“Nursing worldwide has been so confined and controlled by external material, physical reality, found within Westernized medicine and institutions, that it has almost lost it own heritage and purposive existence. It has been so consumed by the modern demand for technological competencies it now is faced with having to restore the under-developed ‘ontological competencies’ so essential to nursing’s maturity and survival as a distinct caring-healing profession” Jean Watson, 2002, p. 2.

How do we come back to the heart of nursing as healing, where so many of us wish to dwell and practice nursing? I ask myself this question frequently and I wonder about the challenges that we face as nurses and educators in supporting one another to create caring-healing spaces. Dr. Watson (2002) called for us to do this by healing our relationship(s) with self and others, creating meaning around our own concerns related to profound and compassionate caring and healing practices in nursing as service, gaining deeper understandings of and thereby transforming our own and other’s suffering, and accepting impermanence and the cycle of life.

This statement makes sense to me, but I also understand that nurses who have not been exposed to Watson’s theory, or who struggle to understand the deep implications of healing and personal evolution, may not grasp the call that Dr. Watson is making here. To simplify this statement a bit, I believe that she is calling for us to be each on our own healing and caring journey; walking into our own suffering, and continually working toward healing ourselves, helps create in each of us a greater capacity for caring for others and remaining compassionate at the bedside.

If we became nurses because we felt called to nursing, we can come back to that original calling and work toward Nightingale’s model of nursing as a spiritual-sacred healing practice. As Watson (2002) reminded us, when we are on the healing path ourselves, we can strive to be fully present with the patient through creating a caring-healing space. In this space, we reflect healing and enact transpersonal caring in such a way that our work as nurses becomes the most rewarding part of our lives, as we connect deeply with another human being and recognize our interconnection with all.

Part of my own healing process has included a journey into yoga practice and yoga teaching. Interestingly, even as I have encountered great healing for myself with yoga, I also find great healing for others and myself when I share the process of teaching yoga. This sort of mutual healing space that is created in a yoga class, is the same sort of space that many nurses are striving for in their caring work.  One of the challenges then becomes how to create the time and space within your practice to connect deeply with your patients, to hold with them a space for healing, and to bring true meaning to your healing work as a nurse?

Unfortunately, there is a perpetuated myth that transpersonal or deep caring- healing takes too much time and is usually left for last after all of the technical demands of the nurse are met, once the charting has been done, once the patient has been stabilized, and so on. I posit here that with practice and with work on one’s own personal caring- healing journey, the nurse can strive for learning to create a caring-healing sustainable practice with everything she does for patients.

Being present to patients and briefly breathing for a minute to set an intention for caring healing spaces does not take more time, though it may take practice, commitment, and reminders for the nurse to return to that healing space again and again and again throughout her busy day. Managing one’s stress and practicing healing for oneself are also the keys to learning to create caring at the bedside on a regular basis, and that may take more time out of one’s personal life, however if one is committed to nursing from a caring-healing space, then that time is an investment for oneself and a requisite to enacting a caring- healing practice.

And nurses may ask “why?”… why bother to create these spaces when it is not valued by the larger demands on the nurse, and takes a personal effort that is likely not always recognized or rewarded? My thoughts on this are:

• If we are not supporting healing we are not nurses, we are technicians. If we lose our value of caring in nursing; we become heartless and our value to society at large diminishes or or is distinguished completely.
• Patients, and their resultant expression of satisfaction, demand a healing presence.
• One way to ensure the nurse has a long and fruitful nursing career, and does not burn out or become ill from stress of the job, is to for the nurse to enact a sustainable caring-healing bedside practice, that is deeply related to her own personal healing journey.
• Because much much of what is going on in hospitals currently is ethically unsound, as damage is done to patients on a regular basis in the hospital environment and unfortunately nurses may also be subject to, or become an aspect of, said damaging environment.

I would like to expand a bit more on this last aspect. According to the New England Journal of Medicine, we now know that patients are leaving the hospital setting with what is being called post hospitalization syndrome, which is basically another term for PTSD related to hospitalization (Krumhloz, 2013). Indeed hospitalization for injury also increases one’s risk for depression and PTSD (Zatsik et al, 2008).

This sort of evidence should be generating questions for nurses, ranging from how they might be contributing to patients’ stress, to how they might be impacted by an environment known for stress induction, to how they are supporting the creation of caring-healing environments to counteract this stress.

Ethically, as purveyors of healing, we are obligated to examine our nursing practices with more depth and determine how we are going to create and be the change that our patients and the world are calling us toward.

“As nurses and nursing enter into this transpersonal aspect of our work, as we are re-patterned  so is our environment, our systems, and our culture. We then, individually and collectively, become the transformed nurse; we become the ethos and culture of caring and healing, living out our timeless heritage and most extant caring ethic, theories and philosophies in our lives, and our work” (Watson, 2002, p. 7).

References:

Krumholz, H.M. (2013). Post hospital syndrome: An acquired transient condition of generalized risk. New England Journal of Medicine, 368, 100-102.

Watson, J. (2002). Nursing: Seeking it’s source and survival (editorial). ICU and Nursing Web Journal,9, 2-7.

Zatsik, et al. (2008). A national US study of post traumatic stress disorder, depression, and work and functional outcomes after hospitalization for traumatic injury. Annals of Surgery, 248, 429-37.