CONNECTIONS
One night as I listened to the change of shift report, I remember the
strange feeling in the pit of my stomach when the evening nurse reviewed
the lab tests on Tracy P Tall, strawberry-blonde and freckle-faced,
Tracy was struggling with the everyday problems of adolescence and
fighting a losing battle against leukemia. Tracy rarely had visitors.
As I talked with Tracy this night I felt resentment from her toward her
mother, and I experienced a sense of urgency that her mother be with
her. With Tracy's permission I called her mother and told her that Tracy
needed her that night. I learned that she was a single mother with
two other small children, and that she lived several hours from the
hospital. When she arrived at the hospital, distance and silence
prevailed. With encouragement, the mother sat close to Tracy and I sat
on the other side, stroking Tracy's arm. I left the room to make rounds
and upon return found Mrs. P. still sitting on the edge of the bed
fighting to stay awake. I gently asked Tracy if we could lie on the bed
with her. She nodded. The three of us lay there for a period of time and
I then left the room. Later, when I returned, I found Tracy wrapped
in her mothers arms. Her mothers eyes met mine as she whispered "she's
gone." And then, "please don't take her yet." I left the room and closed
the door quietly behind me. It was just after 6 o'clock when I slipped
back into the room just as the early morning light was coming through
the window. "Mrs. P," I reached out and touched her arm. She raised her
tear-streaked face to look at me. "It's time," I said and waited. When
she was ready, I helped her off the bed and held her in my arms for
a few moments. We cried together. "Thank you, nurse," she said as she
looked into my eyes and pressed my hand between hers. Then she turned
and walked away. The tears continued down my cheeks as I followed her to
the door and watched her disappear down the hall.
Gayle Maxwell (1990)
This nursing situation is replete with possibilities for nurses, and others, to understand nursing as nurturing persons living caring and growing in caring. A dialogue ensues on the nursing situation that allows participants an opportunity to experience both resonance and uniqueness as personal and shared understandings emerge. As the reader enters into the text, the nursing situation is experienced anew, now within the presence of two nurses, not one. Though intentionally entering the situation, the second nurse experiences d affirms being connected in oneness with both nurse and nursed as caring lived in the moment.
Gayle entered into Tracy's world that night open to hearing a special call. Gayle's openness was partly a reflection of her use of the empirical pathway of knowing, the data given in report, the comparison of empirical observations against biological, psychological, developmental, and social norms. Before discussing our understanding of Gayle's response from the theoretical per-perspective represented, it might be helpful to compare how the call for nursing may have been interpreted if approached, for example, from a psychological framework. If the nurse responded from a psychological framework, the problem identified would perhaps be conceptualized as denial on the part of Tracy's mother. It could be assumed that Tracy's mother was avoiding the reality of the impending death of her daughter. Here, the nursing goal would be assist the mother in dealing with her denial by facilitating grieving. Denial is only one psychological concept that could be applied in this situation; avoidance, anxiety, and loss are others. When nursing care is based on a psychological framework, however, the central theme of care is likely to be deemphasized in favor of a problem-oriented approach. The perspective offered by a normative discipline requires a reliance on empirical knowing. Using only the empirical pathway of knowing, the richness of nursing is lost.
Gayle's personal knowing, her intuition, however, was the pathway that illuminated the appreciation of this situation and prompted her acknowledgement of a call. She heard Tracy's call for intimacy, comfort, and protection of her mother's presence as she (Tracy) summoned courage and hope for her journey. Gayle intuitively knew that the specific caring being called forth was the caring of a mother. Gayle's caring response also took the form of the courageous acknowledgement of a call for nursing that would be difficult to sub-stantiate empirically. Beyond telephoning Tracy's mother, Gayle continued her nursing effort to answer Tracy's call for the presence of a mother as she supported Mrs. P. living her interconnectedness, in being with Tracy. Gayle heard Mrs. P.'s calls for knowing, knowing what to do and knowing that it would be right to do it, for the courage to be with her daughter in this new difficult passage. Her response of showing the way reflects hope and humility. The caring between the nurse and the ones nursed enhanced the personhood of all three, as each grew in caring ways. It is possible that the caring between the original participants in the nursing situation and those of us who are participating through engagement with the text continues to enhance personhood.