...are the ones that make the biggest difference


Well prepared

I am currently heading into the 3rd week of school, which has been wonderfully abridged with the holiday. No class or clinicals - just the lab on Thursday or Friday morning. So far, the nursing classes have been informative but not particularly challenging. Which is not terribly surprising as we've been going through some of the very basic groundwork of the trade; history, safety, asepsis, etc. Most the 'hands-on' stuff we've covered so far I've already learned on the job, and from the instructor's discussion on what we'll be doing & learning for this semester, I think I have been extraordinarily well prepared by my last year of employment. One indicator came last week at the clinical site as we were being assigned patients. The instructor had assigned about half the class and then said a couple of the remaining patients were "medically complex" and wanted to give them to someone with some direct patient care experience. Every thing in her description of their "complexity" is something I deal with every day on almost every one of my patients. I'm very grateful to have been lead to my hospital and for the apparently unique professional experience it has imparted to me.

There have been some things that I have been wholly unprepared for, though. One, due to the often serious status of my patients and the length of their hospital stay prior to coming to us, we are, in all honesty, not overly concerned with their possible embarassment. Many of them have gotten so used to the stuff we have to do, that they don't bat an eye at it anyways, but my instructor and my textbook take a much more serious view to maintaing the patient's dignity. Which is a good thing and a lesson I am trying to take to heart even in my current job. Second, I was not prepared for some of the "theories of nursing" that have been presented to us. Driven largely by what appears to me to be a desire to be considered on par with medicine (ie, doctors), various nursing academics have tried mightily to concoct conceptual frameworks that identify the unique factors that nurses bring to the patient. But as these are academics, some theories have been cross-pollinated by the worst kind of popular tripe that prevails in many of the humanities in the modern university. And with that, I leave you to Parse's Human Becoming Theory

Parse proposes three assumptions about human becoming:

1. Human becoming is freely choosing personal meaning in situations in the intersubjective process of relating value priorities.
2. Human becoming is cocreating rhythmic patterns or relating in mutual process with the universe.
3. Human becoming is cotranscending multidimensionally with the emerging possibles.

The nurse's role involves helping individuals and families in choosing the possibilities for changing the health process. Specifically, the nurse's role consists of illuminating meaning (uncovering what was and what will be), synchronizing rhythms (leading through discussion to recognize harmony), and mobilizing transcendence (dreaming of possibilities and planning to reach them). The Parse nurse uses "true presence" in the nurse-client process. "In true presence the nurse's whole being is immersed with the client as the other illuminates the meaning of his or her situation and moves beyond the moment."


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