Emerging scholar column: bringing one's highest frequency to the practice of nursing.
Integral to Rogers' theory is the concept that unitary human beings are multidimensional (a nonlinear domain without the attributes of time or space) energy fields, characterized by pattern, which cannot be divided or reduced (Rogers, 1990). Similarly, health is an irreducible manifestation of the human energy field not measured by any science such as biology or physics (Rogers, 1990). Nursing is both a science and an art and involves the study of the human and environmental energy fields which are in continual mutual process with each other (Rogers, 1990; Gueldner et al., 2005). The principles of homeodynamics upon which all of her work was predicated were resonancy, helicy and integrality. Resonancy is the transition of energy from a lower frequency to a higher frequency, helicy could be seen as the evolution towards one's potential, and integrality is the notion of the unitary human's mutual process with its environmental field (Gueldner et al., 2005). Two relational propositions of particular relevance here are that the nurse is an environmental component of the client (Rogers, 1970) and the goal of nursing is to promote health, well-being and human betterment (Rogers, 1992).
The clinical setting examined herein is a cardio-vascular intensive care unit at a large hospital. The particular practice situation referred to in this writing is that of a 62 year old man who is two days post-operative from a five vessel coronary artery bypass grafting procedure. At this time, he remains intubated, ventilated and sedated. He has been having periods of serious respiratory distress when either his ventilator settings or his sedation have been weaned. This manifested in a respiratory rate of greater than 40 breaths per minute, an oxygen saturation level of less than 89%, an increase in cardiac ectopy, and a drop in blood pressure which required the initiation of vasopressors. In this situation, a nurse can perform the rote duties of titrating drips, supporting adequate ventilation and providing preventative skin care. However, a proponent of Rogerian nursing science would go beyond the perfunctory care and provide these interventions as a unitary human being who is continuously striving to pattern her/himself in the highest frequency possible in relation to the environmental field and, in turn, facilitate the well being of another unitary human being. Because Rogers did not differentiate greatly between one client population and another, save for the fact that they may offer different levels of frequency in their wave patterns which may manifest as different positions on a continuum of health, the concept of bringing one's highest frequency to the practice of nursing can be applied to any population, including the general population.
In Rogerian practice, the nursing goal is to facilitate a transition from a lower frequency to a higher frequency, promote human betterment, and to support well-being (Gueldner et al., 2005; Rogers, 1992). Watson (2002) describes the nurse as delivering intentional "loving energetic attention" and promoting the "precious energy of healing potential" (p 16). The client, by way of the mutual process with the environmental field, is in the nurse's own wave patterning and frequency. This is intimated by Rogers (1990) and reinforced by others. Perkins (2003) explained that "human beings participate and are integrally involved as every thought carries its own intention and interaction with the environment" (p. 38). Leddy (2004) noted that "the human being (an energy field) is embedded (networked) with interpenetrating environmental energy fields including other human beings. The human being openly participates in energy transformations with the environment, creating mutual change" (p. 17). Newman (2002) asserted that "every entity interpenetrates every other entity" (p. 242). Therefore, the nurse's first intervention in any practice situation is to strive to pattern her/his own energy field to a higher frequency. Cowling (2001) stated that "the capacity of humans to participate knowingly in change and in patterning is one of the central tenets of the science of unitary human beings" (p. 35). He further commented that "unitary appreciative inquiry ... offers inquirer- participants the possibility of looking at one's life situation and change with the perspective of pandimensional awareness or unitive consciousness, which is a concept of the unitary framework" (p. 37). Watson (2002) invited us to evoke "the highest sense of compassionate service--a service that inspires/inspirits one to grow into all of the finest aspects of living and learning a spiritual journey in one's chosen life's work and calling" (p. 17). Perkins (2003) mentioned the extraordinary healing properties of love, which are available to the nurse healer as well as anyone who seeks to employ it. She asserted that on a particulate level, the one who loves and the object of one's love exchange particles and actually merge, becoming one another.
In the practice situation detailed here in which a unitary human being is involved in a mutual process with his environment while lying in a comatose state in the cardiovascular intensive care unit, a proponent of the Rogerian Nursing Science assumes his care. The nurse has been given the report that the client is prone to patterns of lower frequency exhibited by respiratory distress, failing oxygen saturation levels and hypotension. This Rogerian practitioner regularly engaged in activities such as exercise, meditation, focused gratitude and by affirming herself as a conduit of loving, healing energy in an effort to increase her wave pattern. Throughout the course of the interaction, this nurse explained each intervention that she was going to perform and how it would contribute to his body's restoration of well-being. As the ventilator settings and sedation were weaned during the shift, the nurse held the client's hand and patterned her breathing with slow deep breaths. During this time, the client's pattern associated with heart rhythm remained normal sinus. The nurse bathed the client with the "loving energetic attention" that Watson (2002) identified (p.17). Simultaneously, the vasopressors were weaned off. By the end of the shift, the client was ready for extubation. Shortly after the breathing tube was removed, this unitary human being said, "That was the most restful sleep I have ever had!"
The Science of Unitary Human Beings lends itself to many types of interventions by which one could strive to raise her/his own pattern of frequency in order to bring her/his most powerful tool of intervention into her/his practice of nursing. The examples listed above are but a few. Another example would be Watson's (2002) series of intentions by which one creates a deliberate life. The intentions include beginning each day with some form of spiritual practice, being mindful to invoke the unified Spirit or Divine in all of one's tasks, seek to experience the connection one has with others, use events that occur to evolve to a higher frequency, and be mindful to focus upon one's gratitude. Perkins (2003) offers a series of interventions which begin with the nurse that focus on love. She writes "one just has to turn to the love in one's own heart space and call it forth, allowing it to expand to whatever bliss levels one can tolerate. One calls forth such experience by the intention to love. As one starts to look in love's direction, it finds you" (p 37). A third possible intervention which is put forth by Cowling (2001) is called the unitary appreciative inquiry. In this intervention, one sees the individual as a unitary whole and sets out to appreciate the richness and fullness of the client's life experience through such methods as dialogue and storytelling. This intervention can effectively be used upon oneself first, and then one's client.
Although the results detailed in the clinical setting above are anecdotal, they are nevertheless actual. The client did experience the ability to maintain more than adequate oxygen saturation level and respiratory rate while being weaned from the ventilator; he experienced less cardiac ectopy and became more hemodynamically stable. These are some evaluation criteria which may be employed to evaluate the interventions in this particular scenario. However, a challenge remains to design a twofold tool of evaluation whereby one could ascertain that the nurse's intervention upon her/himself actually raised her/his vibrational frequency (or her/his well-being) and secondly, that this increased frequency acted to increase the well-being (or frequency) of the client. Benson and Dundis (2003) suggest that the whole person should be evaluated in ways that go beyond pure health, but instead address "life performance" (p 319). One evaluation tool which has been tested to measure the level of well-being in a broad range of adult populations is the Well-Being Picture Scale (Gueldner et al., 2005). This tool could be used before and after the nurse's intervention as well as before and after the client's intervention to evaluate the effectiveness at raising the vibrational frequency pattern of the nurse as a way to increase the vibrational frequency pattern of the client.
Bringing one's highest frequency to the practice of nursing will enhance the well-being of nurses and patients alike. We interpenetrate the world around us. Let us participate fully in this mutual process with patterns of loving appreciation.
Benson, S. G., & Dundis, S. P. (2003). Understanding and motivating healthcare employees: Integrating Maslow's hierarchy of needs, training and technology. Journal of Nursing Management, 11, 315-320.
Cowling, W. R. (2001). Unitary appreciative inquiry. Advances in Nursing Science, 23(4), 32-48. Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2nd ed.). Philadelphia: F. A. Davis.
Gueldner, S.H., Michel, Y., Bramlett, M.H., Liu, C., Johnston, L.W., & Endo, E. et al. (2005). The well-being picture scale: a revision of the index of field energy. Nursing Science Quarterly, 18, 42-50.
Leddy, S. K. (2004). Human energy: A conceptual model of unitary nursing science. Visions: The Journal of Rogerian Nursing Science, 12,14-27.
McEwen, M., & Wills, E. M. (2002). Theoretical basis for nursing. Philadelphia: Lippincott, Williams & Wilkins.
Meleis, A. 1. (1997). Theoretical nursing: Development and progress (3rd ed.). Philadelphia: Lippincott.
Newman, M.A. (2003). A world of no boundaries. Advances in Nursing Science, 26, 240-245.
Perkins, J.B. (2003). Healing through Spirit: The experience of the Eternal in the everyday. Visions: The Journal of Rogerian Nursing Science, 11, 29-42. Rogers, M. E. (1970). An introduction to the theoretical basis of nursing. Philadelphia: F. A. Davis.
Rogers, M.E. (1990). Nursing: The science of unitary, irreducible, human beings: Update 1990. In E.A. Barrett (Ed.), Visions of Roger's science-based nursing (pp. 5-11). New York: National League for Nursing Press.
Rogers, M. E. (1992). The science of unitary human beings: Current perspectives. Nursing Science Quarterly, 7, 33-35.
Watson, J. (2002). Intentionality and Caring-Healing Consciousness: A practice of Transpersonal Nursing. Holistic Nursing Practice, 16(4), 12-19.
Angela Studer, RN BSN
Graduate Student, University of NC at Charlotte
School of Nursing
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|Publication:||Visions: The Journal of Rogerian Nursing Science|
|Date:||Jan 1, 2006|
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