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An Analysis of Nursing Theory In the Film: Wit Daniel Foytlin Kean University

AN ANALYSIS OF NURSING THEORY IN THE FILM WIT Abstract The Pulitzer Prize winning play Wit, by Margaret Edson, was artfully converted to film in 2001.

The story details the life and reflections of a brilliant, uncompromising, yet cold-hearted English professor, as she endures an experimental treatment for cancer. The film also provides a stark view of the medical community and its various approaches toward end of life care. The analysis of the film discusses the contrast between various Nursing Models, as viewed through the eyes of the patient and her reactions toward each model.


Wit is the story of Vivian Bearing (Emma Thompson), a doctor of English literature, who has recently been diagnosed with stage four, metastatic ovarian cancer. She is encouraged to participate in an experimental, eight month chemotherapy treatment by her Oncologist, Dr. Harvey Kalekian (Christopher Lloyd). Dr. Kalekian speaks to her in medical jargon, not fully explaining exactly what the treatment will entail, but states that if she is "tough" and relies on her inner strength, she should do well. Dr. Bearing, being a hard-nosed, uncompromising type, agrees to the treatment. She attempts to be tolerant and suffers through endless tests, "fake" concern from staff, and the poking and prodding of fellowship doctors on rounds, who gleefully gaze upon her like a child's science experiment; viewing her simply as "research" and not as a human being. Through this ordeal, Dr. Bearing faces the loneliness of the hospital, as well as the grueling passage of time in the isolation ward as she suffers the after effects of chemotherapy. She takes this time to reflect upon her life, and how "putting a semicolon instead of a comma in the wrong place, can change the meaning of everything" (Wit [DVD], 2001). It is that single phrase that resonates through the entire film, as she realizes that her smug, cold, treatment toward others that sought out her humanity, has come full circle back at her. The one bright spot in Vivian's treatment, comes from the care and compassion she receives from her primary nurse, Susie Monahan (Audra McDonald). Susie, who is not an intellectual like herself, simply wishes to provide Vivian with care consistent with her professional obligations, as well as basic human dignity. This goal brings Susie into conflict with the Physicians pushing treatment of the "illness" and not the "person".


The roll of the nurses in the film continued to evolve as the story progressed. During Dr. Bearing's initial hospital stay, staff come and go, tending to basic personal needs (Henderson's Theory) with competent efficiency. Little emotion is conveyed toward her, with the exception of the generic, "How are you feeling?" This is most notably asked as she is vomiting into a bucket after chemotherapy. We observe Peplau's nurse-client theory, which pits primary nurse Susie in conflict with physicians conducting research, instead of patient care, as the chemotherapy dosage is questioned . Neuman's Systems Model, as we follow Vivian's anxiety and stress as her cancer progresses. To me, the most significant role of Susie, the primary nurse, begins when Dr. Bearing returns to the hospital late one night with high fever. Vivian's immune system has been affected by the chemotherapy and is placed into isolation. Until this time, a large part of Susie's role as a Nurse seems to center from Leninger's Sunrise model, focusing upon the culture and background Dr. Bearing projected. Nurse Monahan's use of "culture care preservation/ maintenance, culture care accommodation/ negotiation, and culture care repatterning/ restructuring", was displayed (George, 2011) . Dr. Bearing's intellectual, driven, uncompromising persona, was recognized and approached with respect and professionalism. Over time however, Susie used small acts of kindness and genuine concern to promote a "repatterning" of her patient's outlook of her own situation. From a reserved nursing role, Susie evolved her approach as Vivian became more forthcoming with her feelings, fears, and need for humanity. "Vivian: Now is not the time for verbal swordplay, for unlikely flights of imagination and wildly shifting perspectives, for

AN ANALYSIS OF NURSING THEORY IN THE FILM WIT metaphysical conceit, for wit. And nothing would be worse that a detailed scholarly analysis. Erudition. Interpretation. Complication. Now is the time for simplicity. Now is the time for, dare I say it...kindness" (Wit [DVD], 2001). As Dr. Bearing sheds her armor and allows herself to ask for and receive compassion, Nurse Monahan's role adapts to Watson's Caring Model. "Being authentically present and enabling and sustaining the deep-belief system and subjective life world of self and one-beingcared-for"(George, 2011). The scene in which Vivian purposely triggers an alarm to summon Susie reflects this. Vivian voices her fears and Susie responds with humanity, touching her shoulder, calling her "sweetheart", and brings her a popsicle to soothe her throat. Susie shares a personal memory from childhood and Vivian accepts this act as a token of "friendship" and

begins to open up to her. At this point, the Nurse has become "a sacred healing environment", as Watson's Transpersonal Caring Theory takes center stage. Susie's actions show us that "the nursing arts involve not only the mind and hands, but also the human heart and soul. Where the ultimate form of healing and transcendence is love" (George, 2011). Susie treats Vivian with unconditional acceptance, allowing Vivian to accept her frailties, allow herself to feel human, and accept her fate.


While Watson's Theory stood out to me during the analysis of the film, it became clear that while one's role as a Nurse may have a foundation of one form or another, each individual must evolve their own methodology. There is no one correct theory in the constantly evolving arena of patient care. Each Nurse must identify multiple styles of patient care, taking the parts that best suit their mentality and strengths to eventually evolve unto their own style. It is there, that the true "self" is found. It is that place within one's soul, that reminds us why we aspire to "do what we do', and why we have chosen to become Nurses.

AN ANALYSIS OF NURSING THEORY IN THE FILM WIT References Andrews, M., & Boyle, J. (2012). Transcultural concepts in nursing care. (6th ed.). China: Wolters Kluwer Health. Cherry, B., & Jacob, S. (2011). Contemporary nursing: Issues, trends , and management. (5th ed.). St. Louis: Elsevier Mosby, Inc. Fowler, M. (2010). Guide to the code of ethics for nurses. Silver Springs, Maryland: American Nurses Association. George, J. (2011). Nursing theories: The base for professional nursing practice. (pp. 29, 406434, 454-478). Upper Saddle River, New Jersey: Pearson Education, Inc. Houghton, P., Houghton, T., & Pratt, M. (2009). Apa: The easy way. (6th ed.). Flint, Michigan: Baker College. Jacobs-Summers, H. (2003, JAN 05). Wit (2001). Retrieved from Lipson, J., & Dibble, S. (2007). Cultural and clinical care. University of California-San Francisco: UCSF NursingPress. Nursing Standards Inc. (2010). Nursing: Scope and standards of practice. (2nd ed.). Silver Spring, Maryland: Reed, P., Shearer, N. B. C., & Nicoll, L. B. (2004). Perspectives on nursing theory. (4th ed.). Philadelphia: Lippincott Williams & Wilkins.

AN ANALYSIS OF NURSING THEORY IN THE FILM WIT Rosenfeld, K., Lorenz, K., & Steckart, J. (2003). The wit film project. Retrieved from Watson, J. (2012). Human caring science: A theory of nursing. (2nd ed.). Sudbury, MA : Jones & Bartlett Learning. Wit [DVD]. Edson, M. (playwright), Thompson, E. (teleplay), & Nichols, M. (teleplay), Perf. Emma Thompson, Christopher Lloyd, Audra McDonald, Jonathan Woodward. Home Box Office. 2001.