How to Nurse

/ Peggy L Chinn / 4 Comments

Are you looking for the perfect gift for a nurse on your holiday list?  Or, are you looking for a book that is entirely consistent with the vision of the NurseManifest values and ideals?  Are you still struggling to clearly answer the nagging question: what is nursing? Or do you just need inspiration? Cover How to nurse Look no further this book is the perfect choice – How to Nurse: Relational Inquiry with Individuals and Families in Shifting Contexts.  I reviewed this book for this blog back in January, but I continue to be inspired and encouraged by this book and decided that now is a perfect time to once again bring this book to the attention of NurseManifestors!  Right at the outset, the authors Gwenneth Hartwick Doane and Colleen Varcoe explain what they mean by the term “relational,” and in so doing reveal the close connection with NurseManifest values:

When we use the word “relational” and speak of a relational inquiry approach to nursing practice, many people think we are merely emphasizing the touchy-feely, emotional side of nursing and particularly “nurse–patient” relationships. However, relational inquiry is far more encompassing than that. Although relationships between people are certainly part of relational inquiry, in this book, the term “relational” refers to the complex interplay of human life, the world, and nursing practice. Specifically, relational inquiry involves highly reasoned, skilled action. Relational inquiry  requires (a) a thorough and sound knowledge base; (b) sophisticated inquiry and observational and analytical skills; (c) strong clinical skills including clinical judgment, decision-making skills, and clinical competencies; and knowledge and skills. Rather, a relational consciousness highlights the interplay of a number of factors affecting the point-of-care . . . . This heightened awareness enables more informed decisions and more effective action.

Overall, a relational consciousness

• Sensitizes us to the relational complexities that affect what happens at the point-of-care
• Directs attention toward the “relational transactions” that are occurring within and among people and contexts
• Enables us to be very intentional and consciously choose how to act in response to these complexities and transactions

Specifically, relational consciousness is the action of being mindfully
aware of the relational complexities that are at play in a situation and
intentionally and skillfully working in response to those relational complexities.

(Doane, Gweneth Hartrick; Varcoe, Colleen (2013-12-30). How to Nurse (Page 3-5). LWW. Kindle Edition.)

I cannot recommend this book highly enough!  In addition to this kind of explanation of the principles on which nursing is based, the book is loaded with examples and real-life activities that emphasize what this means in very practical terms.

Let’s start a lively discussion here about the insights that this book offers, and add more insights related to the connections between the perspectives this book offers and our own NurseManifest vision!

 

 

Nurses and Global Peace

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 2 Comments

This blog posting will be a bit different from others I have written, but I believe the NurseManifest page is a place where we can open our hearts and souls to the essence of nursing, which is healing, caring, love, and compassion. In a world seemingly torn asunder from fear, violence, and anger, nurses are called forth to support healing on a local and global level. The call comes from something beyond ourselves, and if you stop and listen closely, I believe you will hear that calling. You are a nurse and there is a reason you were drawn to nursing: to support healing through loving kindness and caring.

A few nights before the recent violence spread around the world, from Beruit to Paris, I lay in bed cuddling my 7 year old daughter close. Every night I am blessed to be able to spend some time reading to my daughters and cuddling as they drift off to dreamland. For a few moments that evening, I found myself floating in a space where I felt like the mother of the universe was whispering to me, not in words, but through a deep felt intuitive process. I knew the goodness, the light, and the powerful strength of peace as they came through clearly to me, carrying with them the message that the mother of all, the earth as a complex system, will heal itself. After the moment of certainty passed, I was left with the usual feelings of uncertainty: how will the good and the light prevail in these times of darkness? Who will help make this happen? What is my role in this process?

Then tragedy struck, and violence and war continue to grow. The feelings of uncertainty have not dissipated, so I sit with those, but I also do remain strongly rooted in the belief that as nurses, we can support global peace and healing through our own efforts of creating local peace and healing. And that local peace starts at the place closest to us all, right from our hearts.

As we practice our own healing, creating our own peace and loving-healing processes, we can begin to spread that healing, peace, and love to others. A practice I try and do daily is called loving kindness meditation. I feel on many levels this practice is about my own healing and self-care so that I can be a better nurse, wife, and mother… and it is also about bringing that healing into the world.

I start with focusing on myself, in my heart space, and intending for myself healing through the following words:

May I know peace, joy, love, and ease. May my heart be full. May I be safe, healthy, and happy.

I than send this intention to the loved ones in my life, wishing them all love, peace, ease, happiness, health, and safety: family, friends, pets, students, and colleagues. As the circle of intention spreads outward, I send the intention and feelings of love and peace out to my “enemies” and challengers, and I end with the whole planet, with every being being sent the intention of peace, love, and healing.  The process takes  5-10 minutes.

As nurses supporting healing, we can think and act both locally and globally. Imagine if every nurse sent out an intention, a prayer, a positive thought for healing and peace for the entire mother earth and all of the beings living here. Consciousness studies show that our thoughts and intentions impact our environment and reality.  I think of Jean Watson’s call for us to practice loving kindness and  Martha Rogers’ concept of Unitary Beings. We can reflect the patterns before us, we can create shifts in consciousness to support healing.

Despite the medical system’s over-emphasis on technology-cure-illness management, I still believe that nurses are truly called toward the healing that all beings are capable of experiencing. If you have been called to be a nurse, can you return to that calling, can you spare a few moments to consider the global situation, and what you can do as a nurse to support healing from the truly local level (yourself) and on to the global level?

I would love to hear from nurses and how they are supporting peace and healing around the globe. The call has been made, how will you answer?

 

peace-signs-clip-art-peace-signs-clip-art-10h call has been made… how will you respond?

 

 

Lessons from the history of nursing… Who was Concepción Arenal?

/ Olga F. Jarrín / 3 Comments

Arenal

I recently returned from a conference in Spain about the economic value of nursing where I spoke about many promising international models of community nursing, including some that were not so new. What sparked the most conversation later was the final image of my presentation with the words of the Spanish feminist writer and activist Concepción Arenal: How many centuries will it take for reason to arrive at the conclusion on [social] justice that the heart instantly understands.

Surprisingly little has been written in English about this remarkable woman, whose work in social reform and the development of nursing was simultaneous with, and comparable to, that of Florence Nightingale. Born in 1820 (the same year as Nightingale), she was the first woman to attend a university in Spain (auditing law school classes dressed in men’s clothing). An early and influential advocate for women’s rights, she wrote extensively about issues affecting marginalized populations including those living in poverty and in jails.

I am just beginning to read Arenal’s original writings in Spanish, and am struck by the parallels between her writing and current conversations in nursing about social justice and cultural humility. For example, her manual for visiting (nursing) the poor begins with the philosophical questions: What is pain? (Ch. 1), What are we? (Ch. 2), and What is poverty? (Ch. 3)  Before moving on to the central chapters on the theory and practice of visiting (nursing) the poor and how to approach and handle different situations with humility, respect, and empathy, while empowering the poor to improve their condition and lives. The book ends with chapters on the importance of having respect for the pain [of the poor] (Ch. 14), and the spirit of the sick (Ch. 15).

Please join me in reading and reflecting (here in the comments on this NurseManifest blog) on the writings of Concepción Arenal. We hope to build connections with colleagues in Spanish speaking countries and bilingual academic settings around the world. Looking forward to learning more about your thoughts inspired by Arenal’s writings (comments welcome in English or Spanish).

Un cordial saludo,

Olga

P.S. Please also reach out if you are interested in working on a Spanish version of the NurseManifest Manifesto.

References and Further reading:

  1. Josep Bernabeu Mestre – Encarna Gascón Pérez (Univ Alicante). Historia de la Enfermería de Salud Pública en España (1860-1977). [The History of Public Health Nursing in Spain] Capitulo 2. Full text pdf (162 pages)
  2. Miguel de Cervantes Virtual Library Collection for Concepción Arenal, including her collected works in digital format http://www.cervantesvirtual.com/portales/concepcion_arenal/autora_biografia/

Direct links to a few of Arenal’s books that I’ll be reading and would love to discuss with others:

Nursing as Practical Magic

/ Wendy Marks, DNS, ANP-BC / 4 Comments

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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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Gun violence: A nursing concern?

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 2 Comments

Once again we find ourselves reeling from a mass shooting, this time in a small community college in Oregon. One of the most disturbing reports of the Umpqua Community College incident was that the dead victims’ cell phones were ringing when police and rescue workers arrived on the scene, as their families and friends tried to make contact with them. The heartbreak for this community is palpable; for nursing educators, the concern of wondering if this could happen in our classrooms, in our schools, is unsettling. Some of us might recall the 2002 Arizona nursing faculty mass shooting, where 3 nursing professors were gunned down and killed by a student who had failed a pediatric class and decided that he had the shooting authority and was angry enough, I suppose, I don’t understand really, why.

What has changed since those 2002 shootings? If you scroll through your facebook feed today, it is likely you will find many postings about the statistics of mass shootings, thoughts about how nothing has changed, and debates over stricter gun control. Meanwhile, I feel that nursing should be viewing the gun violence issue as a public health issue, and we could be the ones helping to lead the way in preventing future mass shootings. We have a strong voice, as we recently proved with the “#Drsstethoscope ” and “#nursesunite ” movements; and now perhaps we could unite over some issues that deeply impact the health of all beings on this planet.

The American Public Health Association (APHA) has made clear statements that gun violence is preventable (https://www.apha.org/~/media/files/pdf/factsheets/gun_violence_prevention.ashx). APHA recognizes that gun violence is contagious and has become an epidemic in the United States. APHA recommends that we:

  • Use surveillance techniques to track- gun related deaths and injurious shootings.
  • Focus on identifying the many risk factors for gun violence.
  • Create, implement, and evaluate interventions that reduce these risk factors and support resilience for those who are suffering.
  • Institutionalize prevention strategies.

We also clearly need more research in this area; we need to examine what common sense gun policies might look like, what have other countries implemented; what worked for them, and what has not worked for them.

Nurses and educators can begin in their work places, looking at their own risks within the workplace, and working toward implementing prevention strategies and trainings around what to do should an issue of gun violence begin to emerge.

We need to also reach out to communities, particularly school settings, and develop and support education around gun safety, bullying, mental health issues, and how to ask for help. We need to have mental health services in place that can truly identify and properly intervene with those who are at risk for gun violence.

Nurses could also bond together, #nursesunite, and create a clear voice around stricter gun control. We could do our own research around what has worked in other countries and what that might look like here, and then bring these ideas forward to our lawmakers. At the very least, we could be calling for better access to mental health services for those in need, and early identification of those who might be at risk for perpetuating gun violence. Childhood traumas likely play a role in this issue as well, and supporting the creation of trauma informed schools should be a nursing advocacy issue.

We have power in our numbers; let’s put it to great use. #nursesunite