Humanistic Nursing

Copyright (C) 2007 by Josephine Paterson and Loretta Zderad.

Humanistic Nursing

(Meta-theoretical Essays on Practice)

by Josephine Paterson and Loretta Zderad

Copyright (C) 2007 by Josephine Paterson and sLoretta Zderad all rights
reserved except as follows. This e-text may be freely copied for
academic and scholarly work with the copyright notice clearly affixed to
all copies. No commercial use may be made of any part of the text
without the express permission of the copyright holders.

This e-text version of the classic text “Humanistic Nursing” is
made available with the kind permission of the authors and copyright
holders, Josephine Paterson and Loretta Zderad. The book was originally
written to define the Humanistic Nursing Theory which presented a way
for each nurse to become-more as a person and to extend that
becoming-more to the community of nurses in which he or she
practices. The offering of this book in the “free” e-text format
reiterates the continuing contribution of these two nurses long after
their retirement from practice. It is their hope that nurses everywhere
will take their vision for nursing and expand on it and integrate it
into their nursing practice. At the request of the authors this e-text
version is complete with the original 1976 Front Matter.

Susan Kleiman

For more information or questions about the subject of Humanistic
nursing or this e-text you may contact Professor Susan Kleiman, PhD, RN,
CS, NPP at: Alternatively you may visit
the web site: The Humanistic Nursing
Inquiry web site provides context for the major initiatives of
humanistic nursing, which celebrate the enduring and immutable ideals of
Humanism that give us insight into the fundamental truths of being in
the world of nurses, patients, families, colleagues, and students.

FOREWORD to the 1976 Edition

These essays will evoke different reactions from different
readers. “Well, I know that,” for example, may be the reaction of a
beginner in nursing; “I wouldn’t have said it that way but I knew that
is really nursing.” “Since they’ve given us a methodology,” perhaps from
one more experienced in nursing; “I’ll give it a try.” Others with still
more or different kinds of experience may respond, “It’s about time
nurses put that into words; it’s about time.”

Timely as these essays are I would prefer not to use up the foreword
with a listing of the crises, the “eco-spasms,” and scientific triumphs
that would document their timeliness. It is my pleasure, rather, to use
this opportunity to relate the six elements of my own reaction:

Nursing has a solitariness until we find it has many companions in
philosophy, science, and art. It has a steadiness about its pace yet
holds a potential for flights to higher elevations. It is constantly
changing yet has an enduring component of permanence. Good is the word
we use every day; our vision, however, is of excellence. Its tasks
often have the appearance of homeliness until we glimpse that kind of
beauty that is humanness. Nursing even sings very softly because our
ears are attuned to “a different drummer.”

Lilyan Weymouth, R.N., M.S. Northampton, Massachusetts October 1975

PREFACE to the 1976 Edition

Out of necessity nursing, as a profession, reflects the qualities of the
culture in which it exists. In our culture for the past quarter of a
century nursing has been assailed with rapid economic, technological,
shortage- abundance, changing scenes’ vicissitudes. In the individual
nurse these arouse turmoil and uncertainty. These cultural stirrings
inflame that part of the nurse’s spirit capable of chaotic conflict and
doubt. Often she questions her professional identity. ”Just what is a
nurse?” Her nurse colleagues, other professionals, and nonprofessionals
freely, directly and indirectly-on television, in the theater, through
the news media and the literature-pummel her with their multitudinous
varied views.

As searching, wondering, reflecting, relating microcosms within this
perplexing health nursing world for longer than a quarter of a century,
we present this book. Descriptively we view the chapters as hard-wrung,
philosophical foundations, synthesized extracts from our lived
experiences. These metatheoretical essays on practice present an
existential alternative approach for a professional nurse’s knowing and

These conceptualized existents are available because Miss Marguerite
L. Burt, formerly Chief of Nursing Service, Northport, N.Y. Veterans
Administration Hospital called them forth from us. These chapters are
our response to her call. In 1972 Miss Burt requested us to develop a
course for the professional nursing staff at Northport V.A.H. This book
has evolved from the original presentations offered to the ten
participants in the first course. While we taught and worked with five
subsequent groups, we learned and continually revised and clarified our
conceptualizations. The course is entitled Humanistic Nursing.

Fifty-three nurses have been involved in this course. Interest,
appreciation, wonderment, effort, and investment characteristically
depict their response. They convey that the humanistic nursing practice
theory reflects what nursing means to them. Their hungry approach to the
suggested readings has both surprised and pleased us. Our amazement
persists over the participants’ ability to concentratedly discuss
abstract theory and concrete nursing practice for weekly day-long
sessions over six-to nine-month periods. Presently requests to
participate in the next humanistic nursing course are mounting from
nurses both within and outside the Northport complex.

The course, the theory, and this book are the fruits of our individual
and collaborative efforts. While sharing seminar responsibility for
graduate students in 1960, we began to dialogically and -dialectically
struggle with professional and /clinical nursing issues. Discussing and
searchingly questioning ourselves and our students became a
value. Through conveying, struggling for clarification, openness to
honest argument, we grew in our awareness that each was moved beyond her
beginning thoughts. Through reflection we have come to view, describe,
and distinguish our dialogues as struggles with, and not against,
others’ ideas. Differences in response are valued for what they can tell
us of our chosen area-nursing. So dialectical dialogue has gradually
become our predominant teaching method. We convey our ideas, are open to
others’ questions, struggle to clarify and really communicate, and
question ourselves, and others. In the process of the humanistic nursing
course, using this methodology, which is deliberate and, yet, natural
and authentic for us, we and our professional nursing staff students
have learned and become more human, more questioning, more clinical, and
just, more.

We value our moreness. Appreciating and valuing the effects of our
actualizing selves as human beings, we must attest to our existential
modes of nurse being; our inner mandate is: share. Hence, Humanistic
Nursing has come into being.

To find the meaning of nursing we have returned “to the thing itself,”
to the phenomenon of nursing as it occurs in the everyday world. Our
reflections on nursing as a lived experience flowed into the realm of
metanursing. Obviously, these thoughts are only a beginning. They are
offered in the hope of stimulating response and further development.
Dialogue may be difficult at first because humanistic nursing represents
one of our discipline’s less articulated streams. Yet, it is a stream
traceable to nursing’s foundation and, as such, is related to nursing’s
artistic, scientific, and technological currents. It is not being,
cannot be, developed in opposition to them.

Science and art are forms of human responses to the human situation.
They are valued in genuine humanism. Thus, the humanistic nursing
approach does not reject advances in nursing technology, but rather it
tries to increase their value by viewing their use within the
perspective of the development of human potential. The same holds true
for scientific, artistic, and clinical developments in nursing
practice. They are the necessary means through which and in which
humanistic nursing (a being and doing) is experienced and developed.

At this time when serious concern is being expressed about the survival
of nursing as a profession, humanistic nursing offers a note of
optimism. By examining the values underlying practice, it focuses on
the meaning and means of nursing’s particular’ mode of interhuman
caring. It increases respect for that caring as a means of human
development. Nurses have the privilege of being with persons who are
experiencing all the varied meanings of incarnate being with men and
things in time and space in the entire range from birth to death. They
not only have the opportunity to co-experience and co-search with
patients the meaning of life, suffering, and death, but in the process
they may become and help others become more-more human.

Beyond this, the humanistic nursing approach respects nursing experience
as a source of wisdom. By describing and conceptualizing the phenomena
experienced in nursing situations, nurses could contribute to the
development of nursing as a discipline. Even more, they could add to the
knowledge of man.

Humanistic nursing, then, is neither a break with nor a repetition of
nursing’s past. It is neither a rejection of nor a satisfaction with
nursing’s present. Rather it is an awakening to the possibilities of
shaping our nursing world here and now and for the future.

Thanks to Miss Marguerite L. Burt are in order for she provoked our
conceptualizations of our lived nursing worlds. Dr. Frederick H. Wescoe,
while Chief of Nursing Service, Northport, N.Y., VAH administratively
facilitated the time and the means for our compiling these materials
into a manuscript. Past nursing students challenged and grappled with
our ideas and theirs insisting always on our forwarding our
thinking. Our consultants, Miss Lilyan Weymouth and Miss Rose Godbout,
were marvelous resources and counselors.

Immediately we are most grateful to the participants in the six
humanistic nursing courses taught here at the Northport VAH. As nurses,
they received and accepted our expressed ideas to the extent of testing
them in the fires of their real lived nursing practice settings. While
struggling with our ideas and us, they gave to us. They were supportive,
loving, and truly present with us in the community of nurses at
Northport, VAH. Miss Sue McCann, clinical nurse specialist, one of our
first course participants, has read and reviewed our materials. More
than this Miss McCann has been a counselor, resource person, and a
dependable friend in our humanistic nursing effort of the last three
years. We hope our chapters give back to others, at least just a part
of what we have received from them in our travels in the nursing world.


[Transcriber’s Note: to the 1988 Edition

Italic text has been marked as text.

Bold text has been marked as ~text~.

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