Speculations on the unpredictable future of the science of unitary human beings.
Speculations concerning the unpredictable future of Rogers' science include developing partnerships with consumers and multidisciplinary colleagues with the possibility of unitary science as a theoretical umbrella for all health care disciplines. Nursing centers are viewed as the hub for all nursing services and are seen as essential both to igniting nursing's visibility and extricating ourselves from the biomedical model The biomedical model of medicine, has been around since the mid-nineteenth century as the predominant model used by physicians in the diagnosis of disease.
This model focuses on the physical processes, such as the pathology, the biochemistry and the physiology of a disease. . Scholarship challenges include expansion of avenues for developing Rogerian knowledge as well as abstraction-integration of existing Rogerian research knowledge, use of Rogerian research methodologies, and translation of Rogerian science into simple language to facilitate communication with consumers and other providers. The impact of the quantum, biomolecular, and computer revolutions and other space age changes on how we will grow Rogerian science in the future are explored.
Key words future, partnerships, scholarship challenges, unitary science, nursing centers
"The future is here. Fantastic, yes, and we are integral with it."
(Rogers, 1994, cover)
"In an ever shrinking world, it is important to embrace diversity."
(Yanni, live in concert, January 17, 1995, New York City New York City: see New York, city.
New York City
City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. )
"Dare to dream big dreams, then will them to happen."
(Howard Schultz This article or section needs copy editing for grammar, style, cohesion, tone and/or spelling.
You can assist by [ editing it] now. , Chairman and CFO See Chief Financial Officer. of Starbucks)
The new world view is alive and well in the year 2000! One could easily imagine that the quotes by Yanni and Schultz were spoken by Rogers. Increasingly it seems as if the world and Rogerian science are on the same wavelength, resonating throughout the unitary universe, creating powerful change. As Rogers used to say, "The future is unpredictable, but it sure is fun to speculate" (Personal communication, August 30, 1993). The major purposes of this article are to present futuristic ideas of unitary emergence of nursing for readers to ponder and to suggest that others explore these possibilities more seriously in future articles.
Futurists agree that the future is both unknowable un·know·a·ble
Impossible to know, especially being beyond the range of human experience or understanding: the unknowable mysteries of life. and undecided. As people and their environments become increasingly diverse, phenomena emerge that could not have been predicted by what came before them. Indeed, the future will continue to emerge through what we do in the years ahead to knowingly or unknowingly create it. Our power lies in recognizing our capability for building our dreams of tomorrow, yet keeping in mind that "in the future there are no roads" (Brown, as cited in Kaku, 1997, p. 265). As Yogi Berra Noun 1. Yogi Berra - United States baseball player (born 1925)
Berra, Lawrence Peter Berra, Yogi said, "prediction is very hard, especially when it is about the future" (Kaku, 1997, p. 3).
Speculating about the future requires letting the Science of Unitary Human Beings (Rogers, 1970, 1992) out of the box, as creative thought is the antithesis of the certainty and comfort of the box (Munhall, 1997). Rogers was the role model par excellence for out of the box thinking in nursing. As Parse (1) To analyze a sentence or language statement. Parsing breaks down words into functional units that can be converted into machine language. For example, to parse the expression sum salary for title = "MANAGER" (1994) eulogized, "Rogers' voice will not be silenced" (p. 47), but why not hook it up to a PA system? Rogerians are all but invisible in the larger world of health care. Isolation stagnates growth. New knowledge in Rogerian thought may die on the vine or at least shrivel and shrink if we keep this knowledge to ourselves in the box. What a tragedy; the Science of Unitary Human Beings is a terrible thing to waste.
It's time to break out of our parochialism. Create new coalitions. Take action with the creative courage to speak our different voice. Too often our nursing practice heritage cautions us to stay in the box, telling us, "We're nurses. We don't make the rules, we don't break the rules; we just follow the rules and jump on the nearest bandwagon riding on the coattails of helped by association with another person. See coattails.
caused by, or immediately following (an event).
See also: coattails coattails medicine." Rogers said, "No way" and started a new unitary science band. Now it's our job to figure out how to broadcast this music. Critics might consider this a call for a Rogerian bandwagon, Nevertheless, the voice for disciplinary nursing knowledge needs to be heard outside our own circles.
We can begin by extending our broadcasting to our fellow nurses and others. Rogers did not develop this science only for nursing and for nurses; it was a gift to the world. She believed it could be used to explain any phenomenon focused on unitary human beings. We need to tell our story through our research, our teaching, our practice, to those who otherwise would not hear it.
An effective way to tell the Rogerian story is through forming mutual process partnerships with consumers, with other disciplines, with philanthropists, with foundations, and with industry including insurance companies. Mutual process partnerships emphasize awareness of the mutual participation of all partners in order to encourage consideration of the nature of involvement in that participation by all partners. Partnerships take us out of the health care box to create a new mutual process between people and providers. Turmoil and dissatisfaction in the present system are growing intolerably. The power of the people is bringing medicine's monopoly of health care to a screeching halt. Health advocacy The examples and perspective in this article or section may not represent a worldwide view of the subject.
Please [ improve this article] or discuss the issue on the talk page. can operationalize Rogers' science in the service of people. Health advocacy is related to mutual process partnerships as people choose with awareness how they will participate in health care changes they wish to create. This is the power of the people.
It's time to go public with the Science of Unitary Human Beings, both within nursing and beyond. It now seems to be common knowledge that consumers, our most important partners, are seeking a new kind of wellness. They're tired of symptom-oriented care given by providers who often don't know their names and usually don't know the first thing about their lives (Gordon, 1998). According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. Gordon (1998, p.65), "The average time a primary care practitioner spends with a patient before writing a prescription is three minutes "Three Minutes" is the 46th episode of Lost. It is the twenty-second episode of the second season. The episode was directed by Stephen Williams, and written by Edward Kitsis and Adam Horowitz. It first aired on May 17, 2006 on ABC. ."
Can we teach people how to enhance their involvement, when they believe that would be beneficial, in health-related decision-making? Can we give them tools to help them become their own health advocates? Can we teach them the scientific art of health patterning power, where power is defined as the capacity to participate knowingly in change (Barrett, 1998a)? Can we use power enhancement to educate consumers to know they are free to make aware choices regarding their involvement in life situations including health issues? Of course we can. Cody (1994), in his plea for nurses to recognize the role of the person as his/her own case manager, warned that "health care professionals now face the probability that if they do not move with health-care consumerism, they are likely to be run over by it" (p. 181).
We can bring education programs and health services health services Managed care The benefits covered under a health contract to universities and to industry. Insurance companies are discovering that health promotion, disease prevention, and health patterning modalities are cost effective and worth reimbursing. Nurses, however, are often not the health professionals providing these health promotion services. Perhaps it is also time to put insurance companies on notice with Nightingale's warning to never mix up medicine and nursing for it spoils both (Nightingale, 1859/1946).
We also need to get our message out by sharing with like-minded groups through publishing in multidisciplinary journals, con ducting duct·ing
1. A duct or system of ducts.
2. Material for making ducts. multidisciplinary research, and presenting at multidisciplinary conferences. In all these arenas, nursing now has a weak presence (Watson, 1995). However, Rogers' science offers a framework for both consumers and health professionals to understand unitary people and their mutual process with the environment from a noncausal, nonlinear view. Could an ontological matrix for health care called unitary science, embracing the postulates and principles of the Science of Unitary Human Beings, emerge? Could unitary science provide a multidisciplinary umbrella for understanding the nature of people and their environments as unitary? Questions of health and well-being, of illness and disease, of living and dying are complex and cannot be answered by the theories and research methods of a single discipline. Knowledge of various disciplines is required to address the diversity of pattern manifestations of the unitary person. A common understanding of the person as unitary would be nursing's unique contribution and, yet, this nursing knowledge could enlighten other disciplines. Imagine the change in health care delivery that would be generated if all professions viewed people through a unitary rather than a particulate, reductionist re·duc·tion·ism
An attempt or tendency to explain a complex set of facts, entities, phenomena, or structures by another, simpler set: "For the last 400 years science has advanced by reductionism ... lens. Sharing of nursing knowledge does not detract from detract from
verb 1. lessen, reduce, diminish, lower, take away from, derogate, devaluate << OPPOSITE enhance
verb 2. our distinctness. Similarly, knowledge developed from the unique perspective of other disciplines is general information that may inform nursing practice.
Unitary science, as an overarching framework to allow many disciplines to understand the unitary person, could heal the current fragmentation in care delivery. One group of health care scientists alone won't be able to create the healing tapestry in its entirety; however, different groups can create the diversity of threads from which it is woven (Kaku, 1997). Could unitary science be the substance that holds it all together? Since nursing is the discipline whose phenomenon of concern is the whole person in mutual process with the environment, could we orchestrate or·ches·trate
tr.v. or·ches·trat·ed, or·ches·trat·ing, or·ches·trates
1. To compose or arrange (music) for performance by an orchestra.
2. transcending the trees of the various disciplines to help others see the big picture of the forest, the unitary view?
Becoming more multidisciplinary, however, does not mean a blending of disciplines nor does it mean becoming less disciplinary. In fact, as the different disciplines come together united by similar world views, the imperative for a unique focus on each discipline's phenomenon of concern will intensify. The contribution of the various disciplines' knowledge to well-being and health care concerns will enhance the overall plan and delivery of care through their specificity. A similar discussion was reported in The New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of Times regarding osteopathic os·te·op·a·thy
A system of medicine based on the theory that disturbances in the musculoskeletal system affect other bodily parts, causing many disorders that can be corrected by various manipulative techniques in conjunction with conventional and allopathic medicine Some medical dictionaries define the term Allopathy or Allopathic medicine as the treatment of disease using conventional medical therapies, as opposed to the use of alternative medical or non-conventional therapies. . A medical sociologist and historian said, "Osteopathic Medicine osteopathic medicine
See osteopathy. has to demonstrate that it can offer something distinctive, unique and beneficial to the patient that allopathic Allopathic
Pertaining to conventional medical treatment of disease symptoms that uses substances or techniques to oppose or suppress the symptoms.
Mentioned in: Traditional Chinese Medicine graduates can not offer. If osteopathic physicians become interchangeable with MD's, then there's no compelling reason for the profession to exist" (Stevens, 1998, F1).
Nowhere is such an argument more relevant than it is in nursing since nurse practitioners have taken on many activities traditionally considered to be within the domain of medicine. Additionally, nursing historically has been closely associated with medicine and has struggled particularly during the past 30 years to establish itself as an autonomous discipline with a distinct knowledgebase. This is not to say that knowledge of one discipline is not useful to practitioners of another discipline; yet, each discipline has its unique focus, and practitioners are not interchangeable.
We must take nursing's story to the public and be consumers' partners and advocates, and we must do it now. Our partnerships can be implemented through nursing centers that will transform Rogers' ideas from being simply "nice to know" to something "essential to use." It is time to update a previous discussion of nursing centers (Barrett, 1990, 1993, 1994a), as the continuing dream is for nursing to extricate itself from the biomedical model and base practice on substantive nursing knowledge represented in the extant nursing theories and frameworks. Establishing many such centers would answer the question of which discipline will define the field of nursing. Andersen and Smereck's (1994) Rogerian nursing care delivery system is a quintessential example that has demonstrated since 1983 that nursing centers based on nursing science frameworks are viable. The Martha E. Rogers Center for the Study of Nursing Science at New York University New York University, mainly in New York City; coeducational; chartered 1831, opened 1832 as the Univ. of the City of New York, renamed 1896. It comprises 13 schools and colleges, maintaining 4 main centers (including the Medical Center) in the city, as well as the has potential to serve as a hub of Rogerian research and other scholarly activities including teaching and consultation, as well as to provide multimedia and human resources The fancy word for "people." The human resources department within an organization, years ago known as the "personnel department," manages the administrative aspects of the employees. , and also deliver consumer services Consumer Services refers to the formulation, deformulation, technical consulting and testing of most consumer products, such as food, herbs, beverages, vitamins, pharmaceuticals, cosmetics, hair products, household cleaners, [paints, plastics, metals, waxes, coatings, minerals, .
Watson (1995) explored why "nurses remain 'invisible' in spite of their achievements" (p. 81). She pointed out that:
the nursing profession has yet to transform itself with respect to advancing within a consistent graduate educational model that is grounded in the nursing paradigm. Moreover, the sad story of tongue and pen is that nursing's caring-healing and health model, and values orientation have largely been ignored, dismissed, or controlled by a medicalizing of health care philosophy and educational and clinical practices--such events have thus monopolized health care policies and politics (p. 81).
Watson's statement regarding "medicalizing" reminds us to continue to address paternalism paternalism (p·terˑ·n and the hierarchial organization of most health care delivery models. This is essential if nursing centers based on nursing frameworks are to optimize their power through knowing participation in transforming the system.
Consumers are driving the health care bus, and they will soon stop parking at places where no one is listening to them. Nursing centers that avoid the cookie cutter approach offer clients a refuge from the health care storm. Perhaps the day will come when all nursing activities will be orchestrated through the centers, including out-patient services as well as providing nurses for hospitals and school-based nursing centers. Nursing centers without walls will take many forms--in churches, health clubs, shopping malls, airports, train and bus stations. Nurses will take clients into their homes after surgery or for rehabilitation or for lifestyle consultation. Nurses will facilitate groups of all kinds teaching people how to thrive rather than survive. Every family will have the option of a family nurse.
The Internet and its related technologies will truly revolutionize the way care will be delivered through nursing health patterning centers. Nurses will make home visits by appearing on consumers' digitized TV wall screens. Intercontinental consulting and commuting across borders will be common. Welcome to work in 2010 (Kaku, 1997). Virtual reality will collapse time and space. It will be possible to learn anything, anywhere, anytime. In fact, consumers will often bypass health professionals altogether by using the computer to access medical and nursing knowledge including professionally developed protocols needed to care for themselves. The Internet will allow both professionals and consumers to surf the tidal waves of change (Kaku, 1997).
Nursing centers will be operated and staffed by advanced practice nurses, either masters-prepared or N.D. as future entry level. Clients will take charge of their health patterning and become their own healer; they will develop their "nurse within." As unitary scientists and artists, we will be living our theories and frameworks as healing partners of those for whom we care. It's about time we speak our truth to the people crying out for the services we can offer.
Although people are unitary, they often experience life, including health care, in a fragmented way. They want an integral experience to bring them in touch with their wholeness (Luck, 1998). Since nursing does not deal with health care phenomena in the domain of other disciplines, nurses need to make appropriate referrals to other unitary practitioners who also will not treat people in bits and pieces. Rather, they will facilitate healing clients' experiences of fragmentation. A unitary, multidisciplinary practitioner who is not a nurse may be a specialist yet able to relate to the whole person. Such practitioners would also make referrals not for " parts," but to other unitary practitioners who see people as a whole even though looking at particular pattern manifestations that are within the domain of a particular discipline or specialization within a discipline (Luck, 1998).
Given the arguments that have been proposed, it seems appropriate to further speculate about the unpredictable future of the Science of Unitary Human Beings. The ever accelerating momentum of the new millennium requires new ways to keep pace. Several scholarship challenges for the immediate days ahead are suggested.
Challenge #1 : New Rogerian Knowledge Makers
We might benefit from Rogerian knowledge workers of three types. First, there will be phenomenon knowers who will increasingly develop new knowledge in unconventional ways such as the theoretical elaboration concerning spirituality and intentionality intentionality
Property of being directed toward an object. Intentionality is exhibited in various mental phenomena. Thus, if a person experiences an emotion toward an object, he has an intentional attitude toward it. that have emerged on the two Rogers listservs(email@example.com; firstname.lastname@example.org). This mutual processing of a group field thinking together in a nontemporal, nonspatial domain allows for pandimensional exploration of new ideas.
The second new type of knowledge makers are the synthesis knowers who abstract scientific literature relevant to new paradigm New Paradigm
In the investing world, a totally new way of doing things that has a huge effect on business.
The word "paradigm" is defined as a pattern or model, and it has been used in science to refer to a theoretical framework. thinking. There's too much information and too little time to put it together ourselves. Conventional methods of reading journals will give way to search processes with synthesized information custom selected according to our interests and delivered to us via the Internet.
The third type are the transformation knowers. They will translate through a Rogerian lens information from phenomenon and synthesis experts thereby providing a matrix for new Rogerian scholarly work to emerge. Consider transformation of Targ and Katra's (1998) statement that "Diseases are conversations or events involving the exchange of information among cells within a living system" (p. 253). Transformation knowers would help us understand this not as physiology or a mind-body link, but as a mutual process of one's unitary wholeness.
Explicating Rogerian research knowledge is a critical challenge before us. Where is this new knowledge? Oh, make no mistake it is there, hiding under piles of paper, covered up in dissertations, other research reports, and various publications. We can't see the trees for the forest. In addition to integrative review articles of various phenomena and meta-analyses when appropriate, it is suggested that these reviews and analyses be extended. That is, previous research needs to be carefully gleaned to extract the new knowledge, stated clearly and organized according to the Rogerian postulates, principles, theories and specific phenomena. Further, research should be analyzed in reference to how it can be woven into the fabric of the Science of Unitary Human Beings. This entire process is called abstraction-integration.
Challenge # 2: Development and Critique of Rogerian Research. Methodologies
Three unique basic research methodologies have been created, respectively, by Butcher, Carboni, and Cowling (Cowling, Barrett, Carboni, & Butcher, 1997). Butcher's unitary field pattern portrait research method reflects a creative synthesis of constructivist con·struc·tiv·ism
A movement in modern art originating in Moscow in 1920 and characterized by the use of industrial materials such as glass, sheet metal, and plastic to create nonrepresentational, often geometric objects. inquiry and Cowling's pattern appreciation theory (Cowling et al, 1997). This qualitative method embraces the participants' description of their experiences, perceptions, and expressions of the phenomenon being investigated. Carboni's work involves the creative idea of "qualitative measurement" which she differentiates from quantitative use of numbers. She proposes that this method transcends time and space and argues that inductive and deductive de·duc·tive
1. Of or based on deduction.
2. Involving or using deduction in reasoning.
de·duc data cannot be separated (Cowling et al., 1997, p. 54). Cowling's pattern appreciation case study method integrates the theory-research-practice trilogy within the pattern appreciation theory providing a context for viewing participants' answers to research questions (Cowling et al., 1997).
We have a disciplinary imperative to use these methods, not exclusively, but extensively (Barrett, 1998b). They represent the next leap toward full disciplinary status and a critical path toward enriching our understanding of unitary human beings.
Parse (1998) recently commented, "Artful criticism is an essential process in the knowledge evolution of a discipline" (p. 43). Rawnsley's (1994) critique of Butcher's research method remains an important example of the process. After noting the excellence of Butcher's efforts, her critique addressed two issues she considered salient. Specifically, she explored "the validity of paradigm status for the Science of Unitary Human Beings and the degree of confidence in its epistemological metaphors" (p. 432). Additional critiquing of unique research methods such as those developed by Butcher, Carboni, and Cowling (Cowling et al., 1997) will further the growth of Rogerian science.
Challenge # 3 : Rogers 101
Translating Rogerian science into simple language continues to be a challenge even for the most seasoned Rogerians. For example, we cannot substitute bodymindspirit for unitary. Since the whole is different from the sum of parts, we must describe the difference that is the wholeness, not the parts. The language dilemma was explored in Gold's (1997) excellent article on unitary vs. bodymindspirit and Dossey's (1997) excellent response. Gold suggested a shift in nursing terminology from bodymindspirit or biopsychosocial wholeness to inseparable or unitary wholeness. Dossey agrees that the essence of humans is inseparable or unitary wholeness, but believes there is usefulness in speaking of parts to get a "fuller, richer view of the whole" (p. 7). She argues that "using terminology that only a small percentage of nurses understand is not smart, for it serves only to silence the impact of our voice" (p. 7). Dossey further proposes that we need to be able to communicate the essence of nursing at a level that all can understand. Gold, on the other hand, notes that with a shift to inseparable, unitary wholeness, "nursing's unique distinctiveness as a profession is clarified and its congruence con·gru·ence
a. Agreement, harmony, conformity, or correspondence.
b. An instance of this: "What an extraordinary congruence of genius and era" with nursing science is clearly reflected" (p. 4). Embracing Gold's plea to shift terminology, yet solving the issue of understandable language clearly articulated by Dossey, could thrust nursing lightyears ahead and further illuminate our position on the health care map.
Although science requires a language of specificity, the language barrier we encounter in communicating to others may be our most difficult and perhaps most important challenge. We can no longer say, even if it is true, that there are no words to adequately describe these ideas or that those we care for understand "it" when they experience Rogerian nursing care, even though they do. If we want to get out of the box, we must find a way to communicate simply without simplistically demolishing the substantive profoundness of this science. We are hard pressed to explain this science in all its majestic richness to the person on the street, even though, paradoxically, these ideas are everywhere. When people ask, "How is this view of people and their world different from other views, holistic or otherwise," we need the language to explain it in understandable words so they "get the difference."
Interface of Rogerian Science with Societal Revolutions
The future development of Rogerian scholarship will not take place in a vacuum. "Human knowledge is doubling every 10 years.... Computer power is doubling every 18 months. The Internet is doubling every year" (Kaku, 1997,p.4). Everyday there are new advances in computers, telecommunications, biotechnology, and space exploration. Many of these seem directly explainable in terms of Rogerian science. A recent example suggests confirmation of Rogers' theory of accelerating change. The discovery that the universe may expand forever and at an accelerating pace (Wilford, 1998) is consistent with Rogers' ideas of the change process. Accelerating expansion of the universe was hailed as a top astronomy discovery of the century worthy of a Nobel Prize Nobel Prize, award given for outstanding achievement in physics, chemistry, physiology or medicine, peace, or literature. The awards were established by the will of Alfred Nobel, who left a fund to provide annual prizes in the five areas listed above. (Wilford, 1998).
Similarly, on the human front, the mutual process is birthing a new era. The actualization actualization Psychiatry The realization of one's full potential of our capacity to participate knowingly in choreographing future changes is accelerating. Unlike any time before, we are increasingly aware of the power of our choices to more fully participate in creating ourselves and our unknowable future. As our pandimensionai awareness further diversifies, our options for innovative involvement proliferate. Actualizing power doesn't just happen; it manifests when we are a knowing participant in all aspects of life and living, death and dying. This acceleration in possibilities for more fully creating ourselves and our environment brings with it awesome responsibility (Kaku, 1997).
Kaku (1997) describes the three scientific revolutions of the 20th, century: the quantum revolution which helped spawn both the biomolecular revolution and the computer revolution by way of x-ray crystallography; the transistor; and the laser emerging from quantum theory quantum theory, modern physical theory concerned with the emission and absorption of energy by matter and with the motion of material particles; the quantum theory and the theory of relativity together form the theoretical basis of modern physics. . "With the basic laws of the quantum, DNA DNA: see nucleic acid.
or deoxyribonucleic acid
One of two types of nucleic acid (the other is RNA); a complex organic compound found in all living cells and many viruses. It is the chemical substance of genes. , and computers discovered, we are now embarking upon a much greater journey, one that ultimately promises to take us to the stars ... as our understanding of space-time increases" (Kaku, 1997, p. 355). The pandimensional Rogerian worldview world·view
n. In both senses also called Weltanschauung.
1. The overall perspective from which one sees and interprets the world.
2. A collection of beliefs about life and the universe held by an individual or a group. provides a theoretical perspective for understanding these 20th and 21st century "revolutionary emergents."
Kaku notes the transition from reductionism reductionism(rē·dukˑ·sh·niˑ·z to synergy and projects that an enhanced cross-fertilization between these revolutions will spawn an accelerating rate of scientific discovery. Often, when an impasse in one field is reached, an unexpected development in another field contains the solution. For example, the ability to map the human genome The human genome is the genome of Homo sapiens, which is composed of 24 distinct pairs of chromosomes (22 autosomal + X + Y) with a total of approximately 3 billion DNA base pairs containing an estimated 20,000–25,000 genes. has been driven by the exponential increase in computer power (Kaku, 1997).
It is possible that there may be similar cross-fertilization in the health care fields. For example, on December 31, 1999 on CBS (Cell Broadcast Service) See cell broadcast. television, representatives from Carnegie Mellon University Carnegie Mellon University, at Pittsburgh, Pa.; est. 1967 through the merger of the Carnegie Institute of Technology (founded 1900, opened 1905) and the Mellon Institute of Industrial Research (founded 1913). were demonstrating an autonomous, mobile robot A Mobile Robot is an automatic machine that is capable of movement in a given environment. Overview
Mobile robots have the capability to move around in their environment and are not fixed to one physical location. named "Flo." It is proposed that this robotic "nurse" will be able to deliver home care to the elderly so they can continue living in their homes independently with health problems that presently preclude remaining at home without a caregiver. "Flo" listens to people and then interacts by talking with them. "Flo" will remind people to take their medications and assist them to carry out various activities of daily living. Although such technological wonders are on the horizon, they will never replace the real thing--a human nurse, since machines will never be different from the sum of mechanical parts. A human being is not a machine and a machine is not a human being. Regardless, Rogerian nursing may rise or fall related to its ability to interface with developments in the quantum, biomolecular, and computer revolutions, as well as other emergent world happenings. For example, the Internet is wiring up the entire planet and relieving us of the mundane, time-consuming tasks of shopping, banking, paying bills, or commuting to work. Our grandchildren will look back on us as we do on our grandmothers who spent Monday washing clothes, Tuesday ironing clothes, and so forth. Yet, will they look back on us as pioneers in responsible use of technology to change delivery of nursing services while maintaining the human presence of the nurse?
On the biotechnological front, many "microorganisms involved in infectious diseases will be conquered in virtual reality by locating the molecular weak spots in their armor and creating agents to attack those weak spots" (Kaku, 1997, p. 15). Yet we know that if the health patterning of the environment is not also considered, new mutations with more serious consequences may arise. "Conquering organisms" is not the language of unitary nursing and does not reflect the mutual process of energy fields. Programs of Rogerian research concerned with health patterning of the environment are urgently needed.
Sometime soon wearable computers will undoubtedly save lives, for example, by recognizing a heart attack or injury from a car accident and alerting the EMS. Currently, IBM (International Business Machines Corporation, Armonk, NY, www.ibm.com) The world's largest computer company. IBM's product lines include the S/390 mainframes (zSeries), AS/400 midrange business systems (iSeries), RS/6000 workstations and servers (pSeries), Intel-based servers (xSeries) has software in developmental stages that allows their handheld computer A computing device that can be easily held in one hand while the other hand is used to operate it. The Palm devices are a popular example. See Palm, smartphone and palmtop. , WorkPad, used with the help of a special server, to access a health records database anytime, anywhere, to obtain a person's history and related information. Researchers are designing the system to include a level of security protecting data and privacy (Rowan Dordick,www.2.software.ibm.com/casestudies/swcs.nsf. Beyond Carnegie Mellon's "Flo," the smart home may even serve as a computerized nurse engaged in continuous pattern manifestation knowing of health and well-being and voluntary mutual patterning of information that will be sent silently to the appropriate health provider (Kaku, 1997). In the future, smart cards Example of widely used contactless smart cards are Hong Kong's Octopus card, Paris' Calypso/Navigo card and Lisbon' LisboaViva card, which predate the ISO/IEC 14443 standard. The following tables list smart cards used for public transportation and other electronic purse applications. will store complete health histories and connect to the Internet.
Nevertheless, there is another side to biotechnology that cannot be ignored. Kaku (1997) says, "It is likely that cloning will soon become a fact of life (p. 255).... But the moral dilemmas raised by cloning pale in comparison to those raised by genetic engineering of humans. Cloning only produces a carbon copy of an individual; genetic engineering promises the ability to change the human genome and hence the human race" (p. 227). Rogers was adamant in her opposition to genetic engineering (Personal communication, 1980, 1991). Will designer children become the 21st century edition of the eugenics movement or the Nazi ideology of breeding the master race (Kaku, 1997)? Will interference with the naturally evolving human-environmental mutual process trigger catastrophe?
Unitary nursing revolutionaries should organize now, not wait until after the fact, to initiate think tanks to grapple with to enter into contest with, resolutely and courageously.
See also: Grapple these disturbing potentialities. Will unitary scientists assume their role as moral and ethical watchdogs for privacy, freedom of speech, confidentiality, and accountability in science and use of technology? Will unitary artists recognize that technological advances increase the need for the human knowledgeable caring of the real live nurse?
Rogerian Science and the Space Age
No discussion of Rogerian science in the future would be complete without a discussion of the space age (Rogers, 1992). Rogers held the first conference on Nursing in Space in 1962, seven years before men landed on the moon (Barrett, 1994b). She (1992) enthusiastically proposed that future planetary citizens, including nurses, would be living and working in moon villages and space colonies. One way or another, it is likely that Rogers' science will inform the vision and the reality of the space mission! She maintained that the extraterrestrial and the terrestrial cannot be separated and that Rogerian science provided an explanatory system equally relevant for life and health on earth and in space (Doyle, Racolin, Rogers, & Walsh, 1990). Rogers' theory of accelerating evolution as well as the principles of homeodynamics suggest that if people were to stay in space, they would likely evolve to live comfortably in zero-g. Rogers noted, "it is a fantastic time to be alive since we are on the edge of a new world, just as when life moved out of the waters onto dry land" (Doyle, et al., p. 375). Our transcendent voyage into space begins the next evolutionary phase of humanity: our transition from humankind to spacekind. Rogers' idea of transcendent unity is "about how a space-directed people change, how the world changes, and how our view of the world changes" (Doyle, et al., p. 375).
Space colonization Space colonization (also called space settlement, space humanization, space habitation, etc.) is the concept of permanent autonomous (self-sufficient) human habitation of locations outside Earth. is not idle speculation. Currently many including Rogerians are joining the worldwide movement to found a space metanation in the year 2000. For $200 one could have become a charter founder and participant in the Constitutional Convention which will gather global delegates to approve a Declaration of Space Interdependence and the Metanation Constitution (Space Governance, 1997, p. 167). "Space Nursing" was reprinted in Space Governance: The Journal of United Societies in Space and the World-Space Bar Association from its original publication in Cutis cutis /cu·tis/ (ku´tis) the skin.
cutis anseri´na transitory elevation of the hair follicles due to contraction of the arrectores pilorum muscles; a reflection of sympathetic nerve discharge. , a dermatology journal (Barrett, 1998c). One can also participate in the Space Nursing Society; President Linda Plush is a founding member, although not a founder, of the Society of Rogerian Scholars. In June 2001, The Society of Rogerian Scholars, the Space Nursing Society, and the American Holistic Nurses Association will cosponsor co·spon·sor
tr.v. co·spon·sored, co·spon·sor·ing, co·spon·sors
To function in the capacity of a joint sponsor of: corporations that cosponsored a marathon.
n. the next space nursing conference at the Space Center in Huntsville, Alabama Huntsville is the county seat of Madison County, Alabama. Huntsville is the largest city in northern Alabama in a region of a half-million people, with the city proper having 168,132 residents (2006 estimate). .
The Stanford Alumni Association An alumni association is an association of graduates (alumni) or, more broadly, of former students. In the United Kingdom and the United States, alumni of universities, colleges, schools (especially independent schools), fraternities, and sororities often form groups with alumni has scheduled December 1, 2001 for the first launching of a vacation trip to outer space for $98,000 per person (Brooke, 1998). Dan Goldin, Administrator of the National Aeronautics and Space Administration (NASA NASA: see National Aeronautics and Space Administration.
in full National Aeronautics and Space Administration
Independent U.S. ) "predicts" an orbiting station that is a hotel for later in the century (Brooke, 1997).
NASA wants to go to the next stage of the frontier and put an orbiting telescope a half billion miles from the sun pointing into space within 100 light years of Earth. The purpose is to search those stars for an Earth-like planet. Recently, digitized pictures captured by the Hubble Space Telescope Hubble Space Telescope (HST), the first large optical orbiting observatory. Built from 1978 to 1990 at a cost of $1.5 billion, the HST (named for astronomer E. P. Hubble) was expected to provide the clearest view yet obtained of the universe. have shown what is believed to be the first image of a planet outside our solar system (Brooke, 1998). It is expected that within the next 10 years through the international space station we will have figured out how people can safely live and work in space. Then the great adventure of people leaving orbit to go on to other planets will begin (King with Piper, 1998).
Dr. Martha E. Rogers' Science of Unitary Human Beings has been described as visionary, pioneering, brilliant, and radical. This science isn't just a curiosity. It's part of the landscape and it's here to stay; these ideas are right on target for the 21st century. In this most exciting of times to be alive, we have the option to fashion a new world of nursing, to put nursing at the hub of the health care universe. That power requires personal and political action from a new generation of Rogers' rebels. Rogers moved her ideas forward by standing up against the establishment. She left her science as a legacy to foster the well-being of all people, sick and well, wherever they may be. What matters now is that we move this science to its rightful place in the world.
The time has come to ask ourselves, as Rogerian nurses, what is our mission statement? It's been said the four rules of life are: show up, pay attention, tell the truth, don't be attached to the results. A few more might be considered for Rogers' rebels: don't belong to choirs where you can't sing your song; give up the myths of helplessness and lack of involvement; and finally, release the fear that prevents passionately speaking our truth with conviction and without anxiety.
We are living in what Rogers called "one world." John Lennon Noun 1. John Lennon - English rock star and guitarist and songwriter who with Paul McCartney wrote most of the music for the Beatles (1940-1980)
Lennon sang in his song, Imagine, "Perhaps it's not hard to imagine a world without nations." Perhaps it's not hard to imagine a world health care system founded on a unitary science embracing multiple ways of knowing the unitary person. After all, isn't it a unitary universe?
Ten years ago, Rogers told us, "The 21st century will arrive with a plethora of manifestations of change.... Whatever the future of nursing may be, it will be within the context of rapid change, diversity, new knowledge, and new horizons" (Rogers, 1988, pp. 99, 102). Now that the new millennium is here, we might consider: First, how far have we come with the disciplinary imperative to develop knowledge of unitary human beings and their environments? Second, what is the current state of Rogerian science and research application in nursing education and practice? Third, how will we knowingly participate in transforming nursing and health care in the 21st century? Lastly, how are we going to get the Science of Unitary Human Beings out of the box?
We might consider as a hint of an answer the wisdom in an Apple Computer ad dedicated to the crazy ones, the likes of Einstein, Ghandi, Buckminster Fuller, and we would add Rogers and other colleagues. It describes them as rebels, rule breakers, change makers, and visionaries. "While some see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world are the ones who do. THINK DIFFERENT!" (The New York Times, October 22, 1997, p. D24).
Andersen, M.D. & Smereck, G.A.D. (1994). In M.Madrid & E.A.M. Barrett, (Eds.),Rogers' scientific art of nursing practice (pp. 261-283). New York: National League for Nursing.
Advertisement for Apple Computers. To the crazy ones. (1997, October 22). The New York Times, p. D24.
Advertisement for Space Metanation (1997). Space Governance. The Journal of United Societies in Space & The World-Space Bar Association, 4 (2), 167.
Barrett, E.A.M. (1990). Rogers'science-based nursing practice. In E.A.M. Barrett, (Ed)., Visions of Rogers' science-based nursing (pp. 31-44). New York: National League for Nursing.
Barrett, E.A.M. (1993). Nursing centers without nursing frameworks: What's wrong with this picture? Nursing Science Quarterly, 6, 115-117.
Barrett, E.A.M. (1994a). Scientists, artists, revolutionaries. In M. Madrid & E.A.M. Barrett, (Eds.), Rogers' scientific art of nursing practice (pp. 61-80). New York: National League for Nursing.
Barrett, E.A.M. (1994b). On the threshold of tomorrow. In V. Malinski & E.A.M. Barrett, (Eds,), Martha E. Rogers: Her life and her work (pp. 271-275). Philadelphia: F.A. Davis.
Barrett, E.A.M. (1998a). A Rogerian practice methodology for health patterning. Nursing Science Quarterly, II, 136-138.
Barrett, E,A.M, (1998b). Unique nursing research methods: The diversity chant of pioneers. Nursing Science Quarterly, 11, 94-96.
Barrett, E.A.M. (1998c). Space nursing. Space Governance: The Journal of United Societies in Space & The World-Space Bar Association, 5, 126-131,145,
Brooke, J. (1998, February 17). Ambitious entrepreneurs planning to send tourists into 'Astronaut Altitude'. The New York Times, p. A16.
Cowling, W.R., Barrett, E.A.M., Carboni, J. & Butcher, H. (1997). Unitary perspectives on methodological practices. In M. Madrid, (Ed.), Patterns of Rogerian knowing(pp.47-62). New York: NLN NLN National League for Nursing. Press.
Cody, W. (1994). Radical health-care reform: The person as case manager. Nursing Science Quarterly, 7, 180-182.
Dossey, B. (1997). Letter to the editor. Beginnings; The Official Newsletter of the American Holistic Nurses Assn., 17(3), 3.
Doyle, M.B., Racolin, A., Rogers, M.E., & Walsh, P. (1990). A conversation with Martha Rogers on nursing in space. In E.A.M. Barrett (Ed.), Visions of Rogers' science-based nursing(pp. 375-386). New York: National League for Nursing.
Gold, J. (1997). The uniqueness of nursing. Beginnings: The Official Newsletter of the American Holistic Nurses Assn. 17(2),4.
Gordon, J. (1998, February). Seven days of breathing, biofeedback biofeedback, method for learning to increase one's ability to control biological responses, such as blood pressure, muscle tension, and heart rate. Sophisticated instruments are often used to measure physiological responses and make them apparent to the patient, who , and bonding. Vegetarian Times, 64-65.
Kaku, M. (1997). Visions: How science will revolutionize the 21st century. New York: Doubleday.
King, L. with Piper, P. (1994). Future talk: Conversations about tomorrow. New York: Harper Collins.
Luck, S. (1998). "Integrating complementary therapies into clinical practice." Presentation at Alternative Therapies in Health and Medicine Conference, San Diego San Diego (săn dēā`gō), city (1990 pop. 1,110,549), seat of San Diego co., S Calif., on San Diego Bay; inc. 1850. San Diego includes the unincorporated communities of La Jolla and Spring Valley. Coronado is across the bay. , March 31, 1998.
Munhall, P.L. (1997). Out of the box. Image: Journal of Nursing Scholarship, 29, 203.
Nightingale, F. (1959, reprinted 1946). Notes on nursing. Philadelphia: Lippincott.
Parse, R.R. (1994). Martha E. Rogers: Her voice will not be silenced. Nursing Science Quarterly, 7, 47.
Parse, R.R. (1998). The art of criticism. Nursing Science Quarterly, 11,43.
Rawnsley, M. M. (1994). Dwelling in the diffuse: A critical response to Butcher's unitary field pattern portrait research method. In M. Madrid & E.A.M. Barrett (Eds.),Rogers' scientific art of nursing practice(pp. 430-435). New York: National League for Nursing.
Rogers, M.E. (1970). An introduction to the theoretical basis of nursing. Philadelphia: F.A.Davis.
Rogers, M.E. (1988). Nursing science and art; A prospective. Nursing Science Quarterly, 1, 99-102.
Rogers, M.E. (1992). Nursing science and the space age. Nursing Science Quarterly, 5, 27-34.
Rogers, M.E. (1994). Quote on cover. Visions: The Journal of Rogerian Nursing Science, 2 (1), cover.
Stevens, W.K. (1998, February 17). Scorned no more, osteopathy osteopathy (ŏstēŏp`əthē), practice of therapy based on manipulation of bones and muscles. This school of medicine, founded by A. T. is on the rise. The New York Times, p. F1, F6.
Watson, J. (1995). Advanced nursing practice ... and what might be. Nursing & Health Care. Perspectives on Community, 16, 78-86.
Wilford, J.N. (1998, April 21). In the light of dying stars, astronomers see intimations of cosmic immortality. The New York Times, p. F1.
A version of this article was presented at the Seventh Rogerian Conference, New York University, June 21, 1998.
Elizabeth Ann Manhart Barrett, RN;PhD;FAAN FAAN
Fellow of the American Academy of Nursing
Professor and Coordinator, Center for Nursing Research
Hunter-Bellevue School of Nursing
Hunter College Hunter College: see New York, City University of. of the City University of New York The City University of New York (CUNY; acronym: IPA pronunciation: [kjuni]), is the public university system of New York City.
Received October, 1999
Accepted April, 2000