FOOTNOTES:
[1] Josephine G. Paterson, "Echo into Tomorrow: A Mental Health Psychiatric Philosophical Conceptualization of Nursing" D.N.Sc. dissertation, Boston University, 1969.
[2] Josephine G. Paterson "From a Philosophy of Clinical Nursing to a Method of Nursology," Nursing Research, Vol. XX (March-April, 1971), pp. 143-146.
[3] Abraham Kaplan, Conduct of Inquiry (San Francisco: Chandler Publishing Co., 1964), p. 23.
[4] Plato, The Republic, trans. Francis MacDonald Cornford (New York: Oxford University Press, 1945), p. 45.
[5] James Agee, Let Us Now Praise Famous Men (New York: Ballantine Books, 1939), pp. 91-102.
[6] Johann Wolfgang von Goethe, "On Originality." In Great Writings of Goethe, ed. Stephen Spender (New York: Mentor Press, 1958), p. 45.
[7] C. G. Jung, Modern Man in Search of a Soul, trans. W. S. Dell and Cary F. Baynes (New York: Harcourt, Brace and World, 1933), p. 118.
[8] Henri Bergson, "Time in the History of Western Philosophy," in Philosophy in the Twentieth Century, ed. William Barrett and Henry D. Aiken (New York: Random House, 1962), p. 252.
[9] Will Durant and Ariel Durant, Lessons of History (New York: Simon and Schuster, 1968), p. 102.
[10] Hermann Hesse, Demian, trans. Michael Roloff and Michael Lebeck (New York: Harper & Row, 1965), p. 4.
[11] Martin Buber, Between Man and Man, trans. Ronald Gregor Smith (Boston: Beacon Press, 1955), p. 93.
[12] Bertrand Russell, The Autobiography of Bertrand Russell, 1914-1944 (Boston: Little, Brown and Co., 1968), p. 97.
[13] Frederick Nietzsche "Thus Spake Zarathustra," trans. Thomas Common, in The Philosophy of Nietzsche (New York: Random House, 1927), p. 239.
[14] Henri Bergson, "An Introduction to Metaphysics," in Philosophy in the Twentieth Century, ed. William Barrett and Henry D. Aiken (New York: Random House, 1962), pp. 303-331.
[15] John Dewey, How We Think (Boston: D. C. Heath & Co., Publishers, 1910), p. 105.
[16] Martin Buber, "Distance and Relation," trans. Ronald Gregor Smith, in The Knowledge of Man, ed. Maurice Friedman. (New York: Harper & Row, Publishers, 1965), pp. 60-82.
[17] Bergson, "An Introduction to Metaphysics," pp. 303-331.
[18] Martin Buber, I and Thou, 2nd ed., trans. Ronald Gregor Smith, (New York: Charles Scribner's Sons, 1958). pp. 3-34.
[19] W. D. Desan, Planetary Man (New York: The Macmillan Company, 1972), p. 77.
[20] Ibid.
[21] Ibid., p. 80.
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7
A PHENOMENOLOGICAL APPROACH TO HUMANISTIC NURSING THEORY
Humanistic nursing is dialogical in the theoretical as well as the practical realm. Just as the meaning of humanistic nursing is found in the existential intersubjective act, that is, in the dialogue as it is lived out by nurse and patient in the real world, so the theory of humanistic nursing is formed, in the dialogical interplay of articulated experiences shared by searching, abstracting, conceptualizing nurses.
The theory of humanistic nursing originates from and is continually revitalized and refined by actual nursing experience. But each nurse, as a unique human being, necessarily experiences the nursing dialogue and her nursing world in a unique way. So the development of humanistic nursing theory rests on the sharing of individual unique angular views. And the theory as a totality will become richer, more consonant with reality, as it represents more and more nurses' views.
So often nurses, even nurses who know that their clinical expertise grew out of their practice, hesitate to share their nursing experiences. They are apt to say deprecatingly, "Oh, that's only my personal experience." Yet that is precisely where the value lies, in the uniqueness of human experience. Since each nurse's description of her nursing experience is a glimpse of a real nursing world, the views cannot justifiably be judged as right or wrong; they simply are. Once the various views are expressed, they can be compared and contrasted, not for the purpose of accepting some and rejecting others but rather in the interest of clarifying each in relation to the other. Such a dialogue of experientially based conceptualizations can result in a complementary synthesis. The process calls for not only a true appreciation of personal experience by each nurse but also commitment to a collaborative effort of open sharing by a genuine community of nurses.
This view, that the development of humanistic nursing practice theory is a dialogical process, has led to our valuing (in fact, insisting on) the description {78} of nursing phenomena. We see phenomenological description as a basic and essential step in theory building. Indeed, considering the "state-of-the-art" of nursing theory development, it is the most crucial and immediate need.
Looking back at the historical evolvement of our humanistic nursing approach, it is obvious that we had been using and developing a phenomenological approach for a number of years before we graced our efforts with the impressive label, "Phenomenological Psychiatric Mental Health Nursing," in a course offered to a group of nurses at Northport Veterans Administration Hospital in April 1972. Although we were aware much earlier that our interests and work were flowing in the general stream of phenomenology, we usually refrained from using the label because it did little to clarify our position.[1] The term has grown less precise with the extension of its use in different disciplines and with variations in methodology.
When we began applying the term "phenomenological" to our work, we learned that to many persons it sounds strange, unpronounceable, foreign; to some forbidding; to others enticing. We later coined the title "humanistic nursing" as being more suitable for it encompasses our general existential bent. However, this change in title does not imply any abandonment of our phenomenological approach. The description of nursing phenomena is as highly prized now as ever. In humanistic nursing, phenomenological and existential currents interrelate. Having an existential view of nursing as a living dialogue influences which phenomena one becomes aware of, experiences, values, studies, and describes. Reciprocally, as one discovers and struggles to describe and develop meaningful ways of describing nursing phenomena, the lived nursing dialogue itself will be continually perfected.
It is more precise to speak of phenomenological methods (in the plural) rather than phenomenological method (in the singular), for, since Edmund Husserl's original work, the approach has been used by different disciplines. With its spread there has developed a corresponding variation in methodology. This, in a sense, is the beauty of phenomenology: it thrives on variety of perspective; it allows, perhaps requires, individual creativeness; it is always open. In this spirit, ideas are offered here with the hope of stimulating imaginative, critical response, and further development of methodology.
This chapter considers some of the more concrete details of phenomenological methodology as they relate to humanistic nursing. The general approach and procedures discussed below have been used, individually {79} and collaboratively, by Dr. Josephine Paterson and myself with individual and groups of nurses to explore and describe their nursing experiences. They have helped nurses in various levels and types of nursing service to take a fresh look at their practice and make desirable changes. We have lived through the process with graduate students in nursing, and it has led both the students and us to new conceptualizations and reconceptualizations of nursing phenomena. We have found this to be a fruitful research method when applied to clinical nursing phenomena personally experienced and/or reported in the literature. And we are currently exploring its potentials with interested nurses at Northport Veterans Administration Hospital.