About Wendy Marks, DNS, ANP-BC

I am a board certified adult nurse practitioner, educator and consultant in New York State, USA. I teach and practice from the caring science paradigm which focuses on healing the unitary being. My research interest is the emancipatory praxis of integral nursing.

Nursing as Practical Magic


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Nursing is a practical magic that creates internal and external environments to promote health or a peaceful death through acts that generate transformation. Ancient wisdoms and civilizations create rituals to honor life’s milestones and seasonal changes.

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Samhain (pronounced sow-een) is known as the ancient Celtic festival of the dead. Celebrated on the 1st day of November, Samhain is a time of introspection, and remembrance of the ancestors.

How do you remember and honor your ancestors?

Wise women throughout the ages, healers, and witches honor the turning of the wheel of life, the seasons, and the rhythms of the natural universe.

Connecting with the moon, stars, plants, animals, self and spirit they give thanks and set intentions to create healing and the life they dream of.

Consider the symbols and talisman of Halloween. One may see that the Broom symbolizes clearing of the old to make way for new; the Owl for wisdom; the Cat for mystery of the unknown; Ghosts for notions of the other world; and Bats for transformation.

As nurses, we inherently make connections with and for our patients and families. We tap into the power of the universe, as we embrace it we realize there’s a little witch in all of us.

Magic isn’t just spells and potions; its symbols and talisman that have whatever meaning you assign to them. What are the symbols and rituals that hold meaning for you?

Healers use their powers to conjure and create by setting intentions and connecting with the inherent energies of their environments.

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The nursing metaparadigm (nurse, person, health, environment) viewed through the Unitary Transformative paradigm conjures an integration of multiple ways of knowing, being and becoming.

As we honor our nursing ancestor Florence Nightengale, we hear her say:

“All disease is a reparative process…an effort to remedy a process of poisoning or decay…I use the word nursing for want of a better. It has been limited to the administration of medicines and applications of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet and diet…”

How do you conjure your environment for healing? How do you create the environment for your patients to heal? What ritual, symbols and talismans and intentions do you use in your self healing and work?

As we connect to our ancestors today, let us begin to reclaim our providence and power as nurse healers.

Listen to you heart, hear the beat of the drum, the drum of your heart as it connects with the hearts of the others and the universe; conjuring, gathering and sending out powers of healing and love to self and universe.

On this day we honor the ancestors, the ancient wisdoms, where we have been and the gifts we have been given.

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See the vibrant colors of the Autumn; red, yellow, orange, and brown. Smell the earthly aromas of patchouli, sandalwood, musk, spice and copal. Hear the rustle of leaves as they fall and fly.

Let your nursing be a practical magic. Conjure a spell and send your intentions off on the winds, allowing the vibrant leaves of red, orange and yellow carry your wishes of health and healing to the earth, animals and humans.

Reference

Nightingale, F. (1859). Notes of Nursing; What is it and What it is not. Barnes & Noble (2003): New York, NY (pp 1-2).

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Freedom


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According to Miriam Webster Dictionary freedom is a noun, and defined as the quality or state of being free. Freedom is the absence of necessity, coercion or constraints in choice or action.

Life, liberty and the pursuit of happiness are the hallmarks of independence. To be liberated from the constraints and restraints of the power from another, or a set of beliefs, yields a quality of life that allows for ease of speech and privilege to be and become what we want.

As nurses, we may experience coercion or constraints, even restraints in our practice. Can we liberate ourselves and define our set of beliefs to have the power to see and say what nursing is and is not?

Contemporary theorists and healers believe we may start by setting the intention for the highest healing good to occur; then see nursing within the context of a set of beliefs and values that promote caring and healing for self, system and others; we take action to liberate our selves and others of the constraints and restraints that bind us from achieving this end.

What is it like to live and work in environments that allow freedom of speech and action? Are we brave enough to challenge those who seek to imprison us in thought and behavior? Is nursing is the home of the free and the brave; or are we constrained  by restrictive rules, mores and narratives?

In my research on caring and healing I have heard nursing narratives that describe transformative advocacy; looking, and seeing where the next right action enfolds … taking the next steps together, with each other, and our patients and families down a new yellow brick road that meets each persons next Freedom.

Nursing, the home of the Free and the Brave; let Freedom reign.

Renewal

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Renewal

by Wendy Marks, DNS, ANP-BC

Renewal

Spring is a time of renewal in nature. Flowers and leaves bud and bloom, birds busy to make their nests, eggs are laid, warmed and hatched, bees make hives, migratory birds fly back to northern homes.

Humans shed winter coats and boots and migrate outdoors to take in the warm breezes, air and sun.

The Unitary-Transformative paradigm informs nursing practice that humans and nature are symbiotic. External environments affect body-mind-spirit. Fresh air, the aesthetics of flowers, birds, and nature sounds affect our feeling tones by soothing our senses. Internal environments are harmonized with rest, nutrition, hydration, and happy thoughts.

Kolcaba’s Comfort Theory (2003) can be used as a guide to understand how patients, families and nurses engage in behaviors to promote physical, psychospiritual, and environmental wellbeing by providing relief, ease, and transcendence towards improved health or peaceful death.

Several Comfort Scales are available to help evaluate comfort in different settings.

Here’s a comfort scale designed for nurses:

http://www.thecomfortline.com/resources/cqs/NursesComfort%20Questionnaire.pdf

You might take the test and then ask yourself where you need to seek renewal for yourself as a human in need of caring and comfort.

What are you doing to renew yourself? Are you going to take a walk outside? Smell and feel the warm, fragrant breezes? Hear the chirp of birds and see the new flowers, leaves and bees? Will you surround yourself with others who value peace, kindness, and love?

Make your values as a nurse healer visible and explicitly engage in health seeking behaviors, free yourself from the burdens of heavy coats and boots. Set sail in the Spring time breezes and feel the sun on your face as you enter a new day and transcend all that no longer serves you.

Reference

Kolcaba, K. (2003). Comfort Theory and Practice. NY, NY: Springer. www.thecomfortline.com

The Emancipatory Praxis of Integral Nursing


This blog will discuss my doctoral research, which was a critical narrative inquiry that sought to identify patterns in the stories of 10 nurses working in an American Nurse Wendy4Credentialing Center (ANCC) Magnet re-designated Oncology unit. Critical narrative inquiry is a research method developed by Dr. Suzie Kim (2010).  Critical narrative inquiry reflects upon societal-contextual experience and prescribed power relationships to identify, transform and transcend oppression. It deconstructs normative hegemony (the way things are or expected to be vs. the way things could be) by analyzing language, communication patterns and symbolic meanings in experience (Dunphey & Longo, 2007).

The method has 3 phases: 1) the nurses tell a story that exemplifies their experience of a theory guided practice; 2) the stories are recorded and transcribed, then critically read and reflected upon by the participants and researcher with the purpose of identifying salient patterns that emerge as facilitators or barriers to their theory guided practice; and 3) the nurses identify opportunities for transformative learning and emancipatory praxis.

During the process of the study I used Dr. Peggy Chinn’s Peace and Power model (2008) to share power with the nurses and optimize emancipatory knowledge acquisition by hearing their voices. I asked them what was important to them in their practice and in their experiences. Our research sessions were a dialogue between colleagues and I was careful to value their voice and power throughout the study and publication.

The purpose of the research was to:

  • Examine the impact of Human Caring theory guided practice upon nursing qua Nursing.
  • Learn about nurses’ educational preparation in theory guided practice and integral nursing.
  • Examine the relationship between nurses knowledge, caring and power in the Magnet environment.
  • Identify patterns that facilitate and create barriers to nursing qua nursing.

What we learned from the research was:

  • Nurses are transformative change agents who advocate for their patients, even against normative views and authoritarian power if it is in the best interest of their patients and families.
  • Nurses have a language and culture of rich values enacted through careful and meaningful comportment via her/his self-agency that protects and preserves the integral health of those in their care, community and environments.
  • Environments are affected by nurse’s behaviors and actions; external environments are carefully created to enhance patient’s internal environments via; lighting, ambient temperature, music, positioning, cultural, spiritual and religious acts, healing intention, touch, voice and presence.

These findings support Jarrin’s (2012) work where she describes nursing as “Situated Wendy1caring shaped by internal and external environments. These environments include: the individual nurse’s state of mind, intention and personal nursing philosophy, their scope, role, level of skill, training and experience societal and professional norms, values, and worldview social, political, and economic systems embedded in education and practice environments” (p. 14).

This research further supports Kagan, Smith, Cowling and Chinn’s (2009) work that rally’s nurses together for social justice and to protect and support professional values that empower nurses at all levels. The nurses in my study identified that working with nurses who value and support each other; while valuing and seeing the big picture or true meaning of protecting, advocating for and enhancing the patient and families integral health experience, creates optimal work and patient care environments.

Emancipatory praxis requires a convergence of multiple patterns of knowing, doing and being; where the nurse can sense and see patterns that are emerging; and imagine what can become for self, colleagues and those in their care. The knowledge, caring and power dialect is a rich area of inquiry for nurses to conduct further research.

References

Dunphey, L. & Longo, J. (2007). Reflections on postmodernism, critical social theory and feminist approaches: The mind of the postmodern. In P. L. Munhall (Ed.) Nursing research: A qualitative perspective (4th ed., pp. 127-142). Sudbury, MA: Jones and Bartlett.

Jarrin, O.F. (2012). Redefining the metalanguage of nursing science: Contemporary underpinnings for innovation in research, education and practice. Advances in Nursing Science, 35(1), 14-24.doi10.1097/ANS.obo13e3182433b89.

Kagan, P. N., Smith, M.C., Cowling, W.R., & Chinn, P.L. (2009). A Nursing Manifesto: An emancipatory call for knowledge development, conscience, and praxis. Nursing Philosophy, 11, 67-84.

Kim, H.S. (2010). The nature of theoretical thinking in nursing (3rd ed.). New York: Springer.

Marks, L.W. (2013). The Emancipatory Praxis of Integral Nursing: The Impact of Human Caring Theory Guided Practice Upon Nursing Qua Nursing in an American Nurses Credentialing Center Magnet® Re-desginated Healthcare System. Retrieved October 21, 2014 from http://tinyurl.com/ovqlk3t

Breaking Down Barriers: Advocacy for Integral Health and Human Caring


As we participate in our personal and professional environments how do we break down barriers by advocating for shared power to promote integral health and human caring?

The Peace and Power process breaks down barriers by challenging ideological beliefs and behaviors that alienate and divide us from one another (Chinn, 2008). This process begins with an honest personal inventory and evaluation of sociocultural mores and conditioning that inform our beliefs. It is from this starting point that we can begin to see the power of our thoughts and feelings. How we act and react creates experiences of nurturance and shared power; or of conflict and derision. “Power is the energy from which action arises” (Chinn, p.17). There are many kinds of power, but Chinn’s definition here spurs the notion of advocacy for the use of power as energy. Energy to free, to heal, to care, to make a better, more loving, understanding, healthy, kind and just world.

What are you thinking and feeling right now about what power means to you and your current (personal and professional) life experiences?

Consider the French philosopher Michel Foucault’s (b.1926- d.1984) ideas of power: Foucault (1982) said “Power is everywhere and in everything.”  He believed the effects of power are linked with knowledge, competence and qualification; and that power is a socialized and embodied phenomenon. He also believed that power is discursive rather than (but can be) coercive. Discursive means “running to and from” and involves the use of language (discourse). Indeed, power is communicated in language (verbal and nonverbal).

We often think power means “power over” and attach negative meaning to it, but for Foucault power takes on a socialized, knowledge based meaning; and helps us to see what Peggy means by “power as energy for action.” For a further explanation of Foucault’s beliefs and influences please follow the link below:

http://www.powercube.net/other-forms-of-power/foucault-power-is-everywhere/

As we critically examine the concept of power, we can look at the socialized and embodied beliefs, behaviors and practices that divide and join us.

Watson (2012) suggests we ask “who is this spirit filled person before me?” As we interact with our environment, and those in it, we can ask this question, and go deeper and wider to ask: what are the sociocultural, internal, external, subjective, even global and historical influences and experiences that inform this person and her or his views of self, other and world?  What are the influences of power upon and within this person?

Breaking down barriers to personal and professional advocacy for integral health and human caring can begin with examining power in all its many manifestations.

References

Chinn, P. L. (2008). Peace and Power: Creative leadership for building community. Jones and Bartlett. Sudbury, Ma.

Foucault, M. (1982). The subject and power. Critical Inquiry, 8(4), 777-795.

Watson, J. (2012). Human caring science: A theory of Nursing. Jones and Bartlett. Sudbury, Ma.