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As such, a nurse is primarily to recognize herself as an individual in the world, with certain responses to this world. When a patient enters the hospital, such a patient is also to be seen as a unique individual who responds to the world and his or her environment in a certain way.
Humanistic nursing is then primarily experiential rather than experimental. This means that new knowledge is gained with every new patient that arrives for treatment. In giving treatment, responses are observed and noted for future reference in similar situations. It is not however assumed that a treatment will work because it did in the past and in similar conditions. Instead, hypotheses are based upon experiences of the past. The recognition that hypotheses may prove incorrect helps the nurse to be open to new experiences. Each human being is then seen as a "world," as it were, with the opportunity to investigate this world and use it for the future improvement of nursing.
In this context, the authors (2008, p. 3) propose what they refer to as dialogical nursing. This means that the world of nursing is lived by means of interaction. The "dialogue" involves not only the nurse and her interactions with other nurses and patients, but also the influences of other factors such as the environment and the requirements of the nursing profession itself. Everything is seen as interacting with everything else. In the world, nursing is then seen as a world itself, which functions within a wider reality. In this way, it is fully contextualized, with a recognition of influences from the environment beyond the immediate setting of the care giving facility.
Part of this contextualization is not only the physical environment, but also the patient's relationship with others, such as family members and friends (Paterson and Zderad, 2008, p. 3). The nurse applies her own experience with family and friends to recognize this. In contrast to the empiricist theory then, environmental factors also include the relationship with other human beings, as these may affect the psychological well-being of the patient and hence his or her responses to the treatment provided.
Often, the help of family and friends may also be used in the humanistic setting in order to provide the patient with the support needed for optimal treatment. This is a view of the person as part of a collective whole rather than an individual separate from other individuals. The nurse relates to the patient among a group of other patients, and as he or she relates to the other patients. This furthers the holistic approach, in that the relationship is plural rather than singular. In this view, patients are always viewed in relation to other human beings. Human beings are continuously part of the influencing environment, affected by and affecting the personal relationships within which they function.
Primarily, the nurse relates to herself, her patients, and other nurses within an increasingly complex world of functions, changes, and specializations. It is therefore important tor recognize that the world is not only experienced in an empiricist way, by means of the senses, but also in humanistic, non-sensory way, by means of psychological responses.
Today, most nursing practitioners follow some form of the humanistic approach. This is so because the approach recognizes the complexities of the influencing environment upon the health of the patient. The patient's psychological responses are unique and unseen, and should be kept in mind when considering optimal treatment options.
If I were to change from a humanistic to empiricist paradigm, many things would change, including my relationship to patients, my approach to illness, and my study of the environment as influencing this illness. Firstly and most importantly, my relationship to patients would become much more clinical. Individuals would no longer be seen as such, but would be viewed as a set of similar entities that respond to their environment in a similar way. Although this is a very impersonal approach, it would enable me to make a much more specific diagnosis and provide treatment without further complexities. On the other hand, this could be problematic, as the patient may not respond as expected to treatments and remedies.
On a personal level, I would not need to take any approach to self-knowledge or the knowledge of others apart from how this affects observable data and hypothesis formation. It would make things considerably less complex, as I can follow a completely impersonal approach to my profession. There would be very clear rules for empirical investigation that would have to be followed.
Furthermore on a personal level, I would be concerned mainly by observing patients in order to collect data. I will then use this data to hypothesize a situation and offer treatment, the results of which will be used for my future situations with patients. The focus is upon studying illness, finding remedies, and providing data for future research. The patient would be seen merely as a subject of study, without attempting any personal involvement with him or her.
I believe that empiricist nursing completely dehumanizes the patient and undermines the caring component of the profession. In a hospital that subscribes to the empiricist paradigm, therefore, I believe that nurses would be much less involved with their patients on a personal level. The focus would be study and gaining knowledge from observable evidence rather than gaining knowledge of the self and other as human beings that respond to similar elements in our environment. The nurse would be a separate and different entity from the patient, with the patient defined in terms of his or her illness rather than in terms of humanity.
Having said this, I do believe that empiricism has an important role to play in the nursing profession. Indeed, without it, there would be no nursing profession to speak of, as empirical data is necessary to ensure certain paradigms of treatment. However, I do not believe that it should be used exclusively as a nursing paradigm. Instead, it should be included in a holistic approach that is primarily humanistic. Patients are human beings. The nurse, recognizing herself also as a human being, interacts with both patients and other professionals within the medical and the wider reality. This provides the profession with a greater sense of richness and fulfillment, while still allowing for the accumulation of empirical knowledge, although this is tempered by observable differences that cannot be explicated by empiricism alone.
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