ( nurs+ con/ructs to ! creation ( !oretical propositions4 ,x is applicable to "o's own cl9ical data & to o!rs' cl9ical data1 "h & n[1 or 9 hi/orical /udy ( ! lit]ature4 ,,me?odological ,,/>t+ ,,po9t ,?is me?od addresses itself to ! "q3 ,h[ c a nurse1 a subjective-objective human be+ "k self & ! o!r & comp>e & complem5t>ily syn!size ^! kn[n betwe5s8 ,basic to ?is me?od is a belief sy/em1 a philosophy ab\t ! nature ( man explicitly comm5t$ on by ?9k]s ?r\gh\t human hi/ory4 ,plato said3 ,i _c be sure :e!r or n ,i see x z x really is2 b we c be sure !re is "s su* reality :i* x conc]ns u to see4#d ,nurses are ) o!r m5 9 times ( peak life exp]i5ces "u ! mo/ intimate circum/ances4 ,we1 too1 c n be c]ta9 ab\t :at we come to "k 9 our betwe5s4 ,we c be sure t ^! realities ( human exp]i5ce are wor?y ( exploration4 ,our opportunities are unique1 only we c describe man 9 ! nurs+ situation4 ,9 ,let ,u ,n[ ,praise ,fam\s ,m51 ,james ,agee voices a simil> conc]n ab\t ! ne$ to describe man-9-8-_w & ! adequacy ( human description4#e ,aw>e ( ! wond]s & complexities ( man he consid]s n try+ to describe worse ?an ! inadequacy ( description4 ,?9k]s h also ackn[l$g$ t we c come to "k f o!rs4 ,a poem by ,goe! expresses an attitude ab\t ?is3 ,somebody says3 ',( no s*ool ,i am "p1 ,nev] to liv+ ma/] lo/ my he>t2 ,nor anymore c ,i be said ,to h le>n$ any?+ f ! dead4' #fh ,t /atem5t--subject to appeal-- ,means3 ',i'm a self-made imbecile4'#f ,9 nurs+ :at bett] ma/] ?an ! nurs+ situation 9 :i* we become ?r\gh our relations ) o!rs4 ,ea* human p]son has some?+ unique to tea* u if we c b he>4 ,ab\t our inadequacies ( expression1 _m ?+s are1 are true1 all-at-once4 ,! law ( contradiction does n apply 9-!-liv$-exp]i5c$-_w4 ,we ea* view ! _w ?r\gh our unique hi/ories4 ,wisdom is _m sid$ tru?4 ,wisdom _c be express$ all-at-once4 ,tru?s c be /at$ only 9 sequ5ce or metaphorically4 ,if ,i 7 sup]critical ( my human limitations to express all-at-once wisdom1 ,i w\ld say no?+4 ,jung po9ts up ! dang]s ( ?is1 he says3 ,i mu/ prev5t my critical p[]s f de/roy+ my creativ5ess4 ,i "k well en\gh t e ^w ,i utt] c>ries ) x some?+ ( myself--( my special & unique self ) its p>ticul> hi/ory & its p>ticul> _w4#g ,ea* nurse's uniqu5ess dictates !n a responsibility to %>e h] p>ticul> kn[+ ) fell[ /ruggl+ human be+s4 ,only ?r\gh ea* describ+ c !re be correction & complem5t>y syn!sis to movem5t beyond4 ,! nurse's _w is an exp]i5tial place = becom+ influ5c$ by ea* p>ticipant's "h & n[ inclusive or orig91 hi/ory1 & hopes1 fe>s1 & alt]natives ( ! confront+ future4 ,positivi/ic sci5ce focuses on select$ p>ticul>s4 ,h5ri ,b]gson says3 444 = u consci\s be+s1 x is ! units t matt]1 = we d n c\nt extremities ( int]vals1 we feel & live ! int]vals !mselves4#h ,ea* human p>ticipant 9 ! nurs+ situation has a unique fl[ ( consci\sness :i* is int]subjectively influ5tial4 ,s z human nurses we are limit$ 9 our ability to express ! reality ( our-liv$ worlds4 ,yet1 also1 ?is _w dep5ds on & dem&s t we1 z human nurses1 give x mean+1 und]/& x 9 accordance ) our #fi humanness4 ,w & ,ariel ,durant1 hi/orians1 pr(essionals :o are =c$ to selectively pres5t ! _w = o!r humans1 say3 ,! hi/orian w n m\rn because he c see no mean+ 9 human exi/5ce except t :i* man puts into x3 let x be our pride t we ourselves may put mean+ into our lives1 & sometimes a significance t transc5ds dea?4#i ,humans are ! only be+s consci\s ( !mselves4 ,nurses are human be+s4 ,z su* we are capable ( look+ at our exi/5ce1 *oos+ our values1 giv+ our _w mean+ & ( con/antly transc5d+ ourselves1 or becom+ m4 ,if we value & prize our human nurs+ _w & our human pot5tial = consci\sness & expression1 we w actuate our pot5tial & conceptualize our human nurse-_w4 ,?is sugge/s que/ions to me4 ,:at d ,i want nurs+ to be8 ,h[ c ,i influ5ce ! mean+ ( ! t]m1 nurs+8 ,h[ committ$ am ,i8 ,:at inve/m5t am ,i will+ to make8 ,w ,i risk explor+ & say+ :at ,i see 9 my nurs+ _w8 ,am ,i op5 to kn[+8 ,h[ c ,i actuate my uniqu5ess to all[ ! reali/ic pot5tial ( my nurs+ pr(ession to become1 become ev] m8 ,am ,i contribut+ my nurs+ "h & n[ to nurs+'s hi/ory ?r\gh a la/+ =m ( expression8 ,( :at importance is :at ,i ?9k or say2 d ,i make any diff]5ce8 ,h]mann ,hesse says ( ea* man's uniqu5ess3 444 e man is m ?an j himself2 he also repres5ts ! unique1 ! v special & always significant & rem>kable po9t at :i* ! _w's ph5om5a int]sect1 only once 9 ?is way & nev] aga94#aj ,or1 a nurse might say3 444 e nurse is m ?an j h]self1 %e also repres5ts ! unique1 ! v special & always significant & rem>kable po9t at :i* ! nurs+ _w's ph5om5a int]sect1 only once 9 ?is way & nev] aga94 ,to me1 human fre$om means recogniz+ our unique pot5tial1 responsibility1 & limitations4 ,our s+ul>ity z a nurse among nurses1 !n1 confronts u ) a responsibility t belongs to "o else4 ,m>t9 ,bub]1 philosophical an?ropologi/ says3 ,z we become free 444 our responsibility mu/ become p]sonal & solit>y4#aa ,our unlik5ess to o!r nurses is a lonely1 v p]son condition$ /ate4 ,only ea* nurse c be responsible = h]self4 ,! wond]s ( fre$om are #gj p>adoxically1 all-at-once1 bo? a delight & a burd54 ,9 nurs+ x is important = u to und]/& fre$om n z oppos+ or agree+3 fre$om is *oos+--*oos+ & say+ yes to "o's self4 ,human endeavor betwe5 man & m5 9 _!-worlds1 9 ?is in/ance pr(essional cl9ical nurs+1 if explor$ & describ$ is view$ z contribut+ to man's human evolvem5t & to k ( ! human condition & h[ man becomes4 ,integrally all ! above /atem5ts are ! bases & biases ( ?is human ph5om5ological me?od ( nursology4 ,9 a phrase1 ,i suppose :at all ^! />t+ po9t /atem5ts say is3 ,nurs+ situations make available human exi/5ce ev5ts significantly wor?y ( description4 ,only human nurses c describe !m4 ,humans' ability to describe reality adequately has its limits4 ,we %\ld describe s9ce pridefully we humans are ! only exi/+ be+s capable ( giv+ mean+ to1 look+ at1 & express+ our consci\sness4 ,9 ! long run ?is ef=t c\ld yield a nurs+ sci5ce4 ,,phases ,,( ,,ph5om5ologic ,,nursology ,phase ,i3 ,prep>ation ( ! ,nurse ,kn[] ,= ,com+ to ,"k ,?is me?od engages ! inve/igator z a risk tak] & z a kn[+ place4 ,risk tak+ necessitates decision4 ,decision imposes confront+ ambival5ce 9 "o's self4 ,! ambival5ce ( want+ to be all-at-once responsible & dep5d5t4 ,sup]impos+ an already accept$ & acceptable /ructure on data is safe feel+4 ,approa*+ ! situation or data op5ly1 lett+ ! /ructure em]ge f x1 n decid+ :at to look =1 be+ will+ to be surpris$1 give feel+s ( excitem5t1 fe>1 & unc]ta9ty4 ,!re exi/s ! possibility t our humanness may include ! dilemma ( our n be+ able to p]ceive ! messages ( our data1 t we w n be able to m]ge ) x & become m4 ,! "q arises1 ,are we kn[+ places t c relate to o!rness & intuitively syn!size k8 ,?is process ( accept+ ! decision to approa* ! unkn[n op5ly is exp]i5c$ z an int]nal /ruggle & we become consci\sly aw>e ( our rigidity & satisfaction ) ! /atus quo4 ,con=m+ to ! usual1 9 ?is case positivism1 gives a security t is n easily rel9qui%$ despite ! advantages ( actualiz+ our unique responsible fre$om4 ,russell's metaphorical phrase1 w9d[s always op5 to ! _w1 depicts ! s\ght /ate ( m9d4 ,8 elaboration on ?is phrase gives ! flavor ( ! process ( prep>+ ! m9d4 ,he says1 ,?r\gh "o's w9d[s "o sees n only ! joy & beauty ( ! _w1 b also its pa9 & cruelty & ugl9ess1 & ! "o is z well wor? see+ z ! o!r1 & "o mu/ look into hell be=e "o has any "r to speak ( heav54#ab ,pa91 cruelty1 ugl9ess1 hell seem appropriate words to convey see+ our #galong-*]i%$ ideas & values1 our security blankets1 z only false gods4 ,nietzs*e 9 speak+ ( confrontation ( "o's values said1 ,& n[ only come? to him ! great t]ror1 ! great outlook1 ! great sickness1 ! great nausea1 ! great seasickness4#ac ,s ?is human me?odology seeks a condition ( be+ 9 ! inve/igator4 ,! inve/igator mu/ be aw>e ( h] own angul> view & democratically op5 to giv+ ! angul> views app>5t 9 ! data1 ! call$ = repres5tation4 ,! fir/ phase ( ?is me?od ( rese>* correlates well ) ! /ruggle exp]i5c$ by me 9 cl>ify+ my approa* to pati5ts 9 public heal?1 m$ical-surgical1 & psy*iatric m5tal heal? situations4 ,9 ^! situations1 "o truly has to /ruggle ) democratically keep+ "o's w9d[s op5 to ! _w4 ,& ?is is a cont9ual process4 ,hav+ exp]i5c$ ?is /ruggle 9 cl9ical nurs+ made ?is approa* to rese>* valid & mean+ful to me4 ,prep>+ ! m9d = kn[+ 9 cl9ical or rese>* endeavors may be accompli%$ by sev]al means4 ,"o means is by imm]s+ "o's self 9 dramatic & lit]>y works & contemplat+1 reflect+ on1 & discuss+ !m z !y relate to ! kn[]'s already kn[n1 9 ?is case1 nurs+ practice4 ,9 cl9ical or rese>* nurs+ ! selection ( lit]>y works to /imulate ! op5+ ( "o's human view is bas$ on _! pres5tation1 depictions1 & descriptions ( man's nature4 ,9 lit]ature au?ors %>e _! ?\ghts z m5 & pres5t possible ways m5 may view & relate to _! worlds4 ,phase ,,ii3 ,nurse ,kn[+ ( ! ,o!r ,intuitively ,b]gson conceives ( man kn[+ ?r\gh a dilatation ( 8 imag9ation gett+ inside (1 into le dure1 into ! rhy?m & mobility ( ! o!r4 ,liv+ ! rhy?m ( ! o!r he believes results 9 an absolute1 intuitive1 inexpressible1 unique k ( ! o!r4 ,he says3 444 an absolute c only be giv5 9 an intuition1 :ile all ! re/ has to g ) analysis4 444 f intuition "o c pass on to analysis1 b n f analysis to intuition4 444 fix$ concepts c be extract$ by our ?\ght f ! mobile reality2 b !re is n means :atev] ( recon/itut+ ) ! fixity ( concepts ! mobility ( ! real4#ad ,! kn[n1 cl9ical nurs+ practice1 gave mean+ to ! above = me4 ,ov] ! ye>s 9 nurs+ conf]5ces ,i _h be5 told my grasp ( nurs+ situations 0 intuitive4 ,mo/ times ?is 0 (f]$ r disp>ag+ly al?\gh ! nurs+ outcomes 7 mo/ times successful4 ,along ) hav+ #gb ! attribute ( intuition assign$ to me p]sons (t5 ask$1 ,:y are y s fasc9at$ ) o!r p]sons' situations8 ,toge!r ^! relate to ,dewey's view ( intuition4 ,he views intuition z a mull+ ov] ( conditions & a m5tal syn!sis t results 9 true judgm5ts s9ce ! controll+ /&>ds are intellig5t selection1 e/imation1 & problem solution4#ae ,9 nurs+ practice rese>* kn[+ ! o!r & h[ he exp]i5ces & views 8 _w is view$ z ! problem4 ,kn[+ intuitively1 z describ$ by ,b]gson1 is comp>able to ,bub]'s consid]ations ( man's necess>y mode ( becom+ ?r\gh ,i-,?\ relation4 ,! crit]ia ,bub] describes z *>act]i/ic = ,i-,?\ relation are subscrib$ to 9 my approa* to nurs+ practice & 9 ?is human or ph5om5ological nursology approa*4#af ,bub] held z pr]equisite = intuitive type kn[+ ( ! o!r1 or imag9+ ! real ( 8 pot5tial = be+1 a kn[]1 & ,i1 capable ( di/ance f ! o!r1 able to see ! o!r z a unique o!r1 "o :o turns to ! o!r1 makes 8 be+ pres5t to ! o!r1 & all[s ! o!r pres5ce4 ,! kn[+1 ,i1 9 ?is case ! nurse1 responds to ! o!r's uniqu5ess1 does n sup]impose1 ma9ta9s a capacity = surprise & "q1 & is ) ! o!r1 z oppos$ to seem+ to be4 ,?is k9d ( relat+ _c be sup]impos$ on a nurse cl9ician or rese>*]4 ,x mu/ be p]sonally responsibly *os5 & inve/$ 94 ,! approa* !n ( ! second phase ( ?is me?od & ( ! transactional phase ( nurs+ :5 nurses are 9 ! ar5a ) o!rs is ! same4 ,?is me?od proposes t to /udy nurs+ f outside ! ar5a = purposes ( objectivity bur/s asund] ! v nature ( nurs+ practice4 ,! /udi] is a "p ( t :i* is be+ /udi$4 ,obs]vations int]pret$ f outside ! situation c\ld be classifi$ only z projections4 ,phase ,,iii3 ,nurse ,kn[+ ! ,o!r ,sci5tifically ,b]gson believes man kn[s incompletely ?r\gh /&+ outside ! ?+ to be kn[n1 metaphorically walk+ ar\nd x1 & obs]v+ x4 ,?is analytical process1 ?is view+ ( a ?+'s _m aspects1 he conceives z ! habitual function ( positive sci5ce4 ,?is is ! ?ird phase ( ?is ph5om5ological nursology me?od4 ,b]gson says3 444 analysis multiplies endlessly ! po9ts ( view 444 to complete ! ev] incomplete repres5tation4 ,all analysis is ?us a translation1 a developm5t into symbols1 a repres5tation tak5 f successive po9ts ( view4 ,analysis 444 is ! op]ation :i* r$uces ! object to elem5ts already kn[n1 t is1 common to t object & to o!rs4#ag #gc ,s ph5om5ological nursology proposes t aft] ! /udi] has exp]i5c$ ! o!r intuitively & absolutely1 ! exp]i5ce be conceptualiz$ & express$ 9 accordance ) ! nurse's human pot5tial4 ,humanly we c express only sequ5tially :ile our actual exp]i5c$ liv$ worlds fl[ 9 an all-at-once fa%ion4 ,our words are kn[n symbols & categories us$ to convey ! exp]i5ce & ?us d5y ! uniqu5ess ( ea* realiz$ exp]i5ce4 ,bub]'s description ( man's ,i-,x way ( relat+ to ! _w is 9 agreem5t ) ,b]gson4 ,he conveys ! necessity ( ?is k9d ( relat+ by man to 8 _w2 & despite its lacks proposes t man prize 8 analytical ability4 ,l ,b]gson1 ,bub] views kn[+ z a movem5t f intuition to analysis1 & n ! o!r way ar\nd4 ,bub] sees k express$ or sci5ce creat$ ?r\gh ! kn[+ ,i transc5d+ itself1 recollect+1 reflect+ on1 & exp]i5c+ its pa/ ,i-,?\ relation z an ,x4 ,?is is man be+ consci\s (1 look+ at1 himself & t :i* he has tak5 91 m]g$ )1 made "p ( himself4 ,?is is ! "t :5 he mulls ov]1 analyzes1 sorts out1 comp>es1 contra/s1 relates1 int]prets1 gives a "n to1 & categorizes4 ,! ?ird phase ( ?is me?odology is ! same z t phase ( cl9ical nurs+ practice 9 :i* ! nurse1 remov$ f ! nurs+ ar5a1 replays & reflects on ?is area & transcribes h] angul> view ( x4 ,9 ?is reflective /ate ! nurse analyzes1 consid]s relation%ips betwe5 compon5ts1 syn!sizes !mes or patt]ns1 & !n conceptualizes or symbolically int]prets a sequ5tial view ( ?is pa/ liv$ reality4 ,! *all5ge ( communicat+ a liv$ nurs+ reality dem&s au!nticity ) ! self & rigor\s ef=t 9 ! selection ( words1 phrases1 & precise gramm>4 ,phase ,,iv3 ,nurse ,complem5t>ily ,syn!siz+ ,kn[n ,o!rs ,9 ?is phase ( ! me?odology ! nurse rese>*]1 ! kn[]1 comp>es & syn!sizes multiple kn[n realities4 ,bub] says ( comp>ison3 ,! act ( contra/+1 c>ri$ out prop]ly & adequately1 leads to ! grasp ( ! pr9ciple4#ah ,9 ?is comp>ison & syn!sis ! ,i ( ! rese>*] assumes ! position ( ! kn[+ place4 ,! kn[]1 l an int]pret]1 all[s dialogue betwe5 ! multiple kn[n realities4 ,^! realities are unkn[able to ea* o!r directly4 ,! kn[] int]prets1 sorts1 & classifies4 ,9 ! human kn[+ place discov]$ diff]5ces 9 simil> realities d n compete1 "o does n negate ! o!r4 ,ea* c be true1 pres5t1 all-at-once4 ,diff]5ces c make visible ! great] realities ( ea*4 ,desan1 ! philosoph]1 says ( ?is k9d ( syn!sis3 #gd 444 a syn!tic view :]e two or m positions are se5 to illum9ate & to transfigure "o ano!r ?r\gh _! mutual pres5ce4#ai ,! kn[] al]t to an aspect pres5t 9 a s+le reality c "q ! o!r reality on ?is aspect4 ,?is aspect may be pres5t 9 bo?1 m blatant 9 "o ?an 9 ano!r4 ,its =ms may be diff]5t or modifi$ 9 ea*4 ,x may be totally abs5t 9 "o4 ,diff]5ces f\nd may ar\se or br+ to consci\sness o!r que/ions to ask ( ! data4 ,?is oscillat+1 dialectical process cont9ues ?r\gh\t reflection on ! multiple realities4 ,?is indirect dialogue is record$ by ! inve/igator z ! complem5t>y syn!sis4 ,?is syn!sis is m ?an additive because x all[s mutual repres5tation & ! illum9ation ( "o reality by ano!r4 ,! f\r? phase ( ?is rese>* me?odology is l t phase ( cl9ical nurs+ 9 :i* a nurse comp>es & syn!sizes ! simil>ities & diff]5ces ( l nurs+ situations & arrives at an exp&$ view4 ,phase ,v3 ,succession ,)9 ! ,nurse ,f ! ,_m to ! ,p>adoxical ,"o ,?is phase ( ph5om5ological nursology is highly probable if n absolutely necess>y4 ,desan says3 ,tru? em]ges 9 & ?r\gh ! relational op]ation4 ,= ! way ( p>adox is ! way ( tru?4#bj ,! inve/igator may /ruggle ) ! multiplicity ( views n[ consci\sly "p ( & )9 h]self4 ,aga9 ,desan3 444 ?is unre/ is ! m9d ( man1 rea*+ its c5t]4444 ,f ?is c5t] ! spl5dor ( multiplicity is visible4#ba ,! rese>*]1 mull+ ov] & consid]+ ! relation%ips betwe5 ! multiple views1 insightfully corrects & exp&s h] own angul> view4 ,?is is n a "r-wrong type ( correction4 ,su* correction w\ld am\nt only to an ongo+ et]nal recurr5ce ( a fru/rat+ nature4 ,r ?is correction takes ! =m ( ev] m inclusiv5ess4 ,/ruggl+ ) ! communion ( ! diff]5t ideas ! kn[] takes an intuitive leap1 ?r\gh & yet beyond ^! ideas1 into a great] und]/&+4 ,%e !n may come up ) a conception or ab/raction t is inclusive ( & beyond ! multiplicities & contradictions4 ,?is inclusive conception or ab/raction is an expression ( ! inve/igator 9 h] "h & n[1 ) ! old tru?s & ! novel tru?s1 none oblit]at$4 #ge ,! fif? phase ( ?is ph5om5ological nursology me?od c be equat$ to t phase ( cl9ical pr(essional nurs+ 9 :i* ! nurse propels nurs+ k =w>d4 ,9 ?is phase a nurse /ruggl+ ) ! mutual communion ( multiple nurs+ situations arrives at a conception t is mean+ful to ! _m or to all4 ,f ! specific concrete ideas ( ! _m situations %e moves ?r\gh dilemma to resolution :i* is nurs+ express$ ab/ractly 9 units or z a :ole1 z "o4 ,exp]i5tial k ( nurs+1 ye>s 9 :i* ,i came to "k self & ! o!r :ile implem5t+ sci5tific facts1 all[$ me z a kn[] to recognize ! relevance ( ?is philosophical nursology me?od4 ,?is me?od does n aim at conv5tionality4 ,r x /rives to mean+fully augm5t & %>e conceptualiz$ nurse-_w realities4 ,,footnotes3 #a ,joseph9e ,g4 ,pat]son1 ,e*o into ,tomorr[3 ,a ,m5tal ,heal? ,psy*iatric ,philosophical ,conceptualization ( ,nurs+ ,d4,n4,sc4 diss]tation1 ,bo/on ,univ]sity1 #aifi4 #b ,joseph9e ,g4 ,pat]son ,f a ,philosophy ( ,cl9ical ,nurs+ to a ,me?od ( ,nursology1 ,nurs+ ,rese>*1 ,vol4 ,,xx 7,m>*-,april1 #aiga71 pp4 #adc-adf4 #c ,abraham ,kaplan1 ,conduct ( ,inquiry 7,san ,francisco3 ,*&l] ,publi%+ ,co41 #aifd71 p4 #bc4 #d ,plato1 ,! ,republic1 trans4 ,francis ,mac,donald ,corn=d 7,new ,york3 ,ox=d ,univ]sity ,press1 #aide71 p4 #de4 #e ,james ,agee1 ,let ,u ,n[ ,praise ,fam\s ,m5 7,new ,york3 ,ballant9e ,books1 #aici71 pp4 #ia-ajb4 #f ,johann ,wolfgang von ,goe!1 ,on ,orig9ality4 ,9 ,great ,writ+s ( ,goe!1 ed4 ,/eph5 ,sp5d] 7,new ,york3 ,m5tor ,press1 #aieh71 p4 #de4 #g ,c4 ,g4 ,jung1 ,mod]n ,man 9 ,se>* ( a ,s\l1 trans4 ,w4 ,s4 ,dell & ,c>y ,f4 ,baynes 7,new ,york3 ,h>c\rt1 ,brace & ,_w1 #aicc71 p4 #aah4 #h ,h5ri ,b]gson1 ,"t 9 ! ,hi/ory ( ,we/]n ,philosophy1 9 ,philosophy 9 ! ,tw5tie? ,c5tury1 ed4 ,william ,b>rett & ,h5ry ,d4 ,aik5 7,new ,york3 ,r&om ,h\se1 #aifb71 p4 #beb4 #i ,w ,durant & ,ariel ,durant1 ,lessons ( ,hi/ory 7,new ,york3 ,simon & ,s*u/]1 #aifh71 p4 #ajb4 #aj ,h]mann ,hesse1 ,demian1 trans4 ,mi*ael ,rol(f & ,mi*ael ,lebeck 7,new ,york3 ,h>p] ,r[1 #aife71 p4 #d4 #aa ,m>t9 ,bub]1 ,betwe5 ,man & ,man1 trans4 ,ronald ,gregor ,smi? 7,bo/on3 ,beacon ,press1 #aiee71 p4 #ic4 #ab ,b]tr& ,russell1 ,! ,autobiography ( ,b]tr& ,russell1 #aiad-aidd 7,bo/on3 ,little1 ,br[n & ,co41 #aifh71 p4 #ig4 #ac ,fr$]ick ,nietzs*e ,?us ,spake ,z>a?u/ra1 trans4 ,?omas ,common1 9 ,! ,philosophy ( ,nietzs*e 7,new ,york3 ,r&om ,h\se1 #aibg71 p4 #bci4 #ad ,h5ri ,b]gson1 ,an ,introduction to ,metaphysics1 9 ,philosophy 9 ! ,tw5tie? ,c5tury1 ed4 ,william ,b>rett & ,h5ry ,d4 ,aik5 7,new ,york3 ,r&om ,h\se1 #aifb71 pp4 #cjc-cca4 #ae ,john ,dewey1 ,h[ ,we ,?9k 7,bo/on3 ,d4 ,c4 ,hea? ,co41 ,publi%]s1 #aiaj71 p4 #aje4 #af ,m>t9 ,bub]1 ,di/ance & ,relation1 trans4 ,ronald ,gregor ,smi?1 9 ,! ,k ( ,man1 ed4 ,maurice ,fri$man4 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 #aife71 pp4 #fj-hb4 #ag ,b]gson1 ,an ,introduction to ,metaphysics1 pp4 #cjc-cca4 #ah ,m>t9 ,bub]1 ,i & ,?\1 #bnd ed41 trans4 ,ronald ,gregor ,smi?1 7,new ,york3 ,*>les ,scribn]'s ,sons1 #aieh74 pp4 #c-cd4 #ai ,w4 ,d4 ,desan1 ,planet>y ,man 7,new ,york3 ,! ,macmillan ,company1 #aigb71 p4 #gg4 #bj ,ibid4 #ba ,ibid41 p4 #hj4 #gf #gg #g ,a ,,ph5om5ological ,,approa* ,,to ,,humani/ic ,,nurs+ ,,!ory ,humani/ic nurs+ is dialogical 9 ! !oretical z well z ! practical realm4 ,j z ! mean+ ( humani/ic nurs+ is f\nd 9 ! exi/5tial int]subjective act1 t is1 9 ! dialogue z x is liv$ out by nurse & pati5t 9 ! real _w1 s ! !ory ( humani/ic nurs+ is =m$1 9 ! dialogical int]play ( articulat$ exp]i5ces %>$ by se>*+1 ab/ract+1 conceptualiz+ nurses4 ,! !ory ( humani/ic nurs+ orig9ates f & is cont9ually revitaliz$ & ref9$ by actual nurs+ exp]i5ce4 ,b ea* nurse1 z a unique human be+1 necess>ily exp]i5ces ! nurs+ dialogue & h] nurs+ _w 9 a unique way4 ,s ! developm5t ( humani/ic nurs+ !ory re/s on ! %>+ ( individual unique angul> views4 ,& ! !ory z a totality w become ri*]1 m consonant ) reality1 z x repres5ts m & m nurses' views4 ,s (t5 nurses1 ev5 nurses :o "k t _! cl9ical exp]tise grew out ( _! practice1 hesitate to %>e _! nurs+ exp]i5ces4 ,!y are apt to say deprecat+ly1 ,oh1 t's only my p]sonal exp]i5ce4 ,yet t is precisely :]e ! value lies1 9 ! uniqu5ess ( human exp]i5ce4 ,s9ce ea* nurse's description ( h] nurs+ exp]i5ce is a glimpse ( a real nurs+ _w1 ! views _c ju/ifiably be judg$ z "r or wrong2 !y simply are4 ,once ! v>i\s views are express$1 !y c be comp>$ & contra/$1 n = ! purpose ( accept+ "s & reject+ o!rs b r 9 ! int]e/ ( cl>ify+ ea* 9 relation to ! o!r4 ,su* a dialogue ( exp]i5tially bas$ conceptualizations c result 9 a complem5t>y syn!sis4 ,! process calls = n only a true appreciation ( p]sonal exp]i5ce by ea* nurse b also commitm5t to a collaborative ef=t ( op5 %>+ by a g5u9e community ( nurses4 ,?is view1 t ! developm5t ( humani/ic nurs+ practice !ory is a dialogical process1 has l$ to our valu+ 79 fact1 insi/+ on7 ! description #gh ( nurs+ ph5om5a4 ,we see ph5om5ological description z a basic & ess5tial /ep 9 !ory build+4 ,inde$1 consid]+ ! /ate-(-!-art ( nurs+ !ory developm5t1 x is ! mo/ crucial & imm$iate ne$4 ,look+ back at ! hi/orical evolvem5t ( our humani/ic nurs+ approa*1 x is obvi\s t we _h be5 us+ & develop+ a ph5om5ological approa* = a numb] ( ye>s be=e we grac$ our ef=ts ) ! impressive label1 ,ph5om5ological ,psy*iatric ,m5tal ,heal? ,nurs+1 9 a c\rse (f]$ to a gr\p ( nurses at ,nor?port ,vet]ans ,adm9i/ration ,hospital 9 ,april #aigb4 ,al?\gh we 7 aw>e mu* e>li] t our int]e/s & "w 7 fl[+ 9 ! g5]al /ream ( ph5om5ology1 we usually refra9$ f us+ ! label because x did little to cl>ify our position4#a ,! t]m has gr[n less precise ) ! ext5sion ( its use 9 diff]5t discipl9es & ) v>iations 9 me?odology4 ,:5 we began apply+ ! t]m ph5om5ological to our "w1 we le>n$ t to _m p]sons x s\nds /range1 unpron\nceable1 =eign2 to "s =bidd+2 to o!rs entic+4 ,we lat] co9$ ! title humani/ic nurs+ z be+ m suitable = x encompasses our g5]al exi/5tial b5t4 ,h[ev]1 ?is *ange 9 title does n imply any ab&onm5t ( our ph5om5ological approa*4 ,! description ( nurs+ ph5om5a is z highly priz$ n[ z ev]4 ,9 humani/ic nurs+1 ph5om5ological & exi/5tial curr5ts int]relate4 ,hav+ an exi/5tial view ( nurs+ z a liv+ dialogue influ5ces :i* ph5om5a "o becomes aw>e (1 exp]i5ces1 values1 /udies1 & describes4 ,reciprocally1 z "o discov]s & /ruggles to describe & develop mean+ful ways ( describ+ nurs+ ph5om5a1 ! liv$ nurs+ dialogue itself w be cont9ually p]fect$4 ,x is m precise to speak ( ph5om5ological me?ods 79 ! plural7 r ?an ph5om5ological me?od 79 ! s+ul>71 =1 s9ce ,edmund ,huss]l's orig9al "w1 ! approa* has be5 us$ by diff]5t discipl9es4 ,) its spread !re has develop$ a correspond+ v>iation 9 me?odology4 ,?is1 9 a s5se1 is ! beauty ( ph5om5ology3 x ?rives on v>iety ( p]spective2 x all[s1 p]haps requires1 individual creativ5ess2 x is always op54 ,9 ?is _s1 ideas are (f]$ "h ) ! hope ( /imulat+ imag9ative1 critical response1 & fur!r developm5t ( me?odology4 ,?is *apt] consid]s "s ( ! m concrete details ( ph5om5ological me?odology z !y relate to humani/ic nurs+4 ,! g5]al approa* & proc$ures discuss$ bel[ h be5 us$1 individually #gi & collaboratively1 by ,dr4 ,joseph9e ,pat]son & myself ) individual & gr\ps ( nurses to explore & describe _! nurs+ exp]i5ces4 ,!y h help$ nurses 9 v>i\s levels & types ( nurs+ s]vice to take a fre% look at _! practice & make desirable *anges4 ,we h liv$ ?r\gh ! process ) graduate /ud5ts 9 nurs+1 & x has l$ bo? ! /ud5ts & u to new conceptualizations & reconceptualizations ( nurs+ ph5om5a4 ,we h f\nd ?is to be a fruitful rese>* me?od :5 appli$ to cl9ical nurs+ ph5om5a p]sonally exp]i5c$ &_/or report$ 9 ! lit]ature4 ,& we are curr5tly explor+ its pot5tials ) int]e/$ nurses at ,nor?port ,vet]ans ,adm9i/ration ,hospital4 ,a ,,ph5om5ological ,,approa* ,! me?od may be *>act]iz$ g5]ally z descriptive b x is n a simple catalogu+ ( qualities or c\nt+ ( elem5ts4 ,basically1 x involves an op5ness to nurs+ ph5om5a1 a _s ( receptivity1 read9ess = surprise1 ! c\rage to exp]i5ce ! unkn[n4 ,equally important is aw>5ess ( "o's own p]spective & ( p]sonal biases4 ,! me?odological process is subjective-objective & intuitive-analytic4 ,besides subjective kn[+ or p]sonal exp]i5c+ ( ! ph5om5on1 rigor\s analysis also is requir$4 ,?is be+-) 7subjective1 intuitive kn[+ & exp]i5c+7 & look+ at 7objective analyz+7 ! ph5om5on all at once sp>ks a creative syn!sis1 a conceptualization f :i* emanates insightful description4 ,m specifically1 ! me?od entails an intuitive grasp ( ! ph5om5on1 analytic exam9ation ( its occurr5ces1 syn!sis1 & description4 ,9 actuality1 z ! me?od is c>ri$ out1 "o does n necess>ily recognize or focus on ^! processes z di/9ct phases or /eps4 ,9 ! fl[ ( ! exp]i5ce1 at times1 "s seem to occur simultane\sly or 9 oscillation4 ,be>+ ?is 9 m9d1 ! processes w be consid]$ 9 m detail4 ,intuitive ,grasp ( ! ,ph5om5on ,ph5om5ology is gr\nd$ 9 exp]i5ce4 ,x values ! raw data ( imm$iate exp]i5ce4 7,to ! ?+s !mselves1 0 ! slogan t inspir$ & guid$ ,huss]l & 8 foll[]s47 ,s ?is approa* requires1 9 ! fir/ place1 attitudes ( op5ness & aw>5ess4 ,x involves le>n+ to become consci\s ( spontane\s p]ceptions1 or 9 o!r words1 gett+ 9 t\* ) "o's s5sations & feel+s4 ,x means captur+ pr]eflective exp]i5ce1 t is1 becom+ aw>e ( "o's imm$iate impression or response to reality be=e label+1 categoriz+1 or judg+ x4 ,9 ?is k9d ( a /ate ( read9ess to receive :at appe>s1 a ph5om5on may be grasp$ intuitively4 ,x is z if a p>ticul> bit ( reality1 a happ5+1 fla%es impressively into "o's aw>5ess4 ,! int5sity ( ! exp]i5ce & ! absorption ( "o's att5tion 9 ! ph5om5on v>y ov] a wide range4 ,!re may be only a fleet+ recognition ( a ph5om5on accompani$ by #hj a half-=mulat$ ?\ght or judgm5t1 su* z1 hmm1 t's int]e/+1 ) imm$iate dismissal f or replacem5t ( x by some?+ else 9 "o's consci\sness4 ,! impression may1 ( c\rse1 be /or$ 9 memory & pop out aga9 at a lat] "t4 ,or ! ph5om5on may /rike on "o's consci\sness m =cefully caus+ fur!r pond]+ & wond]4 ,or ! impression ( ! ph5om5on may be s />tl+ t x fills "o's consci\sness to ! po9t ( pu%+ all else out2 a p]son is mom5t>ily /opp$ 9 8 tracks4 ,9 ! intuitive grasp1 reg>dless ( its int5sity or duration1 ! ph5om5on appe>s cle> & di/9ct4 ,! intuitive grasp is an insight into reality t be>s ! c]ta9ty ( imm$iate exp]i5ce4 ,no discursive process int]v5es2 "o simply kn[s ! ph5om5on z x is exp]i5c$4 ,fur!rmore1 ! intuitive grasp provides a k9d ( def9ite & :ole und]/&+1 a ge/alt1 t all[s recognition ( ! ph5om5on 9 o!r situations4 ,s :5 ! p]son is fac$ ) ano!r ev5t he c say1 ,yes1 t is ! ph5om5on "u consid]ation1 or ,no1 t is n x4 ,9 ord] to be op5 to ! data ( exp]i5ce 9 us+ a ph5om5ological approa*1 "o /rives to elim9ate ! a priori 7t :i* exi/s 9 8 m9d prior to & indep5d5t ( ! exp]i5ce74 ,?is is done by attempt+ to bracket 7hold 9 abeyance7 !oretical presuppositions1 int]pretations1 labels1 categories1 judgm5ts1 & s =?4 ,grant$1 a p]son _c be completely p]spectiveless4 ,man is an individual2 he is a unique "h & n[ p]son4 ,s naturally1 necess>ily1 he has an angul> view = he exp]i5ces reality f ! angle ( 8 own p>ticul> "h & 8 own p>ticul> n[4 ,or1 /at$ diff]5tly1 z a kn[+1 exp]i5c+ subject1 ea* man mu/ h "s p]spective ( ! ph5om5on be+ exp]i5c$4 ,h[ev]1 by recogniz+ & consid]+ ! p>ticul> p]spective f :i* he is exp]i5c+ x1 a p]son may become m op5 to ! ?+ itself4 ,fur!rmore1 ?is k9d ( op5ness to "o's own p]spective c be develop$ ?r\gh delib]ate practice4 ,sev]al approa*es may be us$4 ,to beg9 )1 a p]son c develop ! habit ( recogniz+ & expos+ 8 own biases4 ,?is c\ld involve some?+ z basic z /at+ ! actual physical situation or circum/ance 9 :i* ! ph5om5on 0 exp]i5c$4 ,= example3 ! ph5om5on c\ld be some?+ se5 f above or bel[1 at a di/ance or ne>by2 some?+ he>d 9 a quiet room or above ! d9 ( backgr\nd noise2 a pati5t's behavior 9 a l>ge gr\p or 9 a small gr\p1 ) 8 family1 ) on p>ticul> nurse1 ) 8 doctor2 a pati5t's response :ile be+ f$1 ba!d1 monitor$4 ,beyond ?is unavoidable bias ( ! angle ( p]ception1 ! nurse's exp]i5ce ( h] liv$ _w may be dull$ by habituation4 ,x is necess>y to break ?r\gh ! tunnel vision ( r\t9e4 ,= in/ance1 a nurse new to a situation may notice a pati5t's response to h] & rem>k ab\t x to ano!r nurse4 ,! second nurse1 to :om ! pati5t's behavior is famili>1 may respond1 ,oh1 he's done t = ye>s4 ,(t5 ?is is ! end ( ! dialogue2 x %\ld be ! beg9n+1 = ! duration ( a ph5om5on is n #ha equal to its description or mean+1 b r1 is an indication ( its significance4 ,! my/]y ( ! commonplace is hidd5 by veils ( ! obvi\s4 ,to recognize "o's biases means to put "o's beliefs1 "o's *]i%$ notions1 out on ! table4 ,a helpful aid 9 reflect+ on & articulat+ an exp]i5ce is ! "q1 ,:at am ,i tak+ = grant$8 ,commonly us$ t]ms1 su* z1 psy*iatric pati5t1 or?op$ic pati5t1 oncology unit1 uncoop]ative1 emotional1 *ronic1 t]m9al1 hopeless1 outpati5t1 ambulatory1 visitors1 family1 doctor1 nurse1 adm9i/ration1 front (fice h an aura ( connotations t may correspond to or diff] greatly f ! actual imm$iate exp]i5ce4 ,x may be a case :]e believ+ is see+4 ,! habit ( premature label+ may close a p]son to ! full savor+ ( exp]i5ce4 ,ano!r means ( increas+ op5ness to "o's own p]spective is to consci\sly note :e!r ! ph5om5on is be+ exp]i5c$ actively or passively4 ,= example1 ! ph5om5on may be ! motion ( *ang+ a pati5t's position 9 b$4 ,bo? exp]i5ce ! motion1 b x is a diff]5t exp]i5ce = ! nurse :o actively moves ! pati5t & = ! pati5t :o is mov$ passively4 ,or aga91 _m /udies ( ! ph5om5on ( empa?y h be5 report$ 9 ! lit]ature4 ,almo/ exclusively1 ^! are descriptions ( empa?iz+ ) someone2 only r>ely are !y conc]n$ ) ! exp]i5ce ( be+ empa?iz$ )4 ,yet obvi\sly1 ! active & passive exp]i5ces ( ! ph5om5on ( empa?y are diff]5t4 ,! same holds true = t\*+ & be+ t\*$1 ba?+ & be+ ba!d1 fe$+ & be+ f$1 support+ & be+ support$1 reassur+ & be+ reassur$1 & _m o!r ph5om5a 9 nurs+4 ,simil>ly1 aw>5ess ( "o's p]spective may be increas$ by consci\sly realiz+ :e!r ! ph5om5on is be+ view$ objectively or subjectively4 ,consid] = example1 ph5om5a su* z pa91 anxiety1 sleep1 re/lessness1 bor$om4 ,see+ evid5ce ( pa9 9 ano!r p]son is n ! same z feel+ pa9 )9 myself4 ,recogniz+ objective signs ( anxiety 9 ano!r p]son diff]s f ! subjective exp]i5ce ( feel+ anxi\s myself4 ,sleep+ & obs]v+ someone sleep+ are two diff]5t exp]i5ces4 ,! same hold true = re/lessness1 bor$om1 & s =?4 ,9 view ( nurs+'s dialogical "* x may be assum$ t _m ph5om5a ( major conc]n w\ld be int]subjective or transactional4 ,x is important !n = nurses1 attempt+ to develop op5ness to _! own p]spectives1 to consid] :e!r ! ph5om5on involves two subjects & _! betwe54 ,does ! action g bo? ways8 ,are bo? p]sons call+ & respond+ to ea* o!r simultane\sly8 ,take ! ph5om5on ( tim+ = example4 ,! nurse's v]bal response to a pati5t dep5ds n only on h] p]ception ( h] own "h-&-n[ & 8 p]ception ( 8 "h-&-n[ b r x also involves _! p]ceptions ( _! %>$ "h-&-n[ situation4 ,! nurs+ _w is fill$ ) int]subjective ph5om5a su* z1 eye #hb contact1 t\*1 sil5ce4 ,to describe ^! fully ! nurse mu/ be op5 to h] p]spective1 ! pati5t's p]spective1 & _! betwe54 ,analysis1 ,syn!sis1 & ,description ,aft] a nurs+ ph5om5on is grasp$ intuitively1 x is desirable to f9d z _m in/ances ( x z possible = ! sake ( description4 ,keep+ ! ph5om5on 9 m9d & reflect+ on x f "t to "t1 ! nurse becomes m al]t to its occurr5ce 9 h] liv$ _w4 ,! ph5om5on may be exp]i5c$ directly4 ,9 :i* case1 x is describ$ & reflect$ on & descriptions1 reflections1 & que/ions are record$4 ,:5 %e obs]ves ! ph5om5on 9 o!rs1 ! nurse may ask !m to describe x & v]ify h] own obs]vations4 ,"s nurses h involv$ o!r /aff memb]s 9 discov]+ & describ+ in/ances ( ! ph5om5on be+ /udi$4 ,simil>ly1 "o becomes m op5 to descriptions ( x 9 ! lit]ature--any lit]ature--or 9 any =m ( human expression1 = example1 poetry1 drama1 art1 sci5ce4 ,z _m descriptions ( ! ph5om5on are ga!r$ f z _m angles z possible1 ^! are ! data to be analytically exam9$1 syn!siz$1 & describ$4 ,! ?ree processes ( analysis1 syn!sis1 & description are s int]relat$ & s int]tw9$ 9 reality t x is simpl] to discuss te*niques 9 relation to all ?ree4 ,"s te*niques are equally useful 9 ! analytic exam9ation & ! description ( ph5om5a4 ,9 a s5se1 a p]son does bo? at once4 ,& (t51 x is dur+ ?is process ( %ift+ back & =?1 analyz+ & describ+ an exp]i5ce t syn!sis occurs4 ,a p]son gets a sudd5 insight1 ev]y?+ falls into place1 x clicks4 ,"o gets a ge/alt1 a :ole1 n necess>ily a :ole 9 ! s5se ( complete & entire1 b a :ole frame1 =m1 or /ructure t all[s = fur!r develop+ & fill+ 9 ( details4 ,!re are _m ways ( go+ ab\t ! analysis & description4 ,! foll[+ are "s t h be5 f\nd useful 9 ! explication ( nurs+ ph5om5a4 ,comp>+ & contra/+ in/ances ( ! ph5om5on lead to ! discov]y ( simil>ities & diff]5ces4 ,= in/ance1 9 /udy+ pati5ts' cry+ x 0 f\nd t _! cry+ 0 ) or )\t te>s2 l\d or sil5t2 express+ pa91 ang]1 fe>1 sorr[4 ,or aga91 sil5ce may be def9$ simply z abs5ce ( s\nd4 ,b sil5ce z exp]i5c$ 9 ! real nurs+ _w has o!r *>act]i/ics4 ,x may convey ang]1 fe>1 peacefulness1 & s =?4 ,x is ^! nuances or qualities ( sil5ce t are significant cues = ! nurs+ dialogue4 ,!y c\ld be br\ght to light by comp>+ & contra/+ descriptions ( sil5ce4 ,v>i\s in/ances ( ! ph5om5on be+ /udi$ may be exam9$ to discov] common elem5ts4 ,*>act]i/ics or elem5ts se5 9 "o in/ance are s\ght 9 ! o!rs4 ,= example1 :5 descriptions ( int]p]sonal empa?y 7 scrut9iz$1 x became evid5t t 9 all cases !re 7 physiological1 psy*ological1 & social compon5ts4 ,exam9+ exp]i5ces #hc ( reassurance reveal$ !y _h elem5ts su* z empa?y1 sympa?y1 reality ori5tation1 feel+s ( hope & com=t4 ,"o may det]m9e :i* elem5ts are ess5tial to ! ph5om5on by imag9ative v>iation1 t is1 by try+ to imag9e ! ph5om5on )\t a p>ticul> elem5t4 ,= in/ance1 reassurance )\t empa?y or sympa?y w\ld be false reassurance or1 9 o!r words1 w\ld n reassure4 ,! elem5ts ( ! ph5om5on c be /udi$ to det]m9e h[ !y are int]relat$4 ,"o may ask1 is !re a priority 9 "t8 ,does "o elem5t develop f ano!r8 ,consid] ! ph5om5on ( reassurance2 does empa?y prec$e sympa?y8 ,or1 to take ano!r example1 9 ! empa?ic exp]i5ce1 an op5ness to ! o!r & an imag9ative projection into 8 place lead to ! vic>i\s exp]i5c+ ( 8 situation4 ,= fur!r cl>ification ( its di/9ctive qualities ! ph5om5on may be relat$ to & di/+ui%$ f o!r simil> ph5om5a4 ,= example1 empa?y is simil> to & also diff]5t f id5tification1 projection1 compassion1 sympa?y1 love1 & enc\nt]4 ,by consid]+ :at x has 9 common ) o!r ph5om5a1 ! ph5om5on be+ describ$ may be classifi$ z be+ subsum$ 9 a broad] category4 ,?us1 empa?y is a human response1 a coalesc5t movem5t1 a =m ( relat+4 ,! ph5om5on may be describ$ by select+ its c5tral or decisive *>act]i/ics & ab/ract+ its accid5tals4 ,= in/ance1 int]p]sonal empa?y always involves movem5t into ano!r's p]spective & z a =m ( movem5t x has directions1 dim5sions1 & degrees4 ,x c occur betwe5 p]sons ( diff]5ce age1 education1 exp]i5ce1 sex2 ^! latt] *>act]i/ics are accid5tal4 ,"s descriptions make use ( negation4 ,a ph5om5on _c be describ$ completely by negation b x may be cl>ifi$ to "s ext5t by say+ :at x is n4 ,= in/ance1 empa?y is n sympa?y2 x is n projection2 x is n id5tification4 ,analogy may be us$ to promote analytic exam9ation & description4 ,?is involves a comp>ison bas$ on p>tial simil>ity betwe5 l features ( two ?+s4 ,= example1 ! movem5t ( empa?y is l ! curr5ts 9 ! sea2 ! he>t is l a pump4 ,! advantage ( us+ analogy is t ! comp>ison raises que/ions ab\t ! nature ( ! ph5om5on "u consid]ation4 ,h[ev]1 s9ce ! simil>ity betwe5 ! analogues is always p>tial1 "o mu/ gu>d aga9/ ov]ext5d+ ! comp>ison to unw>rant$ conclusions4 ,! description mu/ always be consonant ) ! ph5om5on z x occurs 9 reality4 ,! use ( a metaphor also may enhance description & analysis4 ,a metaphor sugge/s comp>ison ( ! ph5om5on ) ano!r by ! nonlit]al application ( a ^w4 ,= example1 ! betwe5 is a secret place4 ,! use ( metaphor may be criticiz$ 9 reg>d to its lack ( precision4 ,on ! o!r h&1 !re are "s 7= example1 ,m>cel1 ,bub]7 :o hold t ! int]subjective realm c be describ$ only metaphorically because x is #hd beyond ! level ( objectivity4 ,& to attempt to describe int]subjective ph5om5a 9 precise t]ms relat$ to ! physical _w w\ld t5d to di/ort r ?an cl>ify4 ,_m ( ! nurs+ ph5om5a requir+ description occur )9 ! int]subjective realm4 ,metaphors c\ld ca/ "s light on ^!4 ,,conclusion ,z a !ory ( practice1 humani/ic nurs+ is d]iv$ f individual nurses' actual exp]i5ces 9 _! uniquely p]ceiv$ b commonly %>$ nurs+ _w4 ,its developm5t1 !re=e1 dep5ds on ! articulation ( _! angul> views & also on ! truly collaborative ef=t ( a g5u9e community ( nurses /ruggl+ toge!r to describe humani/ic nurs+ practice4 ,s9ce ! description ( nurs+ ph5om5a is recogniz$ z a basic & ess5tial /ep 9 !ory developm5t1 ?is *apt] pres5t$ an approa* & detail$ "s te*niques us$ by nurses to describe ph5om5a4 ,x is hop$ t ^! w\ld be view$ critically & creatively2 t !y w\ld be us$1 v>i$1 comb9$ adapt$1 & lead to new me?ods suit$ to ! description ( nurs+ ph5om5a4 ,& if !y are develop$1 x is hop$ t !y w be %>$ = ! gr[? ( humani/ic nurs+ dep5ds n only on us+ & %>+ :at we le>n b also on describ+ h[ we come to "k4 ,!n humani/ic nurs+ !ory w gr[ 9 dialogue4 ,,footnotes3 #a ,loretta ,t4 ,zd]ad1 ,a ,concept ( ,empa?y 7,ph4,d4 diss]tation1 ,georget[n ,univ]sity1 #aifh74 ,joseph9e ,g4 ,pat]son1 ,e*o into ,tomorr[3 ,a ,m5tal ,heal? ,psy*iatric ,philosophical ,conceptualization ( ,nurs+ 7,d4,n4,sc4 diss]tation1 ,bo/on ,univ]sity1 #aifi74 ,loretta ,t4 ,zd]ad1 ,empa?y--,f ,cli*e to ,con/ruct1 ,proce$+s ( ! ,?ird ,nurs+ ,!ory ,conf]5ce 7,univ]sity ( ,kansas ,m$ical ,c5t] ,dep>tm5t ( ,nurs+ ,education1 #aigj71 pp4 #df-ge4 ,joseph9e ,g4 ,pat]son1 ,f a ,philosophy ( ,cl9ical ,nurs+ to a ,me?od ( ,nursology1 ,nurs+ ,rese>*1 ,vol4 ,,xx 7,m>*-,april1 #aigb71 pp4 #adc-adf4 ,joseph9e ,g4 ,pat]son & ,loretta ,t4 ,zd]ad1 ,all ,toge!r ,?r\gh ,complem5t>y ,syn!sis1 ,image1 ,vol4 ,,iv1 ,no4 #c 7#aigj-ga71 pp4 #ac-af4 #he #h ,,humani/ic ,,nurs+ ,,& ,,art ,! t]m humani/ic nurs+ (t5 is int]pret$ z imply+ human5ess4 ,logically1 humane c>+ mu/ be "o aspect 7a major aspect7 or a natural expression ( humani/ic nurs+ practice !ory4 ,b ! t]m means m4 ,accord+ to ! position be+ tak5 "h1 nurs+ may be describ$ appropriately z humani/ic s9ce at its v base x is an int]-human ev5t4 ,z an int]subjective transaction1 its mean+ is f\nd 9 ! human situation 9 :i* x occurs4 ,z an exi/5tial act1 x involves all ! p>ticipants' capacities & aims at ! developm5t ( human pot5tial1 t is1 at well-be+ & m-be+4 ,our approa* qualifies1 !n1 z a =m ( humanism1 accord+ to ! diction>y def9ition1 be+ a sy/em or mode ( ?\ght or action 9 :i* human int]e/s1 values1 & dignity are tak5 to be ( prim>y importance4 ,9 ano!r s5se ( ! ^w1 our !oretical /ance is humani/ic by virtue ( its reg>d = ! humanities & arts4 ,philosophy1 lit]ature1 poetry1 drama1 & o!r =ms ( art are valu$ z res\rces = enri*+ our k ( man & ! human situation4 ,!y also are se5 z suitable means = express+ or describ+ ! liv$ realities ( ! nurse's _w4 ,contempor>y nurs+1 be+ a true *ild ( its "t1 reflects ,am]ican society's high reg>d = ,sci5ce4 ,values ( sci5ce are easily disc]nible 9 nurs+ & affect ! "* ( its rese>*1 education1 & practice4 ,consid]1 = in/ance1 h[ ! nurs+ dialogue is influ5c$ by ! priz+ ( objectivity1 precision ( language1 op]ational def9itions1 sci5tific j>gon1 developm5t ( con/ructs & !ories1 me?odology ( sci5tific inquiry1 emphasis on quantification & measurem5t4 ,!re is mu* m writt5 9 our curr5t lit]ature ab\t nurs+ z a sci5ce ?an ab\t nurs+ z an art4 ,al?\gh slight$1 ! humanities h n be5 reject$4 ,9 fact1 "s nurses & educators are urg+ t ! role #hf ( ! humanities & arts be recogniz$ 9 nurs+ & t !y be us$ m effectively 9 und]graduate & graduate nurs+ education4#a ,turn+ to my own p]sonal exp]i5ce1 ,i recall t "o ( ! fir/ def9itions ,i _h to le>n 9 my basic nurs+ program began ) ! /atem5t1 ,nurs+ is an art & sci5ce4444 7,x is int]e/+ t n[1 ye>s lat]1 ?is is all ,i c recall ( ! def9ition67 ,at t "t1 ,i accept$ ! /atem5t at face value4 ,i did n "q x4 ,p]haps ,i _h n ?\ght en\gh ab\t art & sci5ce & c]ta9ly ,i did n "k en\gh ab\t nurs+ to "q ! description4 ,yet ov] ! ye>s _m exp]i5ces & insights h turn$ into que/ions t *all5ge ?is adopt$ *]i%$ notion4 ,9 ! beg9n+ ,i m]ely accept$ ! view t nurs+ is an art 9 ! s5se ( be+ a skillful or ae/hetic application ( sci5tific pr9ciples4 ,aft] all1 we _h a c\rse 9 nurs+ arts 7lat] call$ fundam5tals ( nurs+74 ,?is _h to d ) ba?+1 fe$+1 mak+ b$s1 & hundr$s ( o!r nurs+ proc$ures t 7 pres5t$ z nurs+ arts1 ! do+ ( nurs+4 ,at ! "t ,i also _h c\rses 9 ! humanities & lib]al arts4 ,^! c\rses 7 n relat$ directly to nurs+ by ei!r ! tea*]s or myself1 z ,i recall4 ,i did n ask3 ,9 :at way is nurs+ an art8 ,:at k9d ( art is nurs+8 ,or1 h[ does ! art ( nurs+ diff] f o!r arts8 ,! notion 7p]haps conviction w\ld be m accurate7 t nurs+ is an art 9 "s s5se o!r ?an an artful application ( sci5tific pr9ciples has be5 ) me = a long "t4 ,i d n "k its orig9 nor ev5 ! =m 9 :i* ! view fir/ appeal$ to me4 ,i d recall hav+ difficulty on sev]al occasions 9 try+ to express let alone expla91 my idea4 ,at ^! times1 :at ,i exp]i5c$ subjectively z an intuitive fla% ( insight w\ld end up objectifi$ 9 an amorph\s blob ( words4 ,yet ! !me returns ov] & ov] 9 a v>iety ( que/ions & issues t dem& response if n resolution4 ,?is *apt] (f]s "s fur!r reflections on ! relat$ness ( humani/ic nurs+ & art4 ,,use ,,( ,,arts ,"o ( ! mo/ obvi\s ways 9 :i* nurs+ & art are relat$ is 9 nurs+'s use ( ! arts4 ,?is may be se5 9 nurs+ education z well z 9 nurs+ practice4 #hg ,lib]alization ,usually1 :5 arts & humanities are includ$ 9 nurs+ education programs1 x is = _! humaniz+ effects4 ,traditionally !y h be5 recogniz$ z hav+ a civiliz+ influ5ce4 ,s 9 nurs+ !y are se5 z support+ ! elem5ts ( human5ess & humanit>ianism4 ,fur!rmore1 !y are a necess>y antidote = ! dep]sonalization t accompanies sci5tific te*nology & me*anization4 ,! arts are valu$ also = _! lib]aliz+ effect4 ,!y /imulate imag9ative creativity4 ,!y broad5 a p]son's p]spective ( ! human situation1 ( man 9 8 _w4 ,= in/ance1 depictions ( suff]+ man or ( o!r aspects ( ! human condition t are f\nd 9 poetry1 drama1 or lit]ature are f> m descriptive & mu* clos] to reality ?an ^? giv5 9 typical textbooks4 ,curr5t nurs+ practice reflects ! educational prep>ation ( nurses t is weight$ heavily ) sci5tific c\rses & ! me?odology ( positivi/ic sci5ce4 ,arts & humanities are a necess>y complem5t4 ,sci5ce aims at univ]sals & ! discov]y ( g5]al laws2 art reveals ! uniqu5ess ( ! individual4 ,:ile sci5ce /rives = quantification1 art is m conc]n$ ) quality4 ,/rict con=mance to me?odology & replicability are priz$ 9 sci5tific /udies1 :]eas fre$om & uniqu5ess ( /yle reign 9 art4 ,sci5ce1 =ev] updat+ itself1 op5s ! nurse's eyes to con/ant *ange & innovation2 ! classics promote a s5se ( ! un*ang+ & la/+ 9 man's _w4 ,sci5ce may provide ! nurse ) k on :i* to base h] decision1 b x rema9s = ! arts & humanities to direct ! nurse t[>d exam9ation ( values und]ly+ h] practice4 ,?us1 humani/ic nurs+ has bo? sci5tific & arti/ic dim5sions4 ,expression ,humani/ic nurs+ & art are int]relat$ 9 ano!r way4 ,"s nurses :o are also arti/s use _! respective arts to express _! nurs+ exp]i5ce4 ,poetry is a good example4 ,9 an article1 ,nurses z ,poets1 ,trautman notes t s9ce ! #aidjs progressively great] numb]s ( poems ab\t nurs+ h be5 publi%$ & s9ce ! #aifjs ! quality ( ^! poems has improv$ consid]ably4#b ,%e believes t nurses' ability to express _! feel+s ab\t nurs+ 9 poetry _c be attribut$ entirely to a *ange 9 times4 ,r1 x is a reflection ( *ange 9 nurs+ practice4 ,= "o ?+1 contempor>y nurs+ requires a great deal ( ab/ract ?9k+4 ,x calls = an und]/&+ involv+ m5tal & emotional inve/m5t1 & imag9ative feel+ ) ! pati5t4 ,! #hh nurse-poet puts aside te*nical t]ms1 looks at h] pati5t 9 a fre% & creative way & %>es h] view 9 a poem4 ,a second reason (f]$ by ,trautman is ! increas$ emphasis 9 nurs+ education on communication & v]bal skills4 ,a nurse ) a tal5t = writ+ may be mov$ by a p>ticul> exp]i5ce to %>e x4 ,?us1 ! s5sitive nurse-writ] may use poetic expression to "w ?r\gh a problem1 to muse ab\t a detail1 or to record a pr(\nd exp]i5ce4#c ,f9ally1 %e /ates t "s nurses write poetry ab\t aspects ( _! "w t defy sci5tific analysis & _c be easily conta9$ 9 te*nical pap]s4 ,9 ?is1 !n1 nurses' poetry goes beyond ! p]sonal satisfaction accompany+ expression2 x pres]ves a unique angul> view ( nurs+'s liv$ _w & adds to our /ore ( cl9ical wisdom4 ,z ,trautman concludes3 ,poetry has trail$ ! pr(ession = _m ye>s1 probably because nurses 7 n enc\rag$ 9 creative writ+ ( any k9d4 ,today1 h[ev]1 ,i ?9k t poetry leads ! pr(ession because mo/ ( x nev] loses sight ( human ne$s--bo? nurses' & pati5ts'4 ,our poets l5d a cle> & vital voice to our pr(ession4 ,!y cite _! exp]i5ces1 emotions1 beliefs1 & aw>5ess 9 lieu ( a sci5ce-ori5t$ bibliography4 ,!y appeal to our common s5se b1 m importantly to our he>ts4 ,!y tell u to obs]ve hone/ly & to feel4 ,above all1 our poets tell u to believe 9 our obs]vations & to tru/ 9 our feel+s--= pati5ts1 = ourselves4#d ,"s elem5ts or aspects ( nurs+ l5d !mselves to sci5tific exploration & discov]y :ile o!rs1 equally important & likewise des]v+ expression1 reveal !mselves only ?r\gh ! arti/'s vision4 ,s :at has be5 said ( poetry1 !re=e1 may hold true 9 o!r arts4 ,ea* art has its own =m ( dialogue ) reality4 ,! pa9t]1 = example1 feels ) 8 eyes2 he feels l9es1 po9ts1 planes1 texture1 & color4#e ,:at c\ld ! nurse-pa9t] %>e8 ,or z ,g>n]1 a nurse-musician1 sugge/s1 nurs+ c\ld be conceptualiz$ along ! s*ema ( tones1 texture1 rhy?m1 met]1 int5sity1 temp]am5t4#f ,:at nurs+ cont5t w\ld accrue if ! v>i\s nurse-arti/s us$ _! =ms ( k1 skill1 & vision to explore nurs+ z ! v>i\s nurse-sci5ti/s d8 ,:at c our poets1 pa9t]s1 musicians & danc]s see1 he>1 feel 9 ! nurs+ dialogue8 ,!rapeutics ,!re is a ?ird way 9 :i* humani/ic nurs+ & art are relat$4 ,= _m ye>s1 ! arts h be5 us$ 9 nurs+ = _! !rapeutic effects1 especially ) psy*iatric1 g]iatric1 & p$iatric pati5ts4 ,! nurse & a pati5t or a gr\p ( pati5ts p>ticipate 9 an arti/ic exp]i5ce toge!r4 ,^! may be passive activities1 su* z1 att5d+ a conc]t or play or visit+ #hi an art exhibit2 or !y may be active ones 9 :i* nurse & pati5ts are involv$ 9 arti/ic expression or creation4 ,music1 poetry1 pa9t+1 drama1 & dance h be5 us$ effectively 9 v>i\s nurs+ situations4 ,= in/ance1 ,*ri/(f]s1 a nurse & danc]1 emphasizes ! importance ( body language z communication & supports h] view ) cl9ical evid5ce4 ,%e urges nurses to become physically lit]ate--to develop an und]/&+ & appreciation ( ! "p play$ by body language 9 human relation%ips4#g ,or aga91 accord+ to ,g>n]1 ,music1 :5 c>efully plann$1 c be us$ z a s\rce ( culture1 nurturance1 communication1 socialization1 & !rapeusis4#h ,a major !rapeutic value ( art lies 9 ! fact t x confronts "o ) reality4 ,art is a lie :i* makes u realize ! tru?4#i ,9 8 novel1 ,! ,conspiracy1 ,h]sey has ,lucan1 a poet1 write to ,s5eca3 ,to me ! ideal ( a "w ( art is t ea* man %\ld be able1 9 contemplat+ x1 to see himself z he really is4 ,?us art & reality meet4 ,?is is ! great heal+ /r5g? ( art1 ?is is ! p[] ( art1 444 ,art's p[] :i* no?+ c *all5ge1 is ! bl9d+ light ( recognition4#aj ,by us+ v>i\s art =ms ! nurse helps ! pati5t exp]i5ce1 become aw>e (1 & express 8 feel+s4 ,:5 ! activity occurs 9 a gr\p1 ! memb]s h ! additional advantage ( %>+ 9 o!rs' expressions & ( develop+ fell[-feel+4 ,increas$ socialization is ano!r important !rapeutic effect nurse-arti/s_/art appreciators seek 9 ! use ( art4 ,a coroll>y b5efit is improv$ communication betwe5 ! pati5t & ! nurse or betwe5 ! pati5t & o!rs4 ,obvi\sly1 self-k & fell[-feel+ are consi/5t ) ! aim ( humani/ic nurs+ to nurture well-be+ & m-be+4 ,a p]son develops 8 human pot5tial & becomes ! unique individual he is ?r\gh 8 relation%ips ) o!r m54 ,,nurs+ ,,z ,,art ,?us f>1 ?is *apt] has be5 conc]n$ ) ! relat$ness ( nurs+ & art4 ,x 0 se5 t nurses may /udy arts & humanities = a broad] und]/&+ ( ! human situation1 may express _! nurs+ worlds ?r\gh v>i\s art =ms1 & may use ! arts !rapeutically4 ,n[ ! "q is rais$ :e!r nurs+ is an art1 & if s1 :at k9d ( art4 #ij ,artful ,application ,ev5 ! mo/ sci5tific nurses d n d5y t nurs+ is1 9 "s way1 an art4 ,b precisely h[ ! art & sci5ce ( nurs+ are int]relat$ is n cle>4 ,= example1 ,abdellah writes3 ,! art ( nurs+ mu/ n be confus$ ) ! sci5ce ( nurs+4 ,! =m] conc]ns itself ) intuitive & te*nical skills 7(t5 rituali/ic71 & also ! m supportive aspects ( nurs+2 ! latt] conc]ns itself ) sci5tific tru?s4 ,bo? are important4 ,!y are int]wov5 & complem5t ea* o!r4#aa ,h[ev]1 ,abdellah gives no fur!r elaboration ( ?is po9t4 ,usually1 :5 nurses are ask$ ab\t ! relat$ness ( ! art & ! sci5ce ( nurs+1 ! view express$ is t sci5ce has to d ) g5]al pr9ciples & laws t gov]n nurs+ & art has to d ) ! p>ticul> application ( pr9ciples 9 individual cases4 ,fur!rmore1 :5 a nurse describes "s ev5t z beautiful nurs+ & is press$ to elaborate1 %e usually describes nurs+ actions t 7 p]=m$ artfully1 skillfully1 h>moni\sly4 ,?us1 9 "s way1 ! art ( nurs+ has to d ) ! nurse's response to human ne$s ?r\gh actions t are purposeful & ae/hetic4 ,useful ,art ,9 curr5t usage1 ! t]m art is mo/ commonly associat$ ) ! beautiful1 t is1 ) ae/hetics or ! f9e arts4 ,frequ5tly1 x is re/rict$ ev5 m to signify "o gr\p ( ! f9e arts1 namely1 pa9t+ & sculpture4 ,= in/ance1 "o ref]s simply to an art exhibit or an art museum b specifies fur!r a c5t] = ! p]=m+ arts4 ,h[ev]1 hi/orically ! ^w art 0 relat$ to utility & k1 & its traditional mean+s /ill exi/ today4 ,= example1 we speak ( indu/rial arts & arts & crafts ?r\gh :i* useful ?+s are produc$4 ,on ! o!r h&1 lib]al arts 7"w befitt+ a free man7 are ^? relat$ to skills ( ! m9d4 ,we also ref] to ! art ( m$ic9e1 ( tea*+1 ( nurs+1 ( politics1 ( navigation1 ( milit>y /rategy1 & s =?4 ,! ^w art c ref] to bo? ! effect ( human "w 7works ( art7 & ! cause ( ?+s produc$ by human "w 7! k & skill ( ! arti/74 ,x is obvi\s t n only k b also "s =m ( "w & skill are involv$ 9 all art1 useful or f9e4 ,art is ! root ( artisan z well z ( arti/4#ab ,"s arts1 su* z nurs+1 m$ic9e1 & tea*+1 may be consid]$ useful1 yet !y diff] f o!r useful arts1 su* z indu/rial arts1 = !y #ia d n result 9 tangible products4 ,nurs+ = in/ance1 aims purposively = well-be+1 m-be+1 heal?1 com=t1 gr[?4 ,^! are ! results ( ! art ( nurs+4 ,z an arti/1 !re=e1 ! nurse mu/ "k h[ to obta9 desir$ effects & mu/ "w skillfully to get !m4 ,! nurse _c make well-be+ or com=t or heal? z "o c make a %oe or a pa9t+ or a spee*4 ,! art ( nurs+ involves a skillful do+ r ?an a mak+4 ,fur!rmore1 nurs+ is conc]n$ ) *anges 9 human p]sons n m]ely ) ! trans=mation ( physical objects4 ,x is int]subjective & transactional1 s ! art ( nurs+ mu/ involve a do+ ) & a be+ )4 ,p]=m+ ,art ,along ?is ve91 nurs+ may be view$ z a k9d ( p]=m+ art4 ,fahy1 nurse-educator-actress1 draws an int]e/+ comp>ison betwe5 ! process ( nurs+ & act+ 9 a drama4 ,9 a play ! actors "k c]ta9 ?+s1 !re are a c]ta9 numb] ( giv5 circum/ances3 plot1 ev5ts1 epo*1 "t1 & plan ( action1 conditions ( life1 director's int]pretation4 ,! te*nical ?+s are also !re3 sett+1 props1 lights1 s\nd effects1 & s =?4 ,b x rema9s at ! "t ( curta9 = ! actors to g on alone & produce4 ,9 ! act ( nurs+ !re are "s kn[n facts t ! nurs+ /ud5t or ! nurse c pick up3 "n1 age1 religion1 e?nic backgr\nd1 m$ical diagnosis1 & plan ( c>e 7sometimes71 h] own backgr\nd k & exp]i5ce1 & h] own unique p]sonality4 ,h[ev]1 :5 %e enc\nt]s o!r pati5ts--wat* x6 ,! same ?+ happ5s 9 ! tea*+-le>n+ process4 ,edw>d ,a4 ,wright 9 ,und]/&+ ,today's ,!at] says ab\t ! actor & act+ some?+ :i* ,i believe ab\t ! nurse & nurs+4 '444 ! actor 444 is 8 own in/rum5t4 ,8 tools are himself1 8 tal5t1 & 8 ability4 ,unlike o!r creative arti/s1 he mu/ "w ?r\gh & ) 8 own body1 voice1 emotions1 appe>ance1 & 8 own elusive p]sonal quality4444 ,he uses 8 intellig5ce1 8 memory ( emotions1 8 exp]i5ces1 & 8 k ( himself & 8 fell[ m5--b always he is 8 own in/rum5t4'#ac ,"h is ano!r example ( view+ nurs+ z a p]=m+ art4 ,once a nurse 0 try+ to describe ! nurs+ c>e %e receiv$ f ano!r nurse :5 %e _h be5 ill4 ,%e /ruggl$ ) "s details ( f9] po9ts & !n summ$ x up by say+1 ,i felt h] nurs+ c>e 0 j l a symphony4 ,t's ! only way ,i c describe x4 ,^! comp>isons br+ _m ae/hetic qualities to m9d1 = in/ance1 h>mony1 rhy?m1 tone1 feel+4 ,nurs+ is l music & drama 9 o!r ways4 ,! nurs+ proc$ure1 l a musical score or a play script1 all[s = individual int]pretations1 adaptations1 & embelli%m5ts4 ,al?\gh nurses foll[ ! same g5]al pr9ciples1 ea* c develop h] own unique /yle4 #ib ,if nurs+ really is view$ z a p]=m+ art1 !re are opportunities = creative exploration & developm5t ( ! art ( nurs+4 ,& fur!rmore1 ^! individualiz$ /yles ( nurs+ are wor?y ( description & %>+4 ,ano!r simil>ity is ! ephem]al "* ( nurs+1 music1 & drama4 ,a p>ticul> nurs+ transaction1 l a conc]t or play1 is transitory1 %ort-liv$4 ,yet ! effects may be long-la/+ & rememb]$4 ,!re is ?is diff]5ce 9 nurs+1 ,i believe4 ,ea* nurs+ transaction may fl[ into a /ream ( nurs+ c>e ext5d+ cont9u\sly ov] #bd h\rs a day = weeks1 mon?s1 ye>s4 ,& _m individual nurses get into ! act4 ,h[ does ?is affect ! art ( nurs+8 ,h[ is nurs+ l & unlike ! o!r p]=m+ arts8 ,! answ]s to ^! & simil> que/ions mu/ come f ! nurse-arti/s4 ,,humani/ic ,,nurs+ ,,z ,,cl9ical ,,art ,! relat$ness ( nurs+ & art1 view$ exi/5tially1 is m basic1 m fundam5tal ?an m]e simil>ity ( qualities & *>act]i/ics z discuss$ above4 ,bo? art & nurs+ are k9ds ( liv$ dialogue4 ,9 bo?1 man responds to 8 _w ( m5 & ?+s ?r\gh di/ance & relation4 ,!y affect him & he affects !m ) ! creative =ce ( 8 relation4 ,9 fact1 "o may say fur!r t humani/ic nurs+ is itself an art--a cl9ical art--creative & exi/5tial4 ,?is is evid5t :5 "o returns aga9 to ! ?+ itself1 to ! nurs+ dialogue z x is liv$ 9 ! ev]yday _w4 ,9 g5u9e meet+ ! nurse recognizes ! pati5t z di/9ct f h]self & turns to him z a pres5ce4 ,%e is fully pres5t to him1 au!ntically ) h] :ole be+ & is op5 to him1 n z an object1 b z a pres5ce1 a human be+ ) pot5tials4 ,9 su* a g5u9e liv$ dialogue1 ! nurse sees )9 ! pati5t a =m 7t is1 a possibility7 ( well-be+ or m-be+ 7or com=t or heal? or gr[?1 & s =?74 ,l a beautiful l&scape inspir+ a pa9t] or poet1 ! =m 9 ! pati5t addresses itself to ! nurse1 a call = help dem&+ recognition & response4 ,! =m is cle>] ?an exp]i5c$ objects2 x is n an image ( h] fancy2 x exi/s 9 ! pres5t al?\gh x is n objective4 ,! relation 9 :i* ! nurse 7arti/7 /&s to ! =m is real = x affects h] & %e affects x4 ,if %e ent]s into g5u9e relation ) ! pati5t 7,i-,?\7 h] effective p[] 7c>+1 nurs+ skills1 hope7 br+s =? ! =m 7well-be+1 m-be+1 com=t1 gr[?71 j z ! pa9t]'s or poet's p[] & skill create a pa9t+ or a poem4 ,( c\rse1 !re is ?is diff]5ce4 ,! art ( nurs+1 be+ goal-direct$ & int]subjective1 is m complex ?an ! arts ( pa9t+ & poetry1 = example4 ,z a cl9ical art1 x involves be+ ) & do+ )4 ,= ! pati5t mu/ p>ticipate z an active subject to actualize ! possibility 7=m7 )9 himself4 ,p]haps ! art ( nurs+ c\ld be describ$ z transactional4 ,n only does ! nurse see ! possibilities 9 ! pati5t b ! pati5t also sees a =m 9 ! nurse 7= example1 possibility ( help1 ( com=t1 ( support71 & he responds 9 relation to br+ x =?4 #ic ,!n ! "q logically may be rais$3 ,is ! pati5t's responses 9 relation 7,i-,?\7 a necess>y condition = ! art ( nurs+8 ,or to /ate x diff]5tly3 c !re be any art ( nurs+ ! infant1 ! unresponsive1 ! comatose1 ! dy+8 ,i w\ld answ] t ! art ( nurs+ c exi/ ev5 if ! relation is n mutual4 ,= z ,bub] writes1 ,ev5 if ! man to :om ,i say ,?\ is n aw>e ( x 9 ! mid/ ( 8 exp]i5ce1 yet relation may exi/4 ,= ,?\ is m ?an ,x realises4 ,no deception p5etrates "h2 "h is ! cradle ( ,real ,life4#ad ,,dialogical ,,nurs+3 ,,art-,,sci5ce ,art & sci5ce1 l nurs+1 repres5t angul> views4 ,ea* is a view ) a p>ticul> purpose4 ,!y are human responses to ! ev]yday _w 9 :i* man lives4 ,exi/5tially speak+1 ea* is a =m ( liv+ dialogue betwe5 man & 8 human situation4 ,x is possible t !re is 9 nurs+ a k9d ( human response to reality t is a comb9ation1 a true syn!sis ( art & sci5ce8 ,! m "o focuses on nurs+ z x is liv$1 on ! int]subjective transaction z x is exp]i5c$ 9 ! ev]yday _w1 ! m que/ions arise ab\t x z art & sci5ce4 ,elem5ts ( bo? art & sci5ce are evid5t 9 nurs+4 ,! practic+ nurse mu/ integrate !m 9 h] mode ( be+ 9 ! situation4 ,:ile ,dr4 ,joseph9e ,pat]son 0 develop+ a me?odology ( inquiry f a cl9ical nurs+ process & describ+ h] con/ruct ( ! all-at-once1 %e 0 s int5t on communicat+ ! int]relat$ reality ( ! art & sci5ce elem5ts 9 nurs+1 t %e weld$ !m toge!r ) a hyph5 into "o ^w1 art-sci5ce4 ,& ev5 !n !re is "s dissatisfaction :5 ! weld is int]pret$ m]ely z a seam4 ,= ! comb9ation is m ?an additive2 x is a new syn!tic :ole4 ,i exp]i5c$ a simil> difficulty 9 try+ to describe ! syn!sis ( art & sci5ce t takes place 9 ! nurs+ process4 ,! nurs+ dialogue reflects ! ori5tations ( art & sci5ce = x involves bo? ! pati5t's & ! nurse's subjective & objective worlds4 ,i believe ! syn!sis ( art & sci5ce is liv$ by ! nurse 9 ! nurs+ act4 ,?is is a ph5om5on m readily exp]i5c$ ?an describ$4 ,yet if we truly exp]i5ce nurs+ z a k9d ( art-sci5ce1 z a p>ticul> k9d ( fl[+1 syn!siz+1 subjective-objective int]subjective dialogue1 !n nurs+ (f]s a unique pa? to human k & x is our responsibility to try to describe & %>e x4 ,,footnotes3 #a ,new ,engl& ,c\ncil on ,high] ,education = ,nurs+1 ,humanities & ! ,arts z ,bases = ,nurs+3 ,implications = ,new] ,dim5sions 9 ,g5]ic ,nurs+ ,education1 ,proce$+s ( ! ,fif? ,int]-,univ]sity ,"w ,conf]5ce 7,l5nox1 ,mass3 ,new ,engl& ,c\ncil on ,high] ,education = ,nurs+1 ,june1 #aifh74 ,humanities1 ,human5ess1 ,humanit>ianism1 ,editorial 9 ,nurs+ ,outlook1 ,vol4 #ah1 ,no4 #i 7,septemb]1 #aigj71 p4 #ba4 ,*>les ,e4 ,b]ry & ,e4 ,j4 ,drummond1 ,! ,place ( ! ,humanities 9 ,nurs+ ,education1 ,nurs+ ,outlook1 ,vol4 #ah1 ,no4 #i 7,septemb]1 #aigj71 pp4 #cj-ca4 ,m>ion ,e4 ,kalkman1 ,! ,role ( ! ,humanities 9 ,graduate ,programs 9 ,nurs+1 9 ,doctoral ,prep>ation = ,nurses1 ed4 ,e/h] ,a4 ,g>rison 7,san ,francisco3 ,univ]sity ( ,cali=nia1 #aigc71 pp4 #ach-aee4 #b ,m>y ,jane ,trautman1 ,nurses z ,poets1 ,am]ican ,j\rnal ( ,nurs+1 ,vol4 #ga1 ,no4 #d 7,april1 #aiga71 p4 #gbg4 #c ,ibid41 p4 #gbh4 #d ,ibid4 #e ,*aim ,potok1 ,my ,"n ,is ,a%] ,lev 7,gre5wi*1 ,conn43 ,fawcett ,publications1 #aigb71 p4 #aje4 #f ,grayce ,c4 ,scott ,g>n]1 ,qualitative & ,quantitative ,analyses ( ,s*izophr5ic ,v]bal & ,non-,v]bal ,acts ,relat$ to ,select$ ,k9ds ( ,music1 ,humanities & ! ,arts1 p4 #di4 #g ,c>ol ,ann ,*ri/(f]s1 ,movig5ic ,nurs+3 ,an ,exp&$ ,dim5sion1 ,humanities & ! ,arts1 p4 #ie4 #h ,g>n]1 p4 #dj4 #i ,picasso z quot$ 9 ,my ,"n ,is ,a%] ,lev4 #aj ,john ,h]sey1 ,! ,conspiracy 7,new ,york3 ,alfr$ ,a4 ,knopf1 #aigb71 p4 #hb4 #aa ,faye ,g4 ,abdellah1 ,! ,nature ( ,nurs+ ,sci5ce1 ,nurs+ ,rese>*1 ,vol4 ,,xviii 7,septemb]-,octob]1 #aifi71 p4 #cic4 #ab ,art1 ,! ,great ,ideas3 ,a ,syntopicon ( ,great ,books ( ! ,we/]n ,_w ,i1 ,vol4 #b1 #aieb1 pp4 #fd-fe4 #ac ,ell5 ,t4 ,fahy1 ,nurs+ ,process z a ,p]=m+ ,art1 ,humanities & ! ,arts1 p4 #abd4 #ad ,m>t9 ,bub]1 ,i & ,?\1 #bnd ed41 trans4 ,ronald ,gregor ,smi? 7,new ,york3 ,*>les ,scribn]'s ,sons1 #aieh71 p4 #i4 #id #ie #i ,a ,,heuri/ic ,,culm9ation ,?is *apt] pres5ts an application ( ! humani/ic nurs+ practice !ory ov] "t & an outcome4 ,! outcome repres5ts my pres5t consci\s conceptualization ( my p]sonal !ory ( nurs+4 ,x has gr[n out ( my nurs+ practice exp]i5ce1 my reflect+1 relat+1 describ+1 & syn!siz+4 ,?is is heuri/ic culm9ation ( mu* mull+ ov] my liv$ _w ( nurs+4 ,,angul> ,,view3 ,,pres5t ,,p]spective ,9 #aiga aft] a pres5tation on concept developm5t ,i he>d myself 9 a *atty response to ! audi5ce decl>e my unique !ory ( nurs+4 ,x 0 bas$ 9 con/ructs t ,i _h develop$ & conceptualiz$4 ,previ\sly ,i _h view$ ^! con/ructs only z di/9ct entities4 ,my syn!sis ( !m surpris$ me4 ,?is 0 ! fir/ "t ,i convey$ !m z my :y1 h[1 & :at ( nurs+4 ,?is syn!sis may h em]g$ z a sequ5ce to my reexam9ation & reflection on ea* ( ^! con/ructs 9 prep>ation = ?is #aiga pres5tation4#a ,n[ x became evid5t t _! sequ5tial evolvem5t _h a logic t _h come f my be+ )\t my aw>5ess4 ,s9ce #aiga ,i h plann$ to reflect on ^! syn!tic con/ructs to bett] und]/& h[ !y relate to "o ano!r complem5t>ily4 ,:y8 ,to fur!r ! developm5t ( ^! con/ructs & to /ate !m z propositions4 ,/atem5ts ( propositions are movem5t t[>d nurs+ !ory4 ,!ory is consid]$ "h z a conceptualiz$ vision teas$ out ( my kn[+ f my nurs+ exp]i5ce4 #if ,l ,elie ,wiesel1 ! noveli/ & lit]>y arti/1 ,i write to bett] und]/& & to atte/ to happ5+s4 ,?is *apt] is ! fruit ( ?is endeavor4 ,! fir/ t]m1 com=t1 0 develop$ z a con/ruct 9 #aifg4 ,aft] record+ & explor+ my cl9ical exp]i5tial data1 a conceptualiz$ response em]g$ to my "q3 ,:y1 z a nurse1 am ,i 9 ! cl9ical heal?-nurs+ situation8 ,! second t]m1 cl9ical1 0 develop$ z a con/ruct 9 #aifh4 ,x 0 a conceptualiz$ response to a dialectical process )9 myself4 ,i ask$1 ,:at is cl9ical8 ,i answ]$1 ,i am a cl9ician4 ,i ask$1 ,z a nurse cl9ician :at d ,i d2 :at is ! condition ( my be+ 9 ! nurs+ situation8 ,i answ]$1 ,?is describ$ w\ld equate to cl9ical4 ,consequ5tly ,i comp>$ & contra/$ two nurs+ exp]i5ces simil>ly label$ to prop]ly grasp ! pr9ciple ( cl9ical = conceptualization4 ,! ?ird t]m or phrase1 all-at-once1 arose intuitively )9 me z a con/ruct 9 #aifi & 0 p>tially conceptualiz$4 ,x arose aft] mull+ ov] o!r nurses' publi%$ cl9ical data & ask+1 ,:at c y tell me ( ! cl9ical nurs+ situation8 ,:at d y p]ceive z ! nature ( nurs+8 ,!rese ,g4 ,mull]'s1 ,ru? ,gilb]t's & my ?\ght on ! nurs+ situation m]g$ into a view ( ^! z multif>i\sly load$ ) all levels ( incomp>able data1 ! all-at-once4 ,incomm5surables relate to ! nature ( nurs+ & its conc]ns4 ,h[ c "o /udy unrelat$ appe>ances8 ,mull] (t5 us$ an hi/orical approa* :ile ,gilb]t emphasiz$ individualization4 ,9 humani/ic nurs+ practice !ory a descriptive1 int]subjective1 ph5om5ological approa* is propos$ = great] und]/&+ & atte/ation ( ! ev5ts & process ( ! nurs+ situation4 ,! con/ruction ( com=t1 cl9ical1 & all-at-once ,i w\ld n[ label z conceptualiz$ ph5om5ologically4 ,i view !m z relevant ph5om5a to any nurse & ?is nurse-9-h]-nurs+-_w4 ,!ory3 ,unre/1 ,beg9n+ ,involvem5t ,?is desire to develop nurs+ !ory goes back to my ye>s 7#aiei-fd7 z a faculty memb] 9 a graduate nurs+ program4 ,i fuss$ ) ! idea1 did n "k exactly :at ,i 0 fuss+ ab\t1 & express$ my desire1 int]e/1 & conc]n poorly4 ,mu*1 ,i am sure n[1 to o!rs' dismay4 ,tea*+ 9 nurs+ 0 an (f]+ ( multitud9\s !ories develop$ 9 & = o!r discipl9es us+ nurs+ examples4 ,!re 7 bo? simil>ities & diff]5ces 9 ! _m nurs+ examples 9 :i* attempts 7 made to describe ! qualities ( ! p>ticipants' be+s4 ,emphasis 0 plac$ on ! obs]vations by ! nurse ( ! o!rs' responses 9 ! nurs+ situation4 ,nurs+ education 0 rife ) l5g?y repetitive examples utiliz$ to focus on p>ticul> v>iations4 ,i desir$ a unify+ base applicable to all nurs+ situations4 ,?is 0 n a seek+ = con=mity nor an attempt to negate individuality4 ,c]ta9ly ,i did n want su* a base to exclude individual nurses' tal5ts4 ,r ?is base1 f\ndation ( nurs+ indicative ( ! nature ( nurs+1 w\ld heuri/ically promote endless v>iations to fl[1 blossom1 cross-poll9ate1 & evolve4 #ig ,9 ^! obs]vations & ?9k+s ,i 0 attempt+ to und]/&1 sort out1 & cl>ify ! que/ions t und]lay my puzzlem5t4 ,?is puzzlem5t arose out ( my #ah ye>s 9 nurs+ practice & education4 ,9 a !ory c\rse & a philosophy ( sci5ce c\rse1 :ile 9 doctoral /udy1 ,i recogniz$ & le>n$ to label my unre/ & puzzlem5t z a recognition ( ! ne$ = nurs+ !ory4 ,9 #aiff 9 discuss+ my purposes = doctoral /udy1 ,i express$ ?is unre/ & puzzlem5t4 ,i view$ my v>i$ pa/ exp]i5ces 9 nurs+ z excell5t4 ,i s\ght "t to reflect on ! pa/ #bd ye>s ( liv+ nurs+ to see :at x c\ld tell me1 & to come to bett] und]/& its mean+ to ! pr(ession ( nurs+4 ,! philosophical nature ( ^! que/ions & :at !y express ( myself is evid5t4 ,su* p]sonal revelation at ?is "t is no risk1 & )hold+ w\ld only deprive myself & o!rs ( ! answ]s t might be br\ght =?4 ,z 9 mo/ s*ool situations initially respond+ to class assignm5ts & involvem5t 9 new cl9ical situations consum$ my "t & ?w>t$ my p]sonal1 pr(essional int]e/s4 ,:5 ,i comm5t$ on ?is my int]e/s 7 int]pret$ to me z a desire to live 9 ! pa/4 ,liv+ 9 ! pres5t 0 recomm5d$ & t]ms l up-to-date & progressive 7 employ$4 ,i felt /opp$ cold4 ,i _h nev] view$ myself z old fa%ion$ or non-progressive4 ,_m ( my pa/ nurs+ exp]i5ces 7 /ill avant-g>de z comp>$ ) g5]al curr5t practices4 ,!re 0 some?+ diff]5t ?\gh 9 recall+ & reflect+ on ! pa/ z oppos$ to curr5t exp]i5ces4 ,"o's pa/ w\ld be visible 9 view ( h[ "o approa*$ & exp]i5c$ ! pres5t4 ,self-confrontation mov$ me beyond conf9+ myself ei!r to ! pa/ or to ! pres5t4 ,9 my writ+s "o c\ld detect a comp>ison ( :at _h be5 kn[n ) :at 0 com+ to be kn[n4 ,x 0 z if a light ( a diff]5t hue lit up ! :ole--pa/ & pres5t--z a diff]5t sc5e4 ,simil>ly ,i view$ & exp]i5c$ my cl9ical exp]i5ce diff]5tly4 ,i ga9$ aw>5ess ( a quality ( my be+ t always _h be5 !re1 b :i* ,i hid4 ,n[ ,i valu$ ?is "p1 /ruggl$ ) x1 & express$ x directly ) c\rage1 integrity1 & pride4 ,! p[] ) :i* ?is self-actualization imbu$ me has be5 sculptur+ my ,i into a =m ( my *oos+ ev] m acceptable to me1 & accept+ ( o!rs4 ,concept ,developm5t ,9 a nurs+ !ory c\rse ! f9al assignm5t 03 develop a concept relevant to nurs+4 ,aga9 ,i f\nd myself /ruggl+4 ,! didactically /at$ importance ( inve/+ preci\s "t & en]gy into con/ruct+ a syn!tic conceptualization ( a t]m elud$ me4 ,"t & en]gy sp5t to bett] und]/& man z he 0 kn[n to me 9 ! nurs+ situation seem$ s limit$4 ,9 ^! situations p]sons 7 express+ s _m ?+s at "o "t1 h[ c\ld ! conceptualization ( "o t]m be relevant4 ,f9ally ,i und]/ood3 no "o 0 say+ t any "o t]m c\ld equate any p>ticul> or gr\p ( #ih nurs+ situations4 ,!y 7 say+ t to communicate ! nature or exp]i5ce ( nurs+ ) words1 to develop nurs+ !ory1 relevant t]ms ne$$ cl>ification z to ! mean+ !y convey$ & del9eation z to _! inclusiv5ess & exclusiv5ess4 ,z ?is /ruggle subsid$ ,i c\ld he>1 a t]m c\ld be develop$ z a concept or syn!tic con/ruct if "o conceptualiz$ its :y1 :at1 h[1 :51 & :]e & h[ ^! int]relat$4 ,9 approa*+ concept developm5t ! la/ b n lea/ hurdle 01 :at t]m did ,i consid] relevant en\gh 9 nurs+ to exp5d ?is preci\s "t & en]gy on consid]+ ! _m possibilities4 ,! fir/ t]m ,i began to intellectually play ) 0 ambival5ce4 ,n[1 ,i w\ld attribute my selection ( ambival5ce to my !n exi/+ ambival5ce ab\t conceptualiz+ a syn!tic con/ruct4 ,!n1 ,i bas$ its selection only on its exi/5ce 9 my cl9ical nurs+ _w4 ,i 0 work+ !rapeutically on a regul>1 individual basis ) an ambival5t adolesc5t male label$ diagno/ically z a p>anoid s*izophr5ic4 ,i began to consid] my cl9ically record$ data ( my sessions ) ,bob ?r\gh ambival5ce4 ,:at 7 ! relation%ips betwe5 :y1 h[1 :at1 :51 & :]e ,bob express$ ambival5ce8 ,/ruggl+ ) ! t]m ambival5ce involv$ & int]e/$ me 9 concept developm5t4 ,dur+ ?is phase ,i ov]came my fe> ( expos+ my ?\ghts1 ,i took ! risk1 & my c\rage _h ! upp] h&4 ,nev]!less1 ano!r *oice _h to be made s9ce n[ ,i 0 n will+ to inve/ ?is mu* "t on conceptualiz+ ambival5ce z s relevant to nurs+4 ,p]haps ?is signifi$ t my own ambival5ce _h dissipat$4 ,& aga91 ,i fac$ ! "q1 :at t]m w\ld ,i want to develop z a syn!tic con/ruct8 ,! next "q t occurr$ to me 01 :at t]m w\ld indicate :y1 z a nurse1 ,i am 9 ! cl9ical heal?-nurs+ situation8 ,did ,i view my value ma9ly z gr[?1 heal?1 fre$om1 or op5ness promotion8 ,i work$ = a :ile ) ea* ( ^! t]ms & ev5tually disc>d$ !m4 ,"s long-hospitaliz$ p]sons ) :om ,i 0 work+ on a demon/ration psy*iatric unit to prep>e !m = a m indep5d5t & appropriate =m ( community liv+ w\ld nev] be /ably balanc$ 9 heal?1 gr[+1 fre$om or op5ness4 ,= _m1 ^! c\ld be only flitt+ memorable beautiful mom5ts4 ,/ill ,i believ$ ,i 0 v mu* !re 9 ! nurs+ situation = ^! p]sons1 z well z = ^? :o mov$ into ! community & f\nd "w & social satisfactions4 ,some?+ occurr$ betwe5 all ( ^! #ae pati5ts & myself--& t 0 nurs+4 ,,com=t3 ,,:y ,:ile consid]+ :at con/ruct to conceptualize1 ,i 0 9 ! process ( record+ my ?ree-h\r1 twice a week int]actions 9 ! demon/ration unit4 ,i reflect$ on ^! int]actions & wait$ = ! data to reveal to me ! major value und]ly+ my nurs+ practice4 ,!n ! t]m com=t came #ii to m9d4 ,p]haps at ?is po9t ,i became com=table 9 ?is unit1 or p]haps ! unit1 itself1 became a m com=table sett+4 ,:5 ,i _h fir/ begun my exp]i5ce ) ?is demon/ration unit1 x 0 /ill be+ plann$ & ! hospital 0 new to me4 ,h[ev]1 ! t]m com=t has long be5 associat$ ) nurs+4 ,"o c f9d x z a hi/orical con/ant ?r\gh\t ! pr(essional nurs+ lit]ature4 ,! t]m _h be5 us$ rec5tly 9 an ,,ana publication4#b ,:5 ,i consid]$ ! idea ( com=t+ 9 nurs+ practice ,i felt su* exp]i5ces _h fulfill$ & satisfi$ me1 made me feel adequate4 ,i c\ld recall specific exp]i5ces t w5t back to my initial nurs+ practice sett+s4 ,i c\ld conceive ( com=t z an umbrella "u :i* all ! o!r t]ms--gr[?1 heal?1 fre$om1 & op5ness--c\ld be %elt]$4 ,"s ( my contempor>ies sc(f$ & view$ ?is t]m z mu* too trivial4 ,n[1 aga9 review+ my mon?s ( ga!r$ cl9ical data1 ,i sort$ out #ab nurse behaviors t ,i view$ z aim+ t[>d pati5t com=t4 ,!y 73 #a4 ,i focus$ on recogniz+ pati5ts by "n1 be+ c]ta9 ,i 0 correct ab\t _! names1 & us+ _! names (t5 & appropriately4 ,i also introduc$ myself4 ,names 7 view$ z supportive to ! int]nalization ( p]sonal id5tification1 dignity1 & wor?4 #b4 ,i int]pret$1 taught1 & gave z mu* hone/ in=mation z ,i c\ld ab\t pati5ts' situations :5 x 0 s\ght or :5 puzzlem5t 0 app>5t4 ,?is 0 bas$ 9 ! belief t x 0 _! life1 & *oice 0 _! pr]ogative z !y 7 _! own projects4 #c4 ,i v]baliz$ my acceptance ( pati5ts' expressions ( feel+ ) explanations ( :y ,i exp]i5c$ ^! feel+s ( acceptance :5 ,i c\ld d ?is au!ntically & appropriately4 #d4 ,:5 v]balizations ( acceptance 7 n appropriate1 ,i act$ out ?is acceptance by /ay+ ) or do+ = :5 appropriate4 #e4 ,i express$ purposely1 to bur/ asund] negative self-concepts1 my au!ntic human t5d] feel+s = pati5ts :5 appropriate & acceptable4 #f4 ,i support$ pati5ts' rights to agape-type love relation%ips ) o!rs3 families1 o!r /aff1 & o!r pati5ts4 #g4 ,i %[$ respect = pati5ts z p]sons ) ! "r to make z _m *oices = !mselves z _! curr5t capabilities all[$4 #h4 ,i attempt$ to help pati5ts consid] _! curr5tly express$ feel+s & behaviors 9 light ( pa/ life exp]i5ces & patt]ns1 l & unlike _! curr5t ones4 #ajj #i4 ,i enc\rag$ pati5ts' expression to bett] und]/& _! behavioral messages & to enable me to respond ov]tly z !rapeutically z possible4 #aj4 ,i v]ifi$ my intuitive grasp ( h[ pati5ts 7 exp]i5c+ ev5ts by que/ions & comm5ts & be+ al]t to _! responses4 #aa4 ,i attempt$ to enc\rage hope reali/ically ?r\gh discuss+ individual !rapeutic ga9s t c\ld be d]iv$ f pati5ts' inve/m5t 9 !rapeutic opportunities available to !m4 #ab4 ,i support$ appropriate pati5t self-images ) z _m concrete h>d to d5ies z possible4 ,ea* ( ^! nurse behaviors 0 repeat$ly evid5t 9 ! mon?s ( record+ pati5t-nurse int]actions4 ,= ! conceptualization ( ! t]m com=t1 a repres5tative cl9ical example 0 giv5 to enhance ! mean+ ( ! behavior cit$ 7see ,app5dix74 ,:5 compil+ mat]ials = ! conceptualization ( ?is t]m1 ,i f\nd #ab assumptions ab\t psy*iatric nurs+ t ,i _h writt5 = ! !ory c\rse 9 "o ( ! fir/ class sessions4 ,al?\gh ^! assumptions 7 express$ 9 diff]5t words1 _! congru5ce ) my #ab select$ behaviors made me believe t ^! behaviors 7 someh[ v]ifi$ bo? 9 my conceptualiz$ philosophy ( psy*iatric nurs+ & 9 my behavior :ile be+ a psy*iatric nurse4 ,next ,i /ruggl$ ) an ideali/ic conception ( com=t z oppos$ to a cont9uum ( behavior :i* w\ld indicate a p]son's degree or /ate ( discom=t-com=t4 ,aga91 reflect+ on & teas+ out aspects ( my data1 ,i set up f\r behaviorally recognizable crit]ia = e/imat+ a p]son's discom=t-com=t /ate3 #a4 ,relation%ips ) o!r p]sons :i* confirm "o z an exi/5t important p]son4 #b4 ,affective adaptation to ! environm5t 9 accord ) k1 pot5tial1 & values4 #c4 ,aw>5ess ( & response to ! reality ( ! n[ ) und]/&+ ( ! influ5ce ( & sep>ation f ! pa/4 #d4 ,appreciation & recognition ( bo? p[]s & limitations :i* enlight5 ! alt]natives ( ! future4 ,^! behavioral crit]ia1 too1 c\ld ea* be spread on a cont9uum to evaluate ! effects ( ?is aim ( nurs+ on a pati5t's actual com=t /atus at any p>ticul> po9t 9 "t4 ,consid]+ ! concept ( com=t z a prop] aim ( psy*iatric nurs+ br\ght =? ! necessity ( consid]+ its opposite1 discom=t1 z a concept4 ,evid5ce = ! exi/5ce ( discom=t c\ld be inf]r$ 9 ! abs5ce ( ! above behavioral crit]ia4 #aja ,! basic f\ndation to ju/ify ! concept ( com=t z a prop] aim ( psy*iatric nurs+ w\ld be bo? organic & environm5tal4 ,9 our culture1 among ! species man1 we are mov+ t[>d be+ able to effect "s organic conditions by g5etic controls & surgical & *emical means4 ,! pr(essions h /ruggl$ long ye>s to influ5ce environm5tal det]r5ts to com=t4 ,if an individual z a fetus1 or z an infant1 or "y *ild nev] int]nalizes com=t ( any k9d f 8 environs1 ! probability ( initiat+ a cont9uum )9 himself z an adult t is propell$ t[>d com=t seems unlikely4 ,su* individuals1 lack+ any pot5tial capacity = com=t1 ,i suspect are r>e4 ,!re is evid5ce = ! exi/5ce ( ?is dormant se$ ( com=t 9 p]sons ) s*izophr5ia 9 ! hospital sett+4 ,consid] h[ repetitively & ambival5tly !y rea* out to au?ority figures4 ,?is dormant com=t se$ requires n\ri%m5t ( a high quality = te/+ :e!r x c develop & be> ! fruits ( heal?1 gr[?1 fre$om1 & op5ness4 ,:5 ! developm5t ( ?is syn!tic con/ruct ( com=t 0 discuss$ 9 ! !ory c\rse a "q 0 rais$3 ,is a p]son :o d5ies all feel+1 pres5ts himself z emotionally dead1 com=table8 ,if feel+s are n relegat$ to ! m9d alone1 z ! effects ( a peptic ulc] _c be relegat$ to ! /oma*1 if feel+s are an ess5tial ( ! nature ( humanness1 a human :o d5ies ?is ess5tial ( 8 nature w\ld n fit into ?is concept z com=table4 ,?is syn!tic con/ruct ( com=t1 l its synonym cont5tm5t1 describ$ by ,plut>* ,a4,d4 #df-abj1 does n imply passivity1 resignation1 retirem5t1 or a simple avoid+ ( tr\ble4 ,plut>* said1 ,cont5tm5t comes v de> if its price is inactivity4#c ,i w\ld p]ceive ( com=t or cont5tm5t z imply+ t a human be+ 0 all he c\ld be 9 accordance ) 8 pot5tial at any p>ticul> "t 9 any p>ticul> situation4 ,cont9u+ ! a=em5tion$ twelve nurse behaviors1 obs]v+ behavior ?r\gh ! f\r e/abli%$ crit]ia & conceptualiz+ ! con/ruct ( com=t1 ,i began to wond]4 ,0 ,i see+ :at ,i _h decid$ 0 ! /ate ( psy*iatric pati5ts' conditions ( be+8 ,0 ,i project+ discom=t onto pati5ts8 ,i did n expect /raight answ]s4 ,none!less1 ,i decid$ to ask pati5ts ab\t _! discom=t-com=t /ates to v]ify my p]ception ( ! condition ( _! be+s4 ,all f\rte5 pati5ts ,i ask$ assur$ me by _! responses t ,i 0 n project+ or see+ discom=t :]e x did n exi/4 ,"s describ$ physical discom=t & s\ght ! cause )9 & outside !mselves 7ei!r ano!r caus$ x1 or ano!r c\ld cure x1 pills w\ld cure x71 negatively view$ self-images1 guilt bas$ 9 _! behaviors or ?\ghts4 ,"o pati5t def9$ com=t by analogy & /at$ directly to my surprise t he seldom felt com=table & t 8 excessive rituali/ic behavior 0 8 way ( cop+ ) 8 discom=t4 ,"o repetitively /at$ a happy illusion t he seem$ to hang on to = de> life4 ,:5 ,i ask$ :at he w\ld d if ?is illusion 0 n tru?1 he said t he _h nev] consid]$ #ajb ?is possibility4 ,i knew he _h be5 confront$ ) ! tru? ( 8 situation _m times 9 _m ways4 ,"o pati5t m]ely look$ directly at me & walk$ away4 ,!n ,i aga9 review$ my cl9ical record$ data to see :at k9ds ( k nurs+ ) an aim to com=t w\ld inf] z necess>y4 ,fifty-two items ( k 7 extrapolat$ f ! cl9ical examples select$ z repres5tative ( ! twelve nurse behaviors4 ,^! items 7 categoriz$ "u broad cognitive & affective doma9s4 ,?is 0 an arbitr>y po9t ( sep>ation4 ,!y 7 teas$ ap>t simply z an aid to conceptualization & und]/&+4 ,if ^! k doma9s _h relat$ to "o ano!r 9 a simple direct mann]1 ,i w\ld h convey$ !m 9 a table 9 :i* ea* w\ld h be5 across f its mate4 ,_! relation%ips to "o ano!r 7 f> too complex to be h&l$ 9 any su* a way4 ,! affective doma9 k areas 7 a dynamic int]naliz$ syn!sis ( sev]al k areas f ! cognitive doma94 ,?us1 ! expression ( ^! affective k areas 0 evid5ce ( ! practice ( nurs+ z an artful =m ( express+ cognitive kn[+4 ,9 look+ directly at ! discom=t ( long-t]m hospitaliz$ psy*iatric pati5ts1 ,i f\nd myself fac$ ) behaviors t result$ possibly f a muddle ( _m contributories4 ,:at 9 ! behavior result$ f lifetime environm5tal influ5ces & comp\nd$ responses t deep5$ sc>s8 ,:at result$ f long-t]m hospitalization8 ,h[ _m v>ieties ( ills sup]impos$ l lay]s on ! above 7 express$ 9 :at ,i saw z discom=t 9 ^! psy*iatric pati5ts8 ,diagno/ic classifications are necess>y = /ati/ical economic plann+ reasons4 ,/ill1 h[ naively & sup]ficially !y convey ! human !rapeutic c>e ne$s ( ea* p]son4 ,at ?is po9t ( con/ruct developm5t ,i saw a positive relation%ip 9 my ?9k+ ab\t com=t z a prop] aim ( psy*iatric nurs+ & ,viktor ,frankl's description ( 8 aim 9 logo!rapy t[>d mean+4 ,i _h /ruggl$ ) ! idea ( aim+ at com=t :ile ) pati5ts :o possess$ ability & a favorable prognosis1 (t5 purposefully & delib]ately ask+ !m to consid] ideas t caus$ !m imm$iate great] discom=t4 ,frankl's quotes f ,nietzs*e & ,goe! support$ my altrui/ic int5tion4 ,nietzs*e said3 ,he :o has a :y to live c be> almo/ any h[4#d ,goe! said3 ,:5 we take man z he is1 we make him worse2 b :5 we take man z if he 7 already :at he %\ld be1 we promote him to :at he c be4#e ,9 conclusion to ?is /age ( developm5t ( a syn!tic con/ruct ( com=t z an aim ( psy*iatric nurs+ ,i c say3 ,com=t is an aim t[>d #ajc :i* p]sons' conditions ( be+ move ?r\gh relation%ip ) o!rs by int]naliz+ fre$om f pa9ful controll+ effects ( ! pa/4 ,^! effects h inhibit$ _! self-control1 reali/ic plann+1 & prev5t$ !m f be+ all t !y c\ld be 9 accordance ) _! pot5tial at any p>ticul> "t 9 any p>ticul> situation4 ,i w\ld project ?is z an aim = nurs+ 9 all situations al?\gh ! data = con/ruct+ ?is conceptualization 7 ga!r$ 9 a cl9ical psy*iatric sett+4 ,,cl9ical3 ,,h[ ,z a compon5t ( my doctoral exam9ations ,i 0 fac$ ) hav+ to rewrite a cl9ical pap]4 ,?is l$ to my delib]ately & p]sonally *oos+ to conceptualize a syn!tic con/ruct ( cl9ical4 ,?is 0 my decision4 ,x speaks well = ! value ( hav+ _h ! exp]i5ce ( conceptualiz+ com=t4 ,(t5 x is said t man repeats t :i* he f9ds z mean+ful & good4 ,?is *oice also signifies a real ov]com+ ( my resi/ance & ambival5ce t[>d syn!tic con/ruct developm5t 9 a ye>'s "t4 ,cl9ical 0 develop$ z a syn!tic con/ruct 9 #aifh4 ,x 0 a conceptualiz$ response to a dialectical process )9 myself4 ,if ,i am a cl9ician1 !n h[ ,i am 9 ! heal?-nurs+ situation w\ld equate to cl9ical4 ,9 conceptualiz+ ?is con/ruct ,i teas$ out ( my liv$-nurs+-_w ! h[ ( my work+ t[>d my own & o!rs' com=t4 ,confusion1 ov] :at 0 meant :5 p]sons casually & curr5tly popul>ly attribut$ ! t]m cl9ical to situations & p]sons1 call$ =? ?is conceptualization4 ,x grew out ( comp>+ & contra/+ two nurs+ consultation exp]i5ces 9 ! psy*iatric-m5tal heal? area4 ,beg9n+ ?is conceptualization ,i w\ld h ref]r$ to bo? ^! exp]i5ces z cl9ical4 ,at ! t]m9ation ( ! conceptualization !y 7 bo? cl9ical4 ,!y 7 v diff]5t exp]i5ces = me1 & yet ( equal value 9 my advancem5t t[>d my m ( be+4 ,prior to ?is conceptualization because my att5d+ emotions 7 s di/urb+ & unacceptable to me 9 relation to "o ( ^! exp]i5ces1 automatically ,i repress$ "p ( !m & f\nd reasons to suppress ! re/ ( !m4 ,un=tunately1 all else t 0 ( value to me 9 hav+ liv$ ?is exp]i5ce 0 integrally enme%$ ) ^! emotions4 ,?is1 too1 became unavailable to my consci\s aw>5ess4 ,conceptualization made recall & reflection a necessity4 ,cl9ical includes inh]5tly a process ( exp]i5c+ aw>ely & !n recall+1 look+ at1 reflect+ on1 & sort+ out to come to kn[+4 ,be=e kn[+ h[ to approa* ! rewrit+ ( my cl9ical pap] z a p>tial requirem5t = receiv+ my doctoral degree ,i exp]i5c$ a depression4 ,i felt fright5$1 angry1 & inadequate4 ,! orig9al cl9ical pap] _h be5 judg$ z m intellectual & s*ol>ly ?an cl9ical4 ,i c\ld conceive ( only two alt]natives4 ,bo? seem$ self-defeat+4 ,"o1 ,i c\ld revise my =m] cl9ical pap] into a m intellectual & s*ol>ly pap] t /ill #ajd w\ld n be cl9ical & w\ld /ill leave my ,i out4 ,or1 two1 ,i c\ld revise my =m] cl9ical pap]1 dump all my feel+s 9 ! situational exp]i5ce1 blame ev]yone else = ^! feel+s1 & culm9ate at lea/ ) my cl9ical passions visible4 ,conflict result$ f my consid]+ pursu+ ei!r ( ^! r\tes4 ,i 0 immobiliz$ = a "t4 ,a "t limitation & "t pass+ pu%$ me to beg9 some:]e4 ,i began4 ,*oos+ ! second alt]native 9 ! belief t at lea/ ?r\gh writ+ ,i w\ld bett] und]/& :at ,i _h liv$ 9 ! exp]i5ce4 ,i c\ld support ! value ( dr$g+ up ^! old feel+s & look+ at !m4 ,au!ntically lett+ myself be aw>e ( :at ,i _h exp]i5c$1 n necess>ily communicat+ ?is or act+ out 9 accordance ) ^! r$r$g$ feel+s2 j really look+ at !m might all[ me *oice 9 h[ ,i want$ to live ) !m4 ,"o support = ! value ( look+ at ^! old feel+s 0 my own pa/ ?ree & "o-half ye>s 9 psy*oanalysis 9 :i* ,i pr(it$ ?r\gh su* a process4 ,! o!r support 0 my read+s ( ! pa/ two ye>s4 ,^! includ$ works ( ,russell1#f ,nietzs*e1#g ,plato1#h ,popp]1#i ,dewey1#aj ,bub]1#aa ,b]gson1#ab ,c\s9s1#ac & de ,*>d94#ad ,z ?is exp]i5ce became 9 %ape & mean+ ?r\gh my writ+1 ,i began to view ?is product z l an exi/5tial play fill$ ) blatant atrocities & absurdities t _h to be nonrealities4 ,?is production1 also1 made visible beautiful raw data4 ,z mean+ 9 ?is cl9ical nurs+ consultation exp]i5ce z a graduate /ud5t became evid5t1 comp>ison ( x ) ! mean+ ( cl9ical "w exp]i5ces 9 nurs+ consultation situations fl[$ naturally4 ,!n joy1 x 0 l sun%9e bur/ =? & w>m$ my _s4 ,be=e ent]+ s*ool1 ,i 01 = two ye>s1 a m5tal heal? psy*iatric cl9ical nurse consultant to a /aff ( =ty-five visit+ nurses4 ,i _h become intrigu$ #aje ) :at ,i _h come to und]/& ab\t consultation relat$ to cl9ical situations4 ,i wrote a pap] = publication on ! subject4 ,busy 9 ! process ( return+ to s*ool1 & await+ ! publication ( two o!r pap]s--bo? ( ^! proce$+s feel+ unreal & out ( my control1 n to m5tion self-expos+--,i m]ely fil$ 9 my desk ! typ$ submittable r5dition ( ?is consultation pap]4 ,n[1 ,i dug x out4 ,?is meant t ,i _h two conceptualiz$ pres5tations ( simil> type p]sonal exp]i5ces 9 nurs+ consultation to comp>e & contra/4 ,f ^!1 my conceptualization ( cl9ical1 & ! values on :i* my cl9ical practice re/s1 c\ld be extrapolat$4 ,a ,/ud5t ,consultation ,exp]i5ce ,becomes ,cl9ical ,9 ! graduate /ud5t nurse consultation exp]i5ce ,i felt helpless1 confus$1 unwant$1 guilty1 anxi\s1 & unimportant4 ,x 0 a passion-fill$ exp]i5ce = me4 ,z a nurse-/ud5t consultant among int]discipl9>y non/ud5t-consultants ,i exp]i5c$ dep5d5cy = my be+ & do+ on p]sons ,i view$ z anxi\s1 critical1 nonempa!tic1 & inadequate4 ,we 7 attempt+ to (f] consultation to a pr(essional gr\p ( nonpsy*iatric m5tal heal? ori5t$ consultees :o 7 anxi\s & felt inadequate 9 ?is area4 ,i felt =c$ into an obs]v] r ?an p>ticipant mode ( be+1 & my record$ data support ?is4 ,impot5cy comes to m9d :5 ,i recall ?is exp]i5ce1 z well z a rack+ rage & suff]+ t oblit]ates feel+s ( love1 good-w1 t5d]ness1 or hope4 ,ab\t t "t ,i 0 read+ ,nietzs*e's et]nal recurr5ce ph5om5on#ae & view$ x mo/ pessimi/ically--all 0 awful1 x w\ld cont9ue to be awful1 life 0 j a vici\s cycle ( awfulness4 ,def5se or heal?1 x is que/ionable4 ,sudd5ly1 p]haps x 0 hav+ hit feel+s ( rock bottom1 ,i began to view ,nietzs*e's et]nal recurr5ce ph5om5on optimi/ically4 ,did ! pol>ization ( my negative feel+s magnetically call =? my opposite feel+s8 ,all1 n[1 conta9$ ! new1 x w\ld cont9ue to conta9 ! new1 life 0 a s]ies ( simil> & yet diff]5t cycles t always conta9$ ! new4 ,n[ my reflections let 9 hope1 positiv5ess1 comrade%ip1 good feel+s1 & progress made by myself & o!rs 9 our ye> & a half toge!r z consultants4 ,dur+ ?is p]iod we met ) ! consultees = an h\r once or twice a week4 ,! gr\p _h cont9u$ ov] ?is p]iod despite its compon5ts ( psy*iatric m5tal heal? pr(essionals & nonpsy*iatric m5tal heal? pr(ession culturally1 pr(essionally1 & hi/orically hav+ be5 q ali5at$ f "o ano!r4 ,att5dance _h improv$ "s ov] "t4 ,t[>d ! end ( ! ye> & a half1 dur+ ! la/ ?ree mon?s1 ! focus ( discussion 0 on pati5ts & _! worlds = long] p]iods ( "t4 ,!re 0 less def5sive act+ out 9 :i* ?+s1 fees1 "t1 & me*anics consum$ ! h\r4 #ajf ,t[>d ! end ( ^! sessions ! consultant *ief f\nd m acceptable space 9 :i* to meet = ! consultation4 ,eat+ lun* became "p ( ! session4 ,food c be look$ at 9 _m ways4 ,9 ?is case x seem$ to be a cohesive =ce1 r ?an a di/ract+1 socializ+ =ce4 ,0 ?is because ( ! und]ly+ mean+s food _h = ^! p8 ,or 0 ! mean+ ( food 9 ?is situation concrete8 ,n[ ! consultees c\ld h _! lun* s]v$ to !m :ile receiv+ consultation4 ,?is latt] sav$ _! "t & meant money to !m4 ,?is 0 a giv+ ge/ure on ! "p ( ! consultants ev5 ?\gh ! lun* monies did come out ( ! project fund+ s\rce4 ,! mean+ ( food 0 nev] discuss$ 9 ! gr\p4 ,i wond] if ?is fe$+ 0 done ) delib]ate aw>5ess or 0 j s]5dipit\s4 ,dur+ ! la/ ?ree mon?s ( meet+ ,i began to feel relat$ on a deep] level ) a few ( ! p>ticipants1 consultants & consultees4 ,individual to individual we began to communicate collaboratively ) "o ano!r z pr(essional colleagues4 ,we discuss$ bo? pati5ts' liv$ worlds & ! mean+ ( psy*iatric m5tal heal? t]ms & ideas4 ,i c conceive1 n[1 t ?is may h occurr$ betwe5 o!r gr\p memb]s be=e or aft] sessions4 ,initially !re 7 (t5 only two to ?ree consultees to five or six consultants4 ,lat] ! total gr\p conta9$ fifte5 to sixte5 p4 ,n[ ,i w\ld project t ! v exi/5ce ( ?is gr\p c\ld influ5ce future gr\ps positively4 ,a ,cl9ical ,"w ,consultation ,exp]i5ce ,9 ?is "w consultation exp]i5ce my feel+s 7 op5ness1 reflectiv5ess1 pa91 helpfulness1 al]tness1 se>*fulness1 appreciativ5ess1 receptiv5ess1 responsiv5ess1 want$ness1 compet5ce1 joy1 & importance4 ,x 0 bo? a passionate & a dispassionate exp]i5ce4 ,z a work+ consultant ,i met ) consultees ei!r alone or z "p ( a collaborat+ team ( consultants4 ,(t5 ! situations ! consultees pres5t$ :i* !y /ruggl$ ) & /ay$ 9 /ruck me ) awe4 ,!y ar\s$ my humility :ile mak+ me feel :ole & fulfill$ 9 my p>ticipation ) ! consultees4 ,9 my explorations ( & ) ! consultees my pres5ce1 !r5ess1 & au!nticity 7 all important4 ,bub] w\ld say t my aim 9 consultation 0 to imag9e ! real ( :at ! consultee & ! pati5ts & families %e discuss$ ) me c\ld be4#af ,?is 0 my initial disposition4 ,i aim$ to be op5 to & accept ! pot5tials ( ^! o!rs4 ,9 initial receptiv5ess1 gr\nd$ 9 my com=t1 0 ! key to ! door ( ! consultant-consultee ,i-,?\ relation 9 :i* ,i c\ld come to "k intuitively ! exp]i5ce ( ?is p>ticul> o!r nurse-9-h]-liv$-nurs+-_w4 ,! consultees (f]$ _! liv$-nurs+-worlds ea* 9 _! unique ways4 ,"s discuss$ directly _! pa9s1 joys1 adequacies1 & inadequacies4 ,"s discuss$ indirectly _! panic1 success1 action1 & immobilization4 ,"s beyond be+ able to discuss _! liv$-worlds #ajg spontane\sly act$ out _! liv$-worlds4 ,= example1 ^! (t5 behav$ t[>d me z _! pati5ts & families behav$ t[>d !m4 ,^! k9ds ( act$ out liv$-worlds ,i _h to s5se my way into to und]/&4 ,:5 ,i began to wond] :at x 0 t !y want$ f consultation to take back to _! liv$-nurs+-worlds1 ,i w\ld pull out ( ! ,i-,?\ =m ( relat+4 ,?is wond]m5t became my consci\s clue4 ,x 0 "t to reflect & look at :at my explorations _h uncov]$4 ,at ?is po9t transc5d+ ?is ,i-,?\ relation1 ,i w\ld look at ,x4 ,see+1 n[1 :at 0 )9 me1 :at ! condition ( my be+ 0 t ,i _h intuitively tak5 on f ! consultee1 ,i w\ld set x ap>t f myself1 & see x z an empa?ic response4 ,i knew t ^! feel+s ,i exp]i5c$ :i* ,i receiv$ exi/5tially1 globally ?r\gh ! comp\nd ( ! consultee's words1 tone inflection1 volume1 facial expression1 po/ure1 & position+ to me 7 :at %e exp]i5c$ 9 h]-nurs+ _w4 ,v]balization ( ?is empa?iz$ und]/&+ fulfill$ sev]al purposes3 7#a7 x convey$ my sympa?y or joy )1 & always my c>+1 7#b7 x validat$ t ,i saw x z x 0 = ?is nurse1 & 7#c7 x op5$ ! door to our work+ ?r\gh ! possible mean+s ( ! nurse's exp]i5ce & to speculat+ ab\t outcomes ( alt]native future nurse actions & behaviors4 ,cognitively ! range ( ^! consultation discussions 0 broad4 ,"s common !mes 7 social & heal? hi/ories ( families1 p]t95t psy*ological gr[? & developm5t factors ( p]sons 9 ! families ( conc]n to ! consultees1 relation%ips betwe5 p]sons )9 ! situations1 res\rces available to ! families1 ways ! consultees c\ld relate ) ! p>5ts & pati5ts' families1 fri5ds1 & o!r pr(essionals 9 ! situation1 & ! mean+ ( all ^! !mes to ! p>ticul> consultee4 ,?is cl9ical consultation exp]i5ce necessitat$ my be+ c]ta9 ways4 ,x necessitat$ my be+ au!ntic ) myself ) reg>d to :at responses 7 call$ =? 9 me 9 relat+ ) a p>ticul> consultee4 ,i view$ hone/y ) ! consultee z a value necess>y to ! consultation process4 ,9 approa*+ ! consultation ,i ne$$ to be op5 to ! consultee's angul> view & pr$ispos$ t[>d an ,i-,?\ relation%ip4 ,! ,i-,?\ relat+ necessitat$ subsequ5t sci5tific und]/&+ extrapolat$ f x ?r\gh reflection on x z ,i-,x4 ,my hope 9 consultation 0 to (f] bo? a cognitive1 z well z1 an ontic exp]i5ce 9 :i* a mutual feel+ ap>t f & t[>d ! o!r w\ld exi/4 ,?is latt] seem$ mo/ important to me4 ,if ! consultee exp]i5c$ my be+ au!ntically pres5t ) h]1 %e !n w\ld be apt to (f] ?is type ( relation%ip to ! pati5ts & families ( conc]n to h]4 ,results ( ,comp>ison ,! two cl9ical consultation exp]i5ces 7 juxtapos$1 contra/$1 que/ion$1 relat$1 & syn!siz$ to envision _! unifi$ contribution to ! con/ruct ( cl9ical4 ,! syn!tic con/ruct ( cl9ical is n view$ z a m]e juxtapos+1 a dis9tegrat+1 or recon/ruct+ ( ! contributions #ajh to my kn[+ f ei!r ( ^! exp]i5ces4 ,?is comp>ison is view$ z a fac+ ( ! multiplicities !y bo? pres5t4 ,! syn!sis is an illum9ation ( bo? exp]i5ces ) ea* transfigur$ ?r\gh _! mutual pres5ce 9 ! kn[+ place ( ! comp>]4#ag ,9 ?is comp>ison my appreciation grew ( h[ ,i _h uniquely implem5t$ & conceptualiz$ cl9ical consultation 9 my "w exp]i5ce4 ,i recogniz$ ?r\gh ! comp>ison t adequate cl9ical consultation dem&s bo? a passionate & dispassionate phase ( ,i-,?\ & ,i-,x relat+4 ,)\t ei!r ( ^! =ms ( consultant be+-9-!-situation we degrade ! t]m cl9ical if we employ x4 ,consultation l5ds itself naturally to a collaborative coop]ative relation%ip4 ,! consultant is dep5d5t on ! consultee = pres5tation ( ! specifics ( p>ticul> situations4 ,! consultee is dep5d5t on ! consultant = ! tailor+ ( g5]al k to ! consultees' p>ticul> situations4 ,! relation%ip if appropriately call$ consultation is !n ( necessity int]dep5d5t4 ,9 be+ sep>ate f ! o!r :ile feel+ ) ! o!r ! consultant does n lose ! ability to "q4 ,passion undealt ) or id5tification ) ! consultee inhibits ! cl9ical purpose ( ! consultant & ( ! consultation4 ,9 id5tification "o feels z if he 7 ! o!r1 r ?an turn+ to ! o!r & feel+ ) him4 ,! degree ( anxiety ?is provokes 9 ! consultant c prev5t look+ at ! consultation situation & issues 9 an ,i-,x mann]4 ,! consultant loses ! ability to "q4 ,?r\gh ?is comp>ison ,i 0 able to reflect on ! graduate /ud5t nurs+ consultation exp]i5ce 9 an ,i-,x way4 ,at ?is "t x became a cl9ical exp]i5ce = me4 ,! lack ( ?is reflective phase 9 ?is exp]i5ce highlight$ ! reflective phase already exi/5t 9 ! work+ cl9ical consultation exp]i5ce4 ,! exi/5ce ( ?is phase 9 ! work+ cl9ical consultation exp]i5ce highlight$ its abs5ce 9 ! graduate /ud5t nurs+ consultation exp]i5ce4 ,my commonplace nurs+ _w ?r\gh ?is comp>ison became aw>ely mean+ful & avail$ itself = conceptualization4 ,a situation is n a cl9ical exp]i5ce until ! w\ld be cl9ician c reflect1 analyze1 categorize1 & syn!size x4 ,cl9ical ,is ,a pot5tially cl9ical psy*iatric m5tal heal? situation becomes cl9ical if ! cl9ician relates to ! helpee to awak5 8 unique pot5tial or ontic :ol5ess1 & noetically transc5d+ ?is relat+ conceptualizes its mean+4 ,cl9ician signifies a p>ticul> mode ( be+ & a p>ticul> k9d ( cognitive k4 ,) all 8 human capacity ! cl9ician relates ) 8 cl9ical-_w consci\sly & delib]ately 9 ,i-,?\1 & ,i-,x4 ,relat+ 9 ,i-,?\ ) ! o!r 9-8-cl9ical-_w ! cl9ician gives himself & receives back ! o!r & himself 9 ! sph]e ( ! betwe54 #aji ,he kn[s ! o!r & ! m ( himself 9 ?is relat+4 ,he is confirm$ & confirms ! o!r ?r\gh ! o!r's pres5ce ) him4 ,?us1 he calls =? ! o!r's actualiz+ ( self ?r\gh ! cl9ical relation%ip4 ,9 accept+ ! o!r z he is ! cl9ician imag9es & responds to ! reality ( 8 pot5tial = becom+1 becom+ accord+ to 8 unique capacity = humanness4 ,relat+ 9 ,i-,x ) 8 cl9ical _w ! cl9ician noetically transc5ds himself1 objectifies himself1 & /udies 8 ,i-,?\ kn[+4 ,he teases x ap>t4 ,he classifies & /udies x4 ,he asks x que/ions4 ,he comp>es & contra/s x to o!r cl9ical exp]i5ces4 ,he discusses its _m aspects 9 dialogue ) 8 inw>d1 & possibly outw>d ,?\s4 ,he reord]s its p>ts4 ,he %apes1 creates1 plans f & = its cl9ical exi/5ce4 ,?us1 he ev] augm5ts a _w ( heuri/ic kn[+4 ,?is h[ all[s ! cl9ical fulfillm5t ( my nurs+ :y4 ,com=t is :y ,i1 z a nurse1 am 9 ! heal?-nurs+ situation4 ,z conceptualiz$ com=t is be+ able to freely control & plan = "o's self1 be+ fully 9 accord at a p>ticul> "t1 9 a p>ticul> situation1 ) "o's unique pot5tial4 ,n[1 :at is ! nature ( ! nurse's _w1 ! heal?-nurs+ situation8 ,,all-,,at-,,once3 ,,:at ,! t]m all-at-once1 arose )9 me z a con/ruct t w\ld metaphorically describe ! multif>i\s multiplicities t exi/ )9 nurs+ situations4 ,complet+ my comp>ison ( ,gilb]t's & ,mull]'s writt5 works to grasp h[ !y view$ ! nature ( psy*iatric m5tal heal? nurs+ ,i f\nd myself mull+ ov] & fuss+4#ah ,y\r "q is probably1 mull+ & fuss+ ov] :at8 ,:ile ,i mull$ ov] & fuss$ ,i believe ,i1 too1 0 p]plex$4 ,:y 0 ,i unsatisfi$8 ,i _h comp>$ ,gilb]t's & ,mull]'s writ+ /yles1 _! conceptions ( man1 approa*es to nurs+1 nurs+ education1 sup]vision1 & consultation4 ,_! simil>ities & diff]5ces 7 not$1 & h[ ea* pres5t$ h]self pr$om9antly4 ,!n ,i cit$ ! nurs+ communities !y s\ght to influ5ce & ^? 9 :i* !y 7 :ile writ+4 ,?r\gh review+ _! bibliographies & biographies ,i indicat$ ! s\rces t _h influ5c$ !m4 ,/ill ,i mull$ ov]1 fuss$1 & 0 p]plex$4 ,i awak5$ 9 ! middle ( "o night 9 #aifi und]/&+ :at _h be5 caus+ my /ruggle4 ,! all-at-once 0 my answ]4 ,! description ( s+le con/ructs & s+le examples orig9ally _h felt unrelat$ to ! reality ( ! nurse's _w4 ,!y ov]simplifi$ its complexity4 ,! nature ( nurs+ 0 complex4 ,x seem$ to me t we ne$$1 z a pr(ession1 con/ructs t simplifi$ & all[$ cle> communications4 ,we1 also1 ne$$ con/ructs t convey$ ! reality & complexity ( ! #aaj worlds 9 :i* nurses nurs$4 ,p]haps a description ( :at all-at-once express$ = me w\ld convey to o!rs ! liv$-unobs]vable-worlds ( nurses4 ,nurses relate to o!r man 9 situations ( all-at-once4 ,! all-at-once is equat$ by me to ,bub]'s ,i-,?\ & ,i-,x occurr+ simultane\sly & n only 9 sequ5ce z he express$ x4 ,^! two ways t man c relate to & come to "k 8 _w & himself dem& sequ5tial expression = cle> communication4 ,h[ev]1 ! responsible au!ntic nurse 9 ! nurs+ ar5a lives !m all-at-once4 ,aw>e ( ! multif>i\s multiplicities ( h] responses to ano!r & at once to ! surr\nd+ field ( action1 ! nurse selects & ov]tly expresses h] responses t actualize ! purpose1 values1 & pot5tial ( ! artful sci5ce ( pr(essional nurs+4 ,aw>5ess ( ! multif>i\s multiplicities affect+ ! o!r & ! self 9 ! nurs+ ar5a is a compon5t ( ,i-,?\ relat+4 ,selectively ov]tly express+ concordantly ) ! purpose1 values1 & pot5tial ( nurs+ necessitates a look+ at1 :i* is a compon5t ( ,i-,x relat+1 :ile act+ & be+4 ,!re=e bo? ,i-,?\ & ,i-,x modes ( be+ are all-at-once4 ,?is necessity = a nurse's duality 9 h] mode ( be+ came to my aw>5ess ?r\gh comp>+ ,gilb]t' & ,mull]'s works1 /udy+ ,bub]'s conceptions ( man1 & consid]+ !m 9 relation to my curr5t & pa/ liv$-exp]i5ces 9 ! nurs+-ar5a4 ,9 my nurs+ _w ( ,i-,?\ relat+ reflection is call$ =? prior to my ov]t response to all[ response selection concordant ) my nurs+ purpose4 ,! v "* ( multif>i\s multiplicities ( ! nurs+ _w und\bt$ly has call$ = nurses to develop _! human capacity = duality 9 _! mode ( be+4 ,to make ^! multif>i\s multiplicities explicit ,i w\ld l to (f] a description ( a rec5t1 p]sonal nurs+ exp]i5ce4 ,9 a community psy*iatric m5tal heal? psy*osocial cl9ic1 ,i sat across f & focus$ on relat+ ) a psy*iatric cli5t4 ,aft] long ye>s ( hospitalization he 0 n[ liv+ 9 a community fo/] home & visit+ ! cl9ic ?ree days a week4 ,:5 !re 0 no special cl9ic activity 9 progress & (t5 ev5 :5 !re 01 he sat by himself & play$ pok]4 ,he told me ab\t 8 game _m times1 ov] weeks & mon?s4 ,he dealt out five pok] h&s4 ,ea* h& 0 dealt to a memb] ( 8 family1 long dead4 ,he did n accept _! deadness4 ,"o day :ile describ+ ! pok] games & 8 relatives1 he int]mitt5tly express$ 8 fantasies :i* he project$ on to a sweet *e]ful #fe-ye>-old community volunte]4 ,%e 0 some:at deaf4 ,8 fantasies 7 angry4 ,:5 he ge/ur$ t[>d h]1 %e 9 a mo!rly way came ov] to him1 put h] arm ar\nd him1 & h] e> d[n to 8 m\?4 ,x 0 a mom5t ( possible cli5t explosion4 ,) my eyes ,i attempt$ to communicate ) h]4 ,?is1 & ! tone ( ! pati5t's voice w>n$ h] to move away4 ,:ile ?is 0 occurr+ ano!r pati5t jeal\s ( my att5tions to ?is pati5t walk$ up & d[n1 & 9 pass+ negatively comm5t$ on ! religi\s backgr\nd ( ! man ,i 0 sitt+ )4 ,9 ! re> ( ! room a dietician 0 conduct+ a gr\p on obesity4 ,& all ( ?is 0 set to ! #aaa melodi\s1 sangu9e /ra9s ( ,if ,i ,lov$ ,y be+ poorly beat out on a piano ab\t t5 feet away by ano!r volunte] accompani$ 9 song by a few cli5ts4 ,mean:ile two /aff nurses 7 obs]v+ my "p 9 all ?is s9ce ,i 0 label$ exp]t4 ,! cli5t did support me t day & respond$ to my /ay+ ) him4 ,mu* to my surprise he began play+ pok] ) me4 ,he dealt me out a h&4 ,?is 01 at ?is "t1 a new behavior on 8 "p4 ,x 0 movem5t t[>d 8 pot5tial = relat+ to live p]sons 9 8 curr5t _w4 ,?is1 aga91 is j "o example ( ! multif>i\s multiplicities ( "o v common type ( nurs+ situation4 ,! inf]5ce f ! above is t pr(essional arti/ic-sci5tific nurses relate 9 ,i-,?\1 ,i-,x1 all-at-once to ! specific g5]al1 critical nonconsequ5tial1 & ! heal?y ill4 ,?is pres5ts a p>adoxical dilemma4 ,nurses1 z human be+s1 h a highly develop$ capacity = liv+ all-at-once 9 & ) ! fl[ ( ! multif>i\s multiplicities ( _! worlds4 ,nurses1 z human be+s1 l all o!r human be+s1 are limit$ to ?9k+1 int]pret+1 & express+ conceptually only 9 succession4 ,?is metaphoric syn!tic con/ruct1 all-at-once1 has all[$ me to bett] convey h[ ,i exp]i5ce ! heal? nurs+ situation4 ,x also has aid$ my und]/&+ ( ! multif>i\s multiplicity ( angul> views express$ by sev]al pr(essionals 9 respond+ to & describ+ a simil> situation4 ,i c accept ea* description z tru? = ea* respond]4 ,ea* responds ) 8 uniqu5ess 9 ! situation4 ,comp>+1 contra/+1 & complem5t>ily syn!siz+ ^! multiple views inclusive ( _! inconsi/5cies & contradictions1 none negat+ ! o!r1 all[s a bett] und]/&+ ( man-9-8-_w 9 ! heal? situation ?an ! s frequ5tly pres5t$ ov]simplifications4 ,^! ov]simplifi$ pres5tations usually deal only ) :at is occurr+ t is important to ! p>ticul> int]e/s ( ! report]4 ,& !y are (f]$ only aft] ! select$ mat]ial has be5 put ?r\gh a process ( int]pretation & logical sequ5c+ to emphasize ! report]'s p>ticul> po9t4 ,9 su* report+ ! exi/5t 9 ! situation label$ unimportant1 unacceptable1 or unrelat$ is n consid]$4 ,su* exi/5ts1 none!less1 may control ! pati5ts1 ! families1 ! nurses & heal? pr(essionals g5]ally4 ,_! control may well be m p[]ful ?an any erudite ov]simplification or its pres5tation4 ,humani/ic nurs+ practice !ory 9 ask+ = ph5om5ological descriptions ( ! nurse's liv$-_w ( exp]i5c+ proposes au!ntic aw>5ess ) ! self ( :at is exi/5t 9 ! situation prior to conceptualization = disp]sal4 ,unless nurses appreciate & give recognition to ! dynamic mean+ful bread?1 dep?1 & future influ5ce ( _! worlds ! actualization ( ! pot5tial ?ru/ ( ! nurs+ pr(essional w nev] be or become4 ,a ,,!ory ,,( ,,nurs+ ,a human nurse nurses ?r\gh a cl9ical process ( ,i-,?\1 ,i-,x1 all-at-once to com=t4 #aab ,i-,?\ is a com+ to "k ! o!r & ! self 9 relation1 intuitively4 ,i-,x is an au!ntic analyz+1 syn!siz+1 & int]pret+ ( ! ,i-,?\ relation ?r\gh reflection4 ,! all-at-once symbolizes ! multif>i\s multiplicities ( extremes 7incomm5surables1 criticals1 nonconsequ5tials1 contradictions1 & inconsi/5cies7 z metaphorically repres5tative ( :at exi/s 9 ! nurse's _w4 ,com=t is a /ate valu$ by a nurse z an aim 9 :i* a p]son is free to be & become1 controll+ & plann+ 8 own de/9y1 9 accordance ) 8 pot5tial at a p>ticul> "t 9 a p>ticul> situation4 ,,footnotes3 #a ,joseph9e ,g4 ,pat]son1 ,a ,p]spective on ,tea*+ ,nurs+3 ,h[ ,concepts ,become1 9 ,a ,conceptual ,approa* to ! ,tea*+ ( ,nurs+ 9 ,baccalaureate ,programs1 a report ( a project direct$ by ,rose ,m4 ,h]r]a 7,wa%+ton1 ,d4,c43 ,! ,ca?olic ,univ]sity ( ,am]ica1 ,s*ool ( ,nurs+1 #aigc71 pp4 #ag-bg4 #b ,am]ican ,nurses' ,association1 ,division on ,psy*iatric-,m5tal ,heal? ,nurs+1 ,/atem5t on ,psy*iatric ,nurs+ ,practice 7,new ,york3 ,am]ican ,nurses' ,association1 #aifg71 p4 ,,iv4 #c ,plut>*1 ,cont5tm5t1 9 ,gateway to ! ,great ,books1 ,vol4 #aj1 ,philosophical ,essays 7,*icago3 ,encyclopa$ia ,britannica1 #aifc71 p4 #bfe4 #d ,viktor ,e4 ,frankl1 ,f ,dea?-,camp to ,exi/5tialism 7,bo/on3 ,beacon ,press1 #aifa71 p4 #ajc4 #e ,ibid41 p4 #aaj4 #f ,b]tr& ,russell1 ,! ,autobiography ( ,b]tr& ,russell 7,bo/on3 ,little1 ,br[n & ,company1 #aifh7 & ,an ,outl9e ( ,philosophy 7,clevel&3 ,! ,_w ,publi%+ ,company1 #aifg74 #g ,fr$]ick ,nietzs*e1 ,beyond ,good & ,evil1 trans4 ,hel5 ,zimm]n1 9 ,! ,philosophy ( ,nietzs*e 7,new ,york3 ,! ,mod]n ,libr>y1 #aibg7 & ,?us ,spake ,z>a?u/ra1 trans4 ,?omas ,common1 9 ,! ,philosophy ( ,nietzs*e 7,new ,york3 ,! ,mod]n ,libr>y1 #aibg74 #h ,plato1 ,! ,republic1 trans4 ,francis ,mac,donald ,corn=d 7,new ,york1 ,ox=d ,univ]sity ,press1 #aide74 #i ,k>l ,popp]1 ,conjectures & ,refutations 7,new ,york3 ,basic ,books1 ,publi%]s1 #aifc74 #aj ,john ,dewey1 ,! ,kn[+ & ! ,kn[n 7,bo/on3 ,! ,beacon ,press1 #aidi7 & ,! ,process ( ,?\ght f ,h[ ,we ,?9k1 9 ,gateway to ! ,great ,books1 ed4 ,rob]t ,w4 ,hut*9s1 et al4 7,*icago3 ,encyclopa$ia ,britannica1 #aifc74 #aa ,m>t9 ,bub]1 ,betwe5 ,man & ,man1 trans4 ,ronald ,gregor ,smi? 7,bo/on3 ,beacon ,press1 #aiee72 ,i & ,?\1 #bnd ed41 trans4 ,ronald ,gregor ,smi? 7,new ,york3 ,*>les ,scribn]'s ,sons1 #aieh72 ,! ,k ( ,man1 ed4 ,maurice ,fri$man 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 #aife74 #ab ,h5ri ,b]gson1 ,introduction to ,metaphysics1 9 ,philosophy 9 ! ,tw5tie? ,c5tury1 ,vol4 ,,iii1 ed4 ,william ,b>rett & ,h5ry ,d4 ,aik5 7,new ,york3 ,r&om ,h\se1 #aifb7 & ,"t 9 ! ,hi/ory ( ,we/]n ,philosophy1 9 ,philosophy 9 ! ,tw5tie? ,c5tury1 ,vol4 ,,iii1 ed4 ,william ,b>rett & ,h5ry ,d4 ,aik5 7,new ,york3 ,r&om ,h\se1 #aifb74 #ac ,norman ,c\s9s1 ,:o ,speaks = ,man 7,new ,york3 ,! ,macmillan ,company1 #aiec74 #ad ,pi]re ,teilh>d de ,*>d91 ,lett]s f a ,travel]1 7,new ,york3 ,h>p] ,r[1 ,publi%]s1 #aifb7 & ,! ,ph5om5on ( ,man 7,new ,york3 ,h>p] ,tor*books1 ,h>p] ,r[1 ,publi%]s1 #aifa74 #ae ,nietzs*e1 ,! ,philosophy ( ,nietzs*e1 p4 #dda4 #af ,bub]1 ,! ,k ( ,man1 ,app5dix1 p4 #afh4 #ag ,wilfrid ,desan1 ,planet>y ,man 7,new ,york3 ,! ,macmillan ,company1 #aigb71 p4 #gg4 #ah ,joseph9e ,g4 ,pat]son1 ,e*o into ,tomorr[3 ,a ,m5tal ,heal? ,psy*iatric ,philosophical ,conceptualization ( ,nurs+ 7,d4,n4,sc4 diss]tation1 ,bo/on ,univ]sity1 #aifi74 #aac ,,app5dix ,,nurse ,,behaviors ,,extract$ ,,f ,,cl9ical ,,data ,9 pursu+ ! idea ( conceptualiz+ com=t z a prop] aim ( psy*iatric nurs+ ,i extract$ #ab nurse behaviors f my cl9ical data t 7 us$ repeat$ly to increase pati5t com=t4 ,i quantifi$ ^! behaviors = two mon?s4 ,! foll[+ are a li/ ( ^! behaviors ) a repres5tative example ( all b ! fir/4 ,! fir/ 0 too g5]al & cont9u\s = example4 #a4 ,i focus$ on recogniz+ pati5ts by "n1 be+ c]ta9 ,i 0 correct ab\t _! names1 & us+ _! names (t5 & appropriately4 ,i also introduc$ myself4 ,names 7 view$ z supportive to ! int]nalization ( p]sonal feel+s ( dignity & wor?4 #b4 ,i int]pret$1 taught1 & gave z mu* hone/ in=mation z ,i c\ld ab\t pati5ts' situations :5 x 0 s\ght or :5 puzzlem5t 0 app>5t4 ,?is 0 bas$ on ! belief t x 0 _! life1 & *oice 0 _! pr]ogative s9ce !y 7 _! own projects4 ,examples 7a7 ,:ile dr9k+ c(fee ) a few pati5ts at ! d9+ room table sudd5ly we c\ld he> ,sidney1 9 8 cu/om>y way1 wail+1 moan+1 & mutt]+ 9 ano!r room4 ,x is a sad s\nd4 ,i 0 ab\t to get up & g to him z ,i (t5 d1 :5 ,ar?ur1 :o 0 sitt+ next to me1 face work+1 & t5se po/ure-wise1 aggravat$ly said1 ,sidney doesn't h to d t1 he %\ld control himself1 ! re/ ( u control ourselves4 ,i said1 ,:5 o!rs express h[ mis]able !y feel1 x sometimes ar\ses our own feel+s ab\t our mis]y4 ,?is 0 an attempt to provoke #cb-ye>-old ,ar?ur to "w on 8 own #aad feel+s ( mis]y & to det] 8 projection ( ang] at himself out onto ,sidney4 ,ar?ur look$ at me %>ply1 l he _h gott5 ! message1 & agre$ by relax$ly nodd+ 8 head4 7b7 ,alice1 diagnos$ z manic depressive1 has be5 depress$4 ,?is depression dates f h] go+ out to a dep>tm5t /ore & ask+ = a job4 ,%e 0 hir$ = a five-day-a-week job4 ,?is 0 done on h] own4 ,lat] h] read9ess = a five-day-a-week job & h] p>ticipation 9 ! unit 7 que/ion$4 ,!n ,alice became depress$4 ,alice 0 sitt+ 9 ! dayroom4 ,i sat d[n next to h]4 ,%e look$ v sad1 h] eyelids z well z h] m\?1 droop$4 ,h] m\? work$ z if %e want$ to talk1 b %e 0 quiet4 ,i ask$ h] ab\t h] job decision4 ,%e said t %e _h n tak5 x4 ,i said1 ,y look s sad t ,i feel l hold+ y\r h&4 ,h] h&s 7 9 h] coat pockets1 b %e look$ at me & smil$ weakly4 ,i said1 ,sometimes a conflict ( want+ to d two ?+s at once 9 ! pres5t & n be+ able to c br+ up ! feel+s ( a pa/ v mu* m important simil> exp]i5ce4 ,alice j %ook h] head up & d[n & look$ at me4 ,alice is 9 h] mid-=ties4 ,lat] ,i 0 walk+ d[n ! hall to leave say+ goodbyes to v>i\s p4 ,alice came out ( a side room1 put bo? h] h&s out to me1 & said1 goodbye & ?ank y4 ,9 a previ\s contact ,alice _h discuss$ h] suicidal ?\ghts ) me4 #c4 ,i v]baliz$ my acceptance ( pati5ts' expressions ( feel+s ) explanations ( :y ,i exp]i5c$ ^! feel+s ( acceptance :5 ,i c\ld d ?is au!ntically & appropriately4 ,example ,i met a new pati5t at c(fee4 ,lat] %e 0 ! only pati5t 9 ! dayroom :5 ,i w5t 94 ,%e _h n spok5 at c(fee4 ,n[ %e sat v /iffly 9 h] *air4 ,i sat d[n next to h] & re9troduc$ myself4 ,%e look$ sc>$ b told me h] "n4 ,h] %ift+ eyes rem9d$ me ( a corn]$ animal4 ,%e blurt$ out1 ,i don't believe ,i've met y4 ,x 0 l %e _h said1 g away4 ,i smil$ at h] & said1 ,we 7 introduc$ at c(fee1 b ) s _m new p x's h>d to rememb]4 ,conv]sation cont9u$ to be t5se4 ,at "o po9t ,m>ion bolt$ f h] *air t[>d ! door4 ,i ?\ght %e 0 go+ to leave4 ,i /ay$ 9 my *air4 ,%e w5t to ! fi% b[l 9 ! corn]4 ,we cont9u$ to talk ab\t ! fi%4 ,m>ion came back & sat d[n a few seats away f me4 ,i said t ,i felt ,i'd be5 ask+ h] an awful lot ( que/ions b t ,i 0 only try+ to get to "k h]4 ,m>ion seem$ to relax 9 h] *air & gave a great deal ( in=mation ab\t h]self 9 a /range /iff sort ( way (t5 ins]t+ a ^w t did n h mean+ = me4 ,i enc\rag$1 support$ & %[$ my int]e/4 ,f9ally %e said t %e #aae _h be5 admitt$ to ,mc,lean 9 h] ?ird ye> ( nurses' tra9+ j be=e h] psy*iatric exp]i5ce4 ,%e _h be5 9 !rapy !re1 "o-to-"o = a c\ple ( ye>s4 ,i teas$ h] ab\t kn[+ ! ropes1 yet giv+ me a difficult "t4 ,?is 0 an attempt to increase h] feel+s ( adequacy by br++ out ! simil>ities ( ! old situation :i* %e knew & ?is new situation4 ,= ! fir/ "t %e really gr9n$ at me1 almo/ laugh$4 ,m>ion is 9 h] e>ly ?irties4 #d4 ,:5 v]balizations ( acceptance 7 n appropriate1 ,i act$ out ?is acceptance by my behavior ( /ay+ ) or do+ = :5 appropriate4 ,example ,m>y is a middle-ag$ pati5t :o1 on h] fir/ days 9 ! unit1 0 lib]ally gobbl+ h] food ) al]tness = only m to be _h4 ,h] only r l\d1 irrelevant1 smil+ expression 0 ab\t h] daught] :o 0 a g-g danc]1 _h ?ree *ildr51 & :om %e _h visit$ twice by bus 9 ,cali=nia4 ,?is day %e approa*$ me & ask$ if ,i w\ld file h] nails4 ,i said t ,i w\ld b ask$ if %e knew if !re 0 a file 9 ! unit4 ,ano!r pati5t (f]$ 84 ,we sat d[n & ,i fil$4 ,! pati5t p\r$ out a life /ory full ( mis]y4 ,?is 0 a side ( ?is pati5t t ,i _h n p]ceiv$4 ,i li/5$1 nodd$1 & fil$4 ,! /ory />t$ 9 ! #aicjs ab\t h] husb& & "m-9-law's behavior2 _! m>ital sep>ation2 8 be+ kill$ 9 ,_w ,w> ,,ii2 _! two *ildr52 _! son1 n[ ?irty1 0 born ) c]ebral palsy1 is bl9d & mute1 & has be5 in/itutionaliz$ s9ce elev5 mon?s old2 _! daught]'s husb& left h] ) ?ree *ildr5 aft] f\rte5 ye>s ( m>riage4 ,i sil5tly wond]$ :at old feel+ might h be5 ar\s$ 9 h] by h] daught]'s m>ital sep>ation4 ,h] daught] is s busy t %e is unable to write regul>ly4 ,%e has told ,m>y n to worry if %e doesn't he> f h]4 ,m>y !n express$ conc]n ov] n receiv+ h] usual lett] ?is week f h] "m1 :om %e visits4 ,m>y _h tri$ to rea* h] by phone & w\ld aga94 ,i inquir$ if h] "m liv$ alone4 ,yes1 b next to relatives4 ,%e !n relat$ ! dra/ic physical problems ( a relative4 ,i felt ! sadness ( ?is woman z %e talk$ & empa?iz$ ) ! t\gh "t %e _h _h4 #e4 ,i express$ purposely1 to bur/ asund] negative self concepts1 my au!ntic human t5d] feel+s = pati5ts :5 appropriate & acceptable4 ,example ,i 0 sitt+ 9 a r l>ge gr\p ( pati5ts 9 ! dayroom4 ,a casual conv]sation ensu$ ab\t ,?anksgiv+ z x _h be5 & ,*ri/mas z x might be4 ,!re 0 talk ( hav+ be5 at home & plans = be+ at home4 ,i support$ & enc\rag$ ! discussion because ( ! mean+fulness ( holidays1 pa/ & pres5t4 ,sn[ 0 initiat$ z a #aaf topic4 ,i said1 ,x w\ld be nice to h a :ite ,*ri/mas1 b n too :ite4 ,v9c5t1 a /iff1 exact1 rituali/ic p]son :o avoids /epp+ 9 an obvi\s fa%ion on ?re%olds1 does little jiggle-l dance /eps be=e sitt+ d[n1 & aga9 be=e settl+ 9 8 *air1 sudd5ly spoke4 ,joseph9e1 ,i beg y\r p>don1 b ,i mu/ take issue ) y4 ,i enc\rag$ 8 unusual behavioral expression4 ,he w5t on & on ab\t ! importance ( a :ite ,*ri/mas4 ,i let my m9d fl[ ) 8 jumbl$ disc\rse try+ to deciph] :at he 0 gett+ at r ?an ea* specific rapidly m5tion$ issue4 ,he w5t f :ite to black1 day to night1 goodness to badness1 love to hate1 ?is side ( ! _w to ! o!r side ( ! _w 7,vietnam74 ,i express$ t he seem$ to keep m5tion+ two sides ( ?+s & t = "s reason ,i c\ld n help ?9k+ ( boys & girls4 ,i said t he 0 ov] on t side ( ! _w 7room7 & t ,i 0 ov] on ?is side ( ! _w4 ,i ask$ :y he did n come ov] to my side1 paus$ a m9ute1 felt ?is 0 ask+ too mu* ( ?is pati5t1 & said1 ,well ,i'll come ov] to y\r side !n4 ,:5 ,i sat d[n next to ,v9c5t1 he giggl$ z he does4 ,ar?ur1 a y\ng] pati5t1 made a critical jeal\s type comm5t ab\t ,v9c5t's age 7#ej;i%74 ,ar?ur has done ?is be=e :5 ,i give att5tion to ,v9c5t4 ,has ,ar?ur a /]eotype ( fa!r images & p]haps "m images8 ,i said to ,v9c5t y h beautiful :ite hair1 & big1 br[n1 smil+ ,italian eyes4 ,v9c5t sat back smil+ %yly b com=tably & ! discussion ( ! gr\p cont9u$4 #f4 ,i support$ pati5ts' rights to lov+ relation%ips ) o!rs3 families1 o!r /aff1 & o!r pati5ts4 ,example ,alice ,m4 said t %e 0 sad to be back at ! hospital aft] h] week5d at home4 ,alice is a quiet1 bl&1 s(t-spok5 p]son ab\t fifty4 ,%e we>s a worri$ expression ev5 :5 %e smiles & /rikes me l %e is turn$ inside h]self4 ,i enc\rag$ h] to talk ab\t h] "t at home4 ,%e told me ab\t h[ !y _h pa9t$ ! liv+ room ) :at = h] 0 a %[ ( real excitem5t4 ,i said t h] wi% to be at home 0 v und]/&able4 ,i did ?is because ?is pati5t almo/ :isp]s h] wi% to be at home &1 g5]ally1 no "o responds to x4 ,alice talk$ on ) enc\ragem5t ab\t ! s+le si/] :om %e visits & ! pleasure x gives h] to be ) ?is si/]4 ,i h o!r examples ( ?is nurse behavior t indicate support+ ( relation%ips betwe5 pati5ts & betwe5 pati5ts & o!r p]sonnel4 #g4 ,i %[$ respect = pati5ts z p]sons ) ! rights to make z _m *oices = !mselves z _! curr5t capabilities all[$4 ,example ,discussion ( gr\p at c(fee revolv$ ar\nd ,c>olyn's ne$+ a new pair ( %oes4 ,! issues 7 :]e ^! might be gott5 7,c>olyn has #aag money71 :at k9d %e %\ld get1 & :o & :5 someone w\ld take h] = !m4 ,x /ruck me z if ,c>olyn might n h be5 pres5t4 ,i ask$ ,c>olyn :at k9d ( %oes %e w\ld l4 ,c>olyn respond$ t %e did n "k :e!r %e %\ld buy regul> %oes1 or sneak]s1 or canvas %oes l ,m>ilyn _h gott54 ,%e beam$4 ,s9ce1 %e has come up to me sev]al times & discuss$ ! two pairs ( diff]5t k9ds ( %oes %e b\ght & :y4 ,c>olyn is a sweet1 simple1 ret>d$1 deaf sixty ye> old ^: behavior resembles an eight ye> old4 #h4 ,i attempt$ to help pati5ts consid] _! curr5tly express$ feel+s & behaviors 9 light ( pa/ life exp]i5ces & patt]ns1 l & unlike _! curr5t ones4 ,example ,on my arrival aft] ,*ri/mas1 ,ir5e express$ ang] at me 9 a laugh+ way = hav+ be5 away4 ,!n %e mov$ f a seat 9 ! corn] ( ! room to a *air beh9d me at ! c(fee table4 ,i mov$ to all[ h] to move up to ! table1 b %e did n4 ,aft] c(fee ,ir5e nonv]bally ) eyes & body movem5ts told me to foll[ h]4 ,%e l$ me into a small beauty p>lor room & we bo? sat d[n4 ,%e clos$ h] eyes4 ,i said1 ,y seem to h "s feel+s ab\t u all hav+ be5 away4 ,fir/ %e blurt$1 ,i miss$ y1 !n 9 a quiet] voice d5i$ ?is1 ,x wasn't important t y w]5't "h4 ,i said1 ,x c\ld be helpful to y to talk ab\t y\r pres5t miss+ feel+s z y _h "s v important losses ( p :5 y 7 y\ng]4 ,h] eyes lit]ally popp$ op5 & %e aga9 blurt$1 ,y mean my p>5ts8 ,i said1 ,yes & y\r !rapi/ c\ld help y ) ?is4 ,i !n ask$ if %e ev] _h ! opportunity to talk ) anyone ab\t su* ?+s4 ,%e repli$1 ,no1 well ,i _h a social work] :5 ,i 0 a little girl4 ,i tri$ at ?is po9t to transf] feel+s ( ! pa/ to ! pres5t4 ,oh1 = h[ long8 ,:at 0 %e l8 ,i don't rememb]1 & ,ir5e clos$ h] eyes4 ,9 a few m9utes ,ir5e reque/$ t ,i set h] hair4 ,%e is capable ( do+ ?is h]self4 ,i set h] hair1 b discuss$ ! "q ( :at %e 0 really ask+ =4 ,i believe %e 0 ask+ = concrete att5tion to te/ my ability to c>e = h]4 ,i 0 try+ to say1 concretely1 by sett+ h] hair1 t p c\ld c>e ab\t h]4 #i4 ,i enc\rag$ pati5ts' expression to come to und]/& bett] _! behavioral messages to enable me to respond ov]tly z appropriately & !rapeutically z possible4 ,example ,! previ\s "t ,i 0 at ! hospital ,alice _h n come to ! unit4 ,i 0 told t %e felt too depress$ to come d[n4 ,i w5t to see h]4 ,%e _h look$ surpris$ & impress$ by my visit4 ,%e talk$ on at "s l5g? ab\t h] suicidal ?\ghts4 ,i support$ ?is on ! basis t #aah v]bal expression might make active expression unnecess>y if %e exp]i5c$ empa?y reg>d+ h[ dreadful %e felt4 ,!n ) little enc\ragem5t %e _h come d[n to ! unit ) me4 ,today1 ,alice 0 always ne> me1 b nonv]bal except = concise responses to que/ions t 7 (f]$ ) ef=t4 ,i v]baliz$ my reflections on h] behavior & said t ,i 0 wond]+ ab\t x4 ,%e said1 ,i l hav+ y ar\nd2 x takes me away f my ?\ghts4 ,h[ are y\r ?\ghts8 ,! same1 ,i wond] if ,i'll ev] get bett]8 ,y've gott5 bett] be=e4 ,i wond] if y're n m conc]n$ ab\t :e!r y c /ay well4 ,alice1 eyes wat]y1 agre$ ) a nod4 ,ir5e1 ano!r pati5t1 int]rupt$1 ,don't expect too mu* f me1 ,i've be5 "h twelve ye>s4 ,i respond$ to !m bo?1 ,b1 ,i d expect a lot ( y2 ?+s don't always h to be ! same4 #aj4 ,i v]ifi$ my intuitive grasp ( h[ pati5ts 7 exp]i5c+ ev5ts by que/ions & comm5ts1 & be+ al]t to _! responses4 ,example ,v9c5t's rituali/ic behavior is associat$ 9 my m9d ) 8 exagg]at$ consci\s expression ( only ! true1 ! good1 & ! beautiful4 ,on ?is occasion we _h j _h a long talk ab\t 8 week5d at home1 8 conc]ns ab\t 8 family1 & 8 food likes & dislikes4 ,z we left a room he took 8 usual long /ep ov] ! ?re%old4 ,i not$ ?is al\d & ask$ him if he knew :y he did ?is4 ,8 expression became wide-ey$ & smil+ :i* indicates to me he consci\sly or unconsci\sly is select+ :at he is go+ to say4 ,we came to ! next ?re%old4 ,he /opp$ me by t\*+ my arm & said1 ,joseph9e1 ,i almo/ grabb$ y to prev5t y\r bump+ into t pati5t4 ,9 relation to my la/ "q ,i focus$ on ! grabb$ y & said1 ,v9c5t1 to ?9k ab\t grabb+ me is a pretty natural ?\ght1 & no reason to take a wide /ep ov] a ?re%old4 ,he put 8 foot v delib]ately if r te/ily1 "r 9 ! middle ( ?is ?re%old4 ,he /opp$1 look$ at me ) 8 h&s toge!r & giggl$4 ,!n he _h to g to ! ba?room4 #aa4 ,i attempt$ to enc\rage hope reali/ically ?r\gh discuss+ individual !rapeutic ga9s t c\ld be d]iv$ f pati5ts' inve/m5t 9 !rapeutic opportunities available to !m4 ,example ,my impression ( ,ar?ur1 a ?irty-two ye> old1 is t he works at respond+ to me agreeably z he ?9ks ,i want him to1 he frequ5tly goes out ( 8 way to make cutt+ comm5ts to me ab\t middle-ag$ m5 pati5ts1 & he responds ) ang] or teas+ to a female pati5t 8 age4 ,ar?ur has a "m1 fa!r1 & two old] si/]s4 ,he obvi\sly let me w9 at ,p+-pong sev]al times4 ,i discuss$ ?is ) him & ask$ if #aai he _h ev] talk$ ) anyone ab\t 8 responses to old] wom51 p 9 g5]al1 or if he und]/ood !m4 ,he said1 ,no1 ,i h n be5 able to exactly figure ?is out yet4 ,i repeat$ ! talk+ x ov]4 ,he said1 ,i hav5't _h mu* *ance = t4 ,!n />+ at me he ask$ s]i\sly1 ,d y ?9k talk+ x ov] w\ld help8 ,i said1 ,i ?9k t x w\ld take a great deal ( ef=t on y\r "p1 b ,i believe t x c\ld help4 #ab4 ,i support$ appropriate pati5t self-images ) z _m concrete h>d to d5ies z possible4 ,example ,alice1 a middle-ag$ woman1 9 ! mid/ ( a discussion ( ! difficulties ( liv+ outside ! hospital1 pa/ relation%ips ) nurs+ p]sonnel1 & h] pa/ practical nurse jobs sudd5ly said1 ,i worry ab\t be+ sexually ,,ok4 ,?is 0 k9d ( blurt$ out & %e obs]v$ me closely4 ,i said1 ,i ?\ght t y _h "s conc]ns ab\t ?is 9 relation to h[ y respond$ to my cutt+ ! hairs on y\r face4 ,i guess ev]yone worries at times ab\t _! adequacy 9 ?is area4 ,%e said1 ,i've nev] be5 able to h int]c\rse2 ,i c j g z f> z heavy pett+4 ,p say y c get a lot express$ if y h int]c\rse4 ,i said1 ,"s p c1 b if y h o!r /&>ds t y've gr[n up )1 7,i suspect a r religi\s1 rigid ,jewi% backgr\nd7 x might cause difficulties to g aga9/ ^? /&>ds4 7,alice fir/ became ill at sixte51 left s*ool1 & _h "s treatm5t 9 ! community47 ,x's pretty responsible n to be will+ to br+ a fa!rless baby into ! _w1 & ,i'm sure y'd h feel+s ab\t h[ y\r family might h respond$ to ?is sort ( ?+4 ,alice nodd$ & said ,x's j t ,i don't "k h[ womanly ,i am4 ,i said ) ge/ures & emphatically1 ,well1 ,alice1 if y h two ?+s up "h & no ?+ d[n "h1 !n ! fact is t y are a woman4 ,discussion pursu$ ab\t h] fur!r talk+ ab\t ?is topic ) h] !rapi/ & ! value ( h] work+ ?r\gh h] feel+s 9 ?is area4 ,?is 0 a l5g?y discussion & ! fir/ talk+ ,i _h exp]i5c$ ,alice do+ s9ce h] depression4 #abj #aba ,,gloss>y angul> view4 ,an individual's unique vision ( reality necess>ily re/rict$ by ! angle ( 8 p>ticul> "h & n[4 au!nticity4 ,g5u95ess2 congru5ce ) ! self4 7!7 betwe54 ,! realm ( ! int]subjective4 bracket4 ,hold 9 abeyance4 community4 ,two or m p]sons /ruggl+ toge!r t[>d a c5t]4 exi/5tial4 ,(1 relat+ to1 or affirm+ exi/5ce2 gr\nd$ 9 exi/5ce or ! exp]i5ce ( liv+4 exi/5tial dialogue4 ,a unique individual p]son ) ! :ol5ess ( 8 be+ is pres5t1 op5 to1 & relates to ! o!r se5 9 8 unique individual :ol5ess2 an ex*ange 9 :i* two p]sons transc5d !mselves & p>ticipate 9 ! o!r's be+2 an int]ior unification2 a mutual common union 9 be+4 exi/5tial exp]i5ce4 ,contact ) reality ) ! :ole ( "o's be+2 involves all t a man is z oppos$ to exp]i5c+ ?r\gh "o or sev]al faculties4 exi/5tialism4 ,philosophy bas$ on ph5om5ological /udies ( reality2 c5t]s on ! analysis ( exi/5ce p>ticul>ly ( ! individual human be+1 /resses ! fre$om & responsibility ( ! individual1 reg>ds human exi/5ce z n completely describable or und]/&able 9 ideali/ic or sci5tific t]ms4 "h & n[4 ,an individual's unique exp]i5ce ( 8 pres5t spatial & temporal reality includ+ 8 pa/ exp]i5ces & expectations ( ! future4 humani/ic nurs+4 ,a !ory & practice t re/ on an exi/5tial philosophy1 value exp]i5c+ & ! evolv+ ( ! new1 & aim at ph5om5ological description ( ! art-sci5ce ( nurs+ view$ z a liv$ int]subjective transactional exp]i5ce2 nurs+ se5 )9 its human context4 int]subjective4 ,p]ta9+ to two or m human p]sons & _! %>$ betwe52 a relation%ip ( two or m human be+s 9 :i* ea* is ! orig9ator ( human acts & responses4 #abb liv$ dialogue4 ,a =m ( exi/5tial int]subjective relat+ express$ 9 be+ ) & do+ ) ! o!r :o is reg>d$ z a pres5ce 7z oppos$ to an object72 a liv$ call & response4 liv$ _w4 ,! ev]yday _w z x is exp]i5c$ 9 ! "h & n[4 metanurs+4 ,a discipl9e design$ to deal critically ) nurs+1 ontological /udy ( nurs+2 /udy ( ! ph5om5on ( nurs+2 a critical /udy ( nurs+ )9 its human context4 meta!oretical4 ,transc5d+ !ory2 ontological inquiry f :i* !ory may be d]iv$4 nursology4 ,/udy ( ! ph5om5on ( nurs+ aim$ t[>d ! developm5t ( nurs+ !ory4 ph5om5ology4 ,! descriptive /udy ( ph5om5a4 ph5om5on4 ,an obs]vable fact1 ev5t1 occurr5ce or circum/ance2 an appe>ance or imm$iate object ( aw>5ess 9 exp]i5ce4 ,a ph5om5on may be objective 7t is1 ext]nal to ! p]son aw>e ( x7 or subjective 7= example1 a ?\ght or feel+74 pr]eflective exp]i5ce4 ,prim>y aw>5ess or p]ception ( reality n yet ?\ght ab\t2 spontane\s exp]i5ce2 imm$iate exp]i5ce or p]ception4 pres5ce4 ,a mode ( be+ available or op5 9 a situation ) ! :ol5ess ( "o's unique individual be+2 a gift ( ! self :i* c only be giv5 freely1 invok$1 or evok$4 transactional4 ,an aw>e kn[+ ( "o's effect 9 a situation ( :i* "o is a "p2 an action t goes bo? ways betwe5 p]sons4 #abc ,,select$ ,,bibliography ,9 addition to ! ext5sive discussions t h be5 g5]at$ s9ce ! initial publication ( ,pat]son & ,zd]ad's ,humani/ic ,nurs+1 ! "w has be5 =mally cit$ & or discuss$ 9 ! nurs+ lit]ature4 ,?is select$ bibliography 0 compil$ by ,hel5 ,/reub]t1 ,,msn1 ,,rn doctoral c&idate & rese>* assi/ant 9 ! ,dep>tm5t ( ,nurs+ ,education1 ,tea*]s ,college_/,columbia ,univ]sity1 ,new ,york4 ,,books ,*5itz1 ,w4 ,c4 7#aihf74 ,f practice to gr\nd$ !ory4 ,m5lo ,p>k1 ,cali=nia3 ,addison-,wesley4 ,*9n1 ,p4 ,o41 ,jacobs1 ,m4 ,k4 7#aihc74 ,!ory & nurs+4 ,/4 ,l\is3 ,mosby ,company4 ,duldt1 ,b4 ,w4 7#aihe74 ,!oretical p]spectives = nurs+4 ,bo/on3 ,little-,br[n ,company4 ,ellis1 ,r4 7#aihd74 ,philosophic inquiry4 ,9 ,h4 ,h4 ,w]ley ,j4 ,j4 ,fitzpatrick 7,eds471 ,annual review ( nurs+ rese>* 7pp4 #baa-bbh74 ,new ,york3 ,spr+] ,publi%+ ,company4 ,fitzpatrick1 ,j41 ,:all1 ,a4 7#aihc74 ,conceptual models ( nurs+3 ,analysis application4 ,b[ie1 ,m>yl&3 ,brady ,company4 ,kleiman1 ,s4 7#aihf74 ,humani/ic nurs+3 ,! ph5om5ological !ory ( ,pat]son & ,zd]ad4 ,9 ,p4 ,w9/ead-,fry 7,ed471 ,case /udies 9 nurs+ !ory 7pp4 #afg-aie74 ,new ,york3 ,national ,league = ,nurs+4 ,le9+]1 ,m4 7#aihe74 ,e?nography & e?nonurs+ models & modes ( qualitative data analysis4 ,9 ,m4 ,le9+] 7,ed471 ,qualitative rese>* me?ods 9 nurs+4 ,orl&o1 ,florida3 ,grune ,/ratton4 ,meleis1 ,a4 ,i4 7#aihe74 ,!oretical nurs+3 ,developm5t & progress4 ,philadelphia3 ,lipp9cott4 #abd ,moccia1 ,p4 7,ed474 7#aihf74 ,new approa*es to !ory developm5t4 ,new ,york3 ,national ,league = ,nurs+4 ,munhall1 ,p4 ,l41 ,oil]1 ,c4 ,j4 7#aihf71 ,nurs+ rese>*3 ,a qualitative p]spective4 ,norwalk1 ,connecticut3 ,appleton-,c5tury-,cr(ts4 ,pat]son1 ,j4 ,g4 7#aigh74 ,! tortu\s way t[>d nurs+ !ory4 ,9 ,!ory developm5t3 ,:at1 :y1 h[8 7pp4 #di-fe74 ,new ,york3 ,national ,league = ,nurs+4 ,phipps1 ,w4 ,j41 ,long1 ,b4 ,c41 ,woods1 ,n4 ,f4 7#aihg74 ,m$ical-surgical nurs+3 ,concepts & cl9ical practice 7#crd ed474 ,/4 ,l\is3 ,mosby ,company4 ,roy1 ,c4 7#aihd74 ,introduction to nurs+3 ,an adaptation model 7#bnd ed474 ,englewood ,cliffs1 ,,nj3 ,pr5tice-,hall1 ,inc4 ,/ev5s1 ,b4 ,j4 7#aihd74 ,nurs+ !ory3 ,analysis1 application1 evaluation 7#bnd ed474 ,bo/on3 ,little ,br[n ,co4 ,suppe1 ,f41 ,jacox1 ,a4 7#aihe74 ,philosophy ( sci5ce & ! developm5t ( nurs+ !ory4 ,9 ,h4 ,h4 ,w]ley ,j4 ,j4 ,fitzpatrick 7,eds471 ,annual review ( nurs+ rese>* 7pp4 #bda-bfg74 ,new ,york3 ,spr+] ,publi%+ ,company4 ,zd]ad1 ,l4 ,t4 7#aigh74 ,f "h-&-n[ to !ory3 ,reflections on h[4 ,9 ,!ory developm5t3 ,:at1 :y1 h[ 7pp4 #ce-dh74 ,new ,york3 ,national ,league = ,nurs+4 ,,articles ,bael1 ,e4 ,d41 ,l[ry1 ,b4 ,j4 7#aihg74 ,pati5t & situational factors t affect nurs+ /ud5ts' l or dislike ( c>+ = pati5t4 ,nurs+ ,rese>*1 #cf 7#e71 #bih-cjb4 ,beck/r&1 ,j4 7#aihj74 ,a critique ( sev]al conceptions ( practice !ory 9 nurs+4 ,rese>* 9 ,nurs+ & ,heal?1 #c1 #fi-gi4 ,bottorff1 ,j4 ,l41 ,d'cruz1 ,j4 ,v4 7#aihd74 ,t[>ds inclusive notions ( pati5t & nurse4 ,j\rnal ( ,advanc$ ,nurs+1 #i 7#f71 #edi-eec4 ,braun ,j4 ,l41 ,ba9es1 ,s4 ,l41 ,olson1 ,n4 ,g41 ,scruby1 ,l4 ,s4 7#aihd74 ,heal? ,values1 #h 7#c71 #ab-ae4 ,br[n1 ,l4 7#aihf74 ,! exp]i5ce ( c>e3 ,pati5t p]spectives4 ,topics 9 ,cl9ical ,nurs+1 #h 7#b71 #ef-fb4 ,*5itz1 ,w4 ,c41 ,swanson1 ,j4 ,m4 7#aihd74 ,surfac+ nurs+ process--,a me?od = g5]at+ nurs+ !ory f practice4 ,j\rnal ( ,advanc$ ,nurs+1 #i 7#b71 #bje-bae4 ,drew1 ,n4 7#aihf74 ,exclusion & confirmation3 ,a ph5om5ology ( pati5ts' exp]i5ces ) c>egiv]s4 ,image1 #ah 7#b71 #ci-dc4 ,flask]ud1 ,j4 ,h4 7#aihf74 ,on t[>d a !ory ( nurs+ action skills & compet5cy 9 nurse-pati5t int]action4 ,nurs+ ,rese>*1 #ce 7#d71 #bej-beb4 #abe ,k+1 ,e4 ,c4 7#aihd74 ,humani/ic education3 ,!ory & tea*+ /rategies4 ,nurse ,education #h 7#d71 #ci-db4 ,nahon1 ,n4 ,e4 7#aihb74 ,! relation%ip ( self-disclosure1 int]p]sonal dep5d5cy1 & life *anges to lonel9ess 9 "y adults4 ,nurs+ ,rese>*1 #ca 7#f71 #cdc-cdg4 ,oil]1 ,c4 7#aihb74 ,! ph5om5ological approa* 9 nurs+ rese>*4 ,nurs+ ,rese>*1 #ca 7#c7 #agh-aha4 ,rigdon1 ,i4 ,s41 ,clayton1 ,b4 ,c41 ,dimond1 ,m4 7#aihg74 ,t[>d a !ory ( helpfulness = ! eld]ly b]eav$3 ,an invitation to a new life4 ,advances 9 ,nurs+ ,sci5ce1 #i 7#b71 #cb-dc4 ,s>t]1 ,b4 7#aihg74 ,evolution>y idealism3 ,a philosophical f\ndation = holi/ic nurs+ !ory4 ,advances 9 ,nurs+ ,sci5ce1 #i 7#b71 #a-i4 ,taylor1 ,s4 ,g4 7#aihe74 ,rights & responsibilities3 ,nurse pati5t relation%ips4 ,image1 #ag 7#a71 #i-af4 #abf #abg ,,index ,abdellah1 ,faye ,g41 #ij ,agee1 ,james1 #h1 #fg ,all-at-once1 #d1 #h1 #dd1 #eb1 #ee1 #ef1 #fh1 #gj1 #gc1 #ic1 #if1 #aji-aaa ,analogy1 #cg1 #ed1 #fa1 #hc ,analysis1 #gb1 #gi1 #hb-hd ,angul> view1 #e1 #bj1 #cg-ch1 #ea1 #fe-fg1 #ga1 #gd1 #hj-hb1 #hd1 #hh1 #ie-ih1 #aaa ,art1 #c1 #g-h1 #ad1 #ag1 #eh1 #fj1 #he-ic1 #aaa ,au!nticity1 #d-e1 #ad-ae1 #ee1 #ef-fj1 #fc1 #ajd1 #ajf1 #aaa ,be+ & do+1 #ac-ad1 #ag1 #ai1 #bf1 #ib ,b]gson1 ,h5ri1 #f1 #fh1 #ga1 #gb1 #gc1 #ajd ,betwe51 7!71 #d1 #g1 #ac1 #ba-bb1 #ca1 #dd1 #fg1 #hb1 #ajh4 ,see also ,dialogue2 ,int]subjective2 ,pres5ce2 & ,transaction ,bracket1 #ch1 #fb1 #hj ,bub]1 ,m>t91 #d1 #f1 #af1 #bc1 #ci1 #dd1 #de1 #dg1 #ee1 #fi1 #gb1 #gc1 #ic1 #ajd1 #ajf1 #aaj ,call & ,response1 #c1 #e1 #g1 #bd1 #bi-ca ,*oice1 #d-f1 #ae-ag1 #bj1 #bd1 #cg1 #eg1 #fi1 #gb4 ,see also ,confid5tiality2 ,responsibility ,*ri/(f]s1 ,c>ol ,ann1 #hi ,cl9ical1 #fe1 #fg1 #ib-ic1 #if1 #ajc-aji ,com=t1 #fe1 #if1 #ih-ajc1 #ajf1 #aaa-aab ,community1 #g1 #ad1 #cg-dh1 #fc1 #hd ,complem5t>y syn!sis1 #c1 #h1 #cf1 #fh1 #gc-gd1 #aaa4 ,see also ,syn!sis ,confid5tiality1 #ec-ef4 ,see also ,*oice2 ,responsibility ,c\s9s1 ,norman1 #ci1 #dg1 #ajd ,cross-cl9ical1 #bj de ,*>d91 ,pi]re ,teilh>d1 #f1 #ci1 #da1 #ajd ,desan1 ,wilfrid1 #af1 #ci1 #gc1 #gd1 #ajh ,description1 see ,ph5om5ological description ,dewey1 ,john1 #gb1 #ajd ,dialogue1 #ba-cf1 #gc1 #gg1 #ib-ic4 ,see also ,betwe5 7!72 ,int]subjective2 ,pres5ce2 & ,transaction ,durant1 ,ariel1 #fi ,durant1 ,w1 #fi ,exi/5tial1 exi/5tialism1 #d-i1 #ad1 #ae1 #bc1 #ch1 #dg1 #fe-ff4 ,see also ,ph5om5ology2 ,philosophy ,fahy1 ,ell5 ,t41 #ia ,family1 #ch-de ,frankl1 ,viktor ,e41 #f1 #ajb ,g>n]1 ,grayce ,c4 ,scott1 #hh1 #hi ,gilb]t1 ,ru?1 #fe1 #if1 #aji1 #aaj ,goe!1 ,johann ,wolfgang von1 #f1 #fg1 #ajb #abh ,he9le91 ,rob]t ,a41 #de ,"h & n[1 #dj1 #da1 #eg1 #fh1 #fi1 #hj1 #ha ,h]sey1 ,john1 #ci1 #hi ,hesse1 ,h]man1 #f1 #ci1 #dj1 #de1 #fi ,humani/ic nurs+1 #c1 #e1 #ad-bj1 #ba1 #he1 #ib-ic ,humani/ic nurs+ practice !ory1 #c1 #f-g1 #h1 #ag-bj1 #ba1 #ee1 #fj1 #fb1 #fe1 #gj1 #gg-hd1 #ie-aab ,human situation1 #aa1 #ah-bj1 #hg1 #hi ,huss]l1 ,edmund1 #ef1 #gh1 #gi ,int]subjective1 #ac1 #ae-ag1 #ba-bb1 #bf-bg1 #ca-cb1 #ce-cf1 #fh1 #ha1 #ij1 #ic4 ,see also ,betwe51 7!72 ,dialogue2 ,pres5ce2 & ,transaction ,intuition1 intuitive1 #ai1 #bc1 #eb1 #ga-gb1 #gc1 #gi-hb1 #if1 #aji ,i-,x1 #bg1 #cf1 #dd-de1 #gc1 #ajf-aab ,i-,?\1 #f1 #bg1 #cf1 #dd-de1 #fb1 #gb1 #gc1 #ib1 #ajf-aab ,jung1 ,c>l ,g41 #f1 #eh1 #fh ,kaplan1 ,abraham1 #ff ,kiell1 ,norman1 #dc ,la+1 ,r4 ,d41 #ag ,lemkau1 ,paul ,v41 #ed-ee ,man1 concept (1 #e1 #ae-af1 #ah-ai1 #bf1 #ch-de1 #ea1 #eb1 #ed-ef1 #fg-ga ,m>cel1 ,gabriel1 #f1 #af1 #bc1 #da ,may1 ,rollo1 #f ,meet+1 #ah1 #bd-bf ,metanurs+1 #bj ,metaphor1 #ed1 #fa1 #hd ,me?odology1 #fe-ge1 #gg-hd1 #ie-aab ,microcosm-macrocosm1 #cg-ch1 #dj1 #dh ,m-be+1 mor5ess1 #d-f1 #ab1 #af-ag1 #ai1 #bi1 #cb1 #cf1 #dd-de1 #dh1 #fc1 #fi1 #hi1 #ib ,mull]1 ,!resa ,g41 #ci1 #fe1 #if1 #aji1 #aaj ,nietzs*e1 ,fr$]ick1 #f1 #ci1 #dj1 #da1 #df1 #dg1 #ed1 #ga1 #ajb1 #ajd1 #aje ,nurs+1 #c1 #e1 #g1 #aa-ag1 #ba1 #de-dh1 #eg-eh1 #fe1 #fi1 #ga1 #gb1 #gc1 #gd1 #ge1 #ij-ib1 #ie-aab4 ,see also ,humani/ic nurs+ ,nursology1 #fe1 #fg1 #gj1 #gb1 #gc1 #gd ,nurture1 #ac1 #ah-ai1 #be ,objective1 see ,subjective-objective ,p>adox1 #d1 #ci1 #gj ,ph5om5ological description1 #c1 #f-h1 #ac-ad1 #ed1 #fj-fb1 #gj1 #gg-hd1 #if1 #aaa ,ph5om5ology1 #f1 #i1 #fj-fb1 #ff1 #fg1 #gb1 #gh1 #gi ,phillips1 ,g5e1 #d ,philosophy1 #ag1 #dj1 #ff1 #fg1 #ge1 #ig4 ,see also ,exi/5tialism2 ,ph5om5ology ,plato1 #f1 #cg1 #de1 #fg1 #ajd ,plut>*1 #aja ,popp]1 ,k>l1 #ci1 #ajd ,practice1 see ,humani/ic nurs+ practice !ory ,pres5ce1 #c1 #e1 #f1 #ac1 #ae1 #af1 #bg-bi1 #dg1 #ef1 #eh1 #gb1 #ajf4 ,see also ,betwe51 7!72 ,dialogue2 ,int]subjective2 & ,transaction ,pr\/1 ,m>cel1 #f ,rese>*1 #ea-fc ,responsibility1 #c1 #f1 #af-ag1 #bj1 #bh1 #da1 #ec-ee1 #eg1 #fc1 #fi1 #gj1 #gb1 #aaj4 ,see also ,*oice2 ,confid5tiality ,r\sseau1 ,jean-,jacques1 #f ,russell1 ,b]tr&1 #gj1 #ajd ,sci5ce1 sci5tific1 #c1 #f1 #g1 #h1 #ae1 #ag1 #ce1 #de1 #eb1 #ec1 #eh1 #fj1 #ff1 #fh1 #gj1 #gb1 #he-hg1 #hh1 #ij1 #ic1 #aaa #abi ,socrates1 #ch ,space1 #ah-bj1 #cd-ce ,subjective-objective1 #bg1 #ce-cf1 #eb1 #fg1 #gi1 #ha1 #ic ,syn!sis1 #gb-gd1 #gi1 #hb-hd1 #ic1 #ie1 #ajb1 #ajc1 #ajh1 #aaa4 ,see also ,complem5t>y syn!sis ,!ory1 see ,humani/ic nurs+ practice !ory ,"t1 #ah-bj1 #bi1 #cc-cd ,transactions1 #aa1 #ab-ac1 #af-bj1 #ba1 #ce-cf4 ,see also ,betwe51 7!72 ,dialogue2 ,int]subjective2 & ,pres5ce ,trautman1 ,m>y ,jane1 #hg1 #hh ,uniqu5ess1 #d1 #g1 #ae1 #bc1 #be1 #bf1 #bg1 #cb1 #cd1 #ce-cf1 #dj1 #de1 #ef1 #fh1 #fi1 #gb1 #gg1 #aaa ,value1 #f1 #af1 #ag1 #ah1 #cj1 #ci1 #df-dh1 #ed1 #ef-eg1 #fi1 #ga1 #gg1 #gi1 #he1 #ig1 #ih1 #ajd1 #aje ,well-be+1 #ab1 #af1 #cf1 #hi1 #ib ,:itehead1 ,alfr$ ,nor?1 #f ,wiesel1 ,elie1 #g1 #if ,weym\?1 ,lilyan1 #ee ,words1 #h1 #fj-fb1 #gc1 #ha1 #ih ,wright1 ,edw>d ,a41 #ia ,transcrib]'s ,note3 ,! foll[+ corrections h be5 made 9 ?is v]sion4 ,page iv 'exhilirat+' correct$ to 'exhil>at+'3 same exhil>at+ feel+ 'evalute' correct$ to'evaluate'3 & evaluate4 ,page #aa 'sitution' correct$ to 'situation'3 ! human situation 'app]s' correct$ to 'appe>s'3 nurs+ appe>s 9 ,page #ab 'limtations' correct$ to 'limitations'3 & limitations ( ,page #ad 'siuation' correct$ to 'situation'3 n[ %>$ situation ,page #ae 'wo?\t' correct$ to ')\t'3 goes )\t say+ 'e*os' correct$ to 'e*oes'3 process e*oes exi/5tial ,page #ah 'wiscom' correct$ to 'wisdom'3 ( cl9ical wisdom 'w\rlds' correct$ to 'worlds'3 liv$ nurs+ worlds ,page #bj 'apprao*' correct$ to 'approa*'3 nurs+ approa* is 'cross-cl9cal' correct$ to 'cross-cl9ical'3 g5u9e cross-cl9ical ,page #ba 'clairty' correct$ to 'cl>ity'3 ga9$ 9 cl>ity 'nus+' correct$ to 'nurs+'3 runs ?r\gh nurs+ 'conveyt+' correct$ to 'convey+'3 /ream convey+ ! ,page #bb 'languge' correct$ to 'language'3 ) our language 'consititu5t' correct$ to 'con/itu5t'3 compon5t or con/itu5t 'relfect+' correct$ to 'reflect+'3 ,once :ile reflect+ ,page #bc 'dicion>y' correct$ to 'diction>y'3 ! typical diction>y ,page #be 'ot' correct$ to 'to'3 expects to give 'reflectd' correct$ to 'reflect$'3 meet+ is reflect$ ,page #bf '= =' correct$ to '='3 h a capacity = 'tor' correct$ to '='3 necess>y = ev]yday ,page #bg 'objectivication' correct$ to 'objectification'3 ,?r\gh objectification '8' correct$ to '?is'3 b ?is 9 ,page #bh 'availbility' correct$ to 'availability'3 & availability 9 ,page #bi 'beg9' correct$ to 'be+'3 modes ( be+ 'purposefull' correct$ to 'purposeful'3 a purposeful call ,page #cj 'communicaion' correct$ to 'communication'3 nurse-pati5t communication ,page #ca 'expecially' correct$ to 'especially'3 /agg]+1 especially s ',fu!rmore' correct$ to ',fur!rmore'3 ,fur!rmore1 9 c>+ ,page #cc 'occur$' correct$ to 'occurr$'3 may h occurr$ 'possiblities' correct$ to 'possibilities'3 ,^! possibilities may ,page #ce 'exm9ation' correct$ to 'exam9ation'3 ! exam9ation turn$ ,page #dj 'e*os' correct$ to 'e*oes'3 _w e*oes its ,page #da '*ildr5s'' correct$ to '*ildr5's'3 _! *ildr5's worlds 'intial' correct$ to 'initial'3 ?is initial home ,page #db 'errupt' correct$ to 'erupt'3 x might erupt8 ',(5' correct$ to ',(t5'3 ,(t5 "o saw ,page #dc 'long-rememb]d' correct$ to 'long-rememb]$'3 long-rememb]$ ev5ts '( (' correct$ to '('3 times ( feel+ '!re' correct to '!re are'3 !re are multiple 'give' correct$ to 'gives'3 x gives satisfaction ,page #dg 'contemporaires' correct$ to 'contempor>ies'3 ) my contempor>ies ,page #ea 'necesss>y' correct$ to 'necess>y'3 is necess>y 9 'reasonbale' correct$ to 'reasonable'3 bo? reasonable & ,page #eb 'sub/anitat$' correct$ to 'sub/antiat$'3 be sub/antiat$ fully ,page #ec '(' correct$ to 'or'3 c>e or :5 ,page #ee 'viewd' correct to 'view$'3 is view$ z 'pr(esion' correct$ to 'pr(ession'3 nurs+ pr(ession4 ,utiliz+ 'reponses' correct$ to 'responses'3 /ruggl+ responses ,page #eg 'kn[lege' correct$ to 'k'3 disp]sion ( k ,page #ei 'cl9cial' correct$ to 'cl9ical'3 ,z cl9ical sup]visor '!apeutic' correct$ to '!rapeutic'3 pati5ts' !rapeutic ne$s ,page #fj 'civilzation' correct$ to 'civilization'3 8 civilization )9 ,page #fa 'some?imes' correct$ to 'sometimes'3 sometimes l a 'u' correct$ to 'use'3 & use ( weasel ,page #fb 'presitigi\s' correct$ to 'pre/igi\s'3 =eign pre/igi\s t]ms 'intial' correct$ to 'initial'3 to initial aw>e ,page #ff 'mehtodology' correct$ to 'me?odology'3 ! me?odology 9 'reexema9ation' correct$ to 'reexam9ation'3 available = reexam9ation1 'ph5om5ologic' correct$ to 'ph5om5ological'3 a ph5om5ological me?od ,page #fh 'citical' correct$ to 'critical'3 my critical p[]s ,page #gj 'excietm5t' correct$ to 'excitem5t'3 feel+s ( excitem5t 'easilty' correct$ to 'easily'3 n easily rel9qui%$ ,page #ga 'cl9cal' correct$ to 'cl9ical'3 /ruggle 9 cl9ical 'reconsitut+' correct$ to 'recon/itut+'3 ( recon/itut+ ) ,page #gb 'assund]' correct$ to 'asund]'3 bur/s asund] ,page #gd 'oscilat+' correct$ to 'oscillat+'3 ,?is oscillat+1 dialectical ,page #gh '! !' correct$ to '!'3 ! approa* has be5 'descipl9es' correct$ to 'discipl9es'3 by diff]5t discipl9es 'deatils' correct$ to 'details'3 m concrete details ,page #ha 'p]pectives' correct$ to 'p]spectives'3 _! own p]spectives 'aslo' correct$ to 'also'3 r x also ,page #hb 'a' correct$ to 'z'3 angles z possible 'expliction' correct$ to 'explication'3 ! explication ( '*ract]i/ics' correct$ to '*>act]i/ics'3 has o!r *>act]i/ics 'convy' correct$ to 'convey'3 may convey ang] ,page #hc 'empahty' correct$ to 'empa?y'3 ,?us1 empa?y is ,page #he 'o!' correct$ to 'o!r'3 & o!r =ms ,page #hg 'pep>ation' correct$ to 'prep>ation'3 educational prep>ation 'sce9tific' correct$ to 'sci5tific'3 ) sci5tific c\rses 'quanitification' correct$ to 'quantification'3 /rives = quantification ,page #ij - footnote #aa ',sce9ce' correct$ to ',sci5ce'3 ,nurs+ ,sci5ce ,page #ia 'physcial' correct$ to 'physical'3 ( physical objects ,page #ic 'responsses' correct$ to 'responses'3 human responses to 'x' correct$ to 'is'3 ,x is possible ,page #ig 'nusr+' correct$ to 'nurs+'3 = nurs+ !ory 'veiw$' correct$ to 'view$'3 nev] view$ myself ,page #ajj 'opportunties' correct$ to 'opportunities'3 !rapeutic opportunities available ,page #ajb 'neces>y' correct$ to 'necess>y'3 are necess>y = 'contribut>ies' correct$ to 'contributories'3 ( _m contributories ',geo!' correct$ to ',goe!'3 ,nietzs*e & ,goe! ,page #ajd 'comp>ision' correct$ to 'comp>ison'3 comp>ison ( x ,footnote #i ',pbuli%]s' correct$ to ',publi%]s'3 ,basic ,books1 ,publi%]s ,page #ajf 'conta9t$' correct$ to 'conta9$'3 total gr\p conta9$ ,page #aaj 'nurse'' correct$ to 'nurse's'3 a nurse's duality ,page #aaa 'nus+' correct$ to 'nurs+'3 ,humani/ic nurs+ practice ,page #aad '',sometimes' correct$ to ',sometimes'3 ,i said1 ,sometimes ,page #aae '"k' correct$ to 'knew'3 if %e knew 'assund]' correct$ to 'asund]'3 to bur/ asund] ,page #aag 'enc\rg$' correct$ to 'enc\rag$'3 ,i enc\rag$ pati5ts' ,page #aah '!rapeautic' correct$ to '!rapeutic'3 individual !rapeutic ga9s 'aggreeably' correct$ to 'agreeably'3 to me agreeably ,page #aba 'mure' correct$ to 'm'3 two or m ,page #abc ',hurs+' correct$ to ',nurs+'3 ,zd]ad's ,humani/ic ,nurs+ ,page #abd ',refelections' correct$ to ',reflections'3 ,reflections on h[ ',dcruz' correct$ to ',d'cruz'3 ,d'cruz1 ,j4 ,v4 ,page #abh ',nietz*e' correct$ to ',nietzs*e'3 ,nietzs*e1 ,fr$]ick1