Editorial
Writing Nursing’s Story
”One has to have found out for oneself that
one has to decide for oneself what one is to
make of oneself.”
Bernard Lonergan, S.J.
A fter nearly four years of working in a Jesuit
institution, I suppose it was inevitable that I would in
time begin an editorial with a quote from a Jesuit.
Lonergan earned the option, and what he has to say
has a certain fit for me with the complex of challenges
we nurses face today. €or the conceptualist, nursing is
nursing, independent of any context or individual
manifestation of nursing. It exists in its own right as
a distinct and profound discipline. Yet, ”knowing
nursing’’ experientially always occurs in some
context, in interaction with one or more individuals
who are nurses.
Numerous nurses, from a variety of roles and
backgrounds, catalyzed by Patricia Benner and others,
are increasingly grappling with this issue of
experiential knowing. A n honest confrontation with
the limits of scientific knowing elicits an inexorable
next step: How else can we know? One way of
knowing we increasingly honor as essential is that of
experiential knowing, a somewhat mythopoetic mode
of discovey through the living of a personal stoy as a
nurse. Nurses are beginning to tell their stories.
Happily, at the same time, some people are beginning
to tell some new stories of nurses. Both initiatives are
embryonic. They warrant scrutiny at these early
stages. We might then better choose to create optimal
conditions for this new mode of knowing.
One of the true things about being an emby o is that it
is often dcpendent on a source of sustenance unknown
and unacknowledged.An emby o has not yet
differentiated from the surrounding environs;
individuation lurks in an elusive future. Embryos just
Nursing Fonun Volume 27, No. 2,April-June1992
grow and grow. They don’t self-consciously ponder
realities. They don’t interact with their environment in
any conscious and deliberate way. Indeed, when called
upon to do so, the precipitant is often crisis. Their
embryonic pat~waymeets an obstacle, deterrent, or
threat. An embyo is in a pretty vulnerable position.
We invest in emby o s for the promise of new life to
come, new options, creations, dimensions to be known
and experienced. Hence, this new embyo of knowing
in nursing and knowing of nursing might be ofering
us some new windows on reality. We might wish to
care for and nurture this emby o with this
understanding guiding our responses.
Nursing leadership in the United States has been
evolving systematically, and the focus of evolution has
been persistently directed at self-presentation. We
have soul searched on the role of nurses, the image of
nurses, the impact of nurses, the value of nurses, the
frustrations of nurses. All of these themes assume a
central premise: We wish to make something of
ourselves. Often this desire has been embedded in the
hope of others acknowledging our desire. Too often
such acknowledgement becomes a goal in itself.
Using the criteria of a given culture or context to
determine the approach we use in order to explain
ourselves is risky. In accommodating the criteria
given, we may distort or diminish our message.
Worse, we might begin to believe the cultural givens
are the reality. Then, acknowledgement from this
culture is purchased at the price of our integrity.
During tough times these risks escalate.
Today’s healthcare culture in the United States is awash
in crises and confusions. We nurses hope to mter the
discourse on these crises to make a constructive
contribution, to make a difference. We work hard to
accommodate the realities presented in the discourse -
3
Editorial
the primacy of medical self-interest, the limits of fiscal
resources, the voraciousness of overdeveloped technology,
the denial of death. These are not easy accommodations.
We tend to describe ourselves as engaging in
healthcare policy, and we work hard to bring nursing
to the negotiation table. Once there, we often find
ourselves struggling to present a value orientation
that, if stated clearly, is dissonant with assumptions
at the table. Conversely, if we accommodate the
assumptions at the table, our message is maimed or
destroyed. The margin for error here is modest at best.
Nursing stories might help. If indeed we are able to
honor such stories as another mode of knowing, and
give them the honest dignity they deserve, we might
find in them a way to share our knowledge of
nursing with others. W e then could use a mode of
knowing that lifts us out of the constraints of
historic policy discourse in this country, yet enables
us to speak to the policy issue in human terms
congruent with our values. W e can become so taken
with the language at the table that we forget
alternate languages, more closely akin to our own,
may both inform and alter the process. W e have
always wished to inform the process; it will take
courage and clarity to alter the process.
This plan, of course, assumes a willingness on the
part of nurses to continue to share ways of knowing,
to honor the diversity of ways of knowing, and to let
each enrich the other, leading to further spirals of
creative thought. The first and most honest way we
might set this plan in motion is to begin to become
honest within ourselves, one by one, about the
importance of our own stories. W e might then begin
honestly to share them.
4 Nursing Forum Volume 27,No. 2,April-June1992
It is here we will learn and affirm that we each will
make ourselves whatever we choose to make of
ourselves, whether consciously or not. Following
Lonergan, we will then also discover that
paradoxically, to do well, we need to discover we can
do well. W e have to discover and uncover the
decisions we make day to day that write our
individual stories of nursing.
n
Phyllis B. Kritek
Acknowledgement and Apology
The 1991 issue of Nursing Forum (Vol. 26, No. 1, pp. 4-8)
included an article entitled, ”The Caring Ethic: More Than
Kindness, the Core of Nursing Science.”
This article included significant portions of an article enti-
tled, “Maintaining the Ethic of Caring in Nursing,” which was
published in the Iournal of Advanced Nursing (Blackwell Scientific
Publications, Ltd.) and authored by Lynda Hanison, RN, PhD.
These portions were not credited to the on& publication and
author, resulting in an inadvertent copyright infringement on
the part of the Editor and Publisher of Nursitzg Forum. We wish
to apologize to Dr. Hanison and her publishers for OUT failure
to seek and receive permission to use the material from this
publication. We also wish to apologize to our readers for this
inadvertent copyright infringement.Dr.Harrison’s work can be
reviewed in its entirety in the following publication:
Harrison, L. (1990). Maintaining the ethic of caring in nursing. /oumal
of Advanced Nursing, 15,125-127.