By Garrick Macatangay – NYU Nursing Student Class January 2016
The use of film or visual images has been used as potent media for aesthetic knowing in education (Carper, 1978). In nursing, films has the potential to evoke emotional responses to situations nursing students may not have the chance to experience first hand. The American Nurse documentary produced and directed by Carolyn Jones is one such film. The unveiling of the work-life of nurses in film resonates with the proverbial philosophical questions: how do nurses know nursing and what does it mean to nurse someone? Inspired by the care she received during her bout with breast cancer, Miss Jones has immortalized in film the virtue of nursing and virtuosity of nurses. Watching the film prompted me to reflect on my pursuit of nursing and examine my personal philosophy of professional nursing. My decision to become a nurse was initially based on a vague awareness to live a life of social responsibility. Though still a novice learner, I view nursing as rooted in action but fundamentally a practice in selflessness, unconditional respect and preservation of dignity of the person-patient. The film allowed me to validate the reasons of my informed decision to enter nursing school.
Similar to the experiences of the nurses featured in the film, the path that led me to nursing was rather unexpected and unconventional. Nurse Jason Short was a truck driver and mechanic before he pursued nursing. Before nurse Brian McMillon came to serve wounded soldiers suffering from Post Traumatic Stress Disorder (PTSD), he simply made a choice to follow an idea proposed by his father. For me the unconditional support from my family allowed me to pursue many dreams. In 2001, I graduated with a degree in Biology and Education, and shortly after, I moved to Los Angeles to pursue a career as a professional dancer. For several years I enjoyed many aspects of my dance career. It afforded me opportunities to experience the world and perform with amazing talent. However, in between jumps, turns and splits, I thought about my role in contributing to the betterment of others. The struggle between the conflicting lure of the spot light and my personal belief in doing something larger than a stage loomed closely, like the background scenery that stood on guard as I danced.
The rhythm of dissatisfaction with a performing life that seemed more superficial and self-serving (though it can be exciting and glamorous), urged me to find a passion committed to serving others. And this is where nursing philosophy comes in handy, although I didn’t know it then. A theory that permeates a classic discussion in nursing philosophy is the notion that “personal knowledge is concerned with the knowing, encountering and actualizing of the concrete, individual self. One does not know about the self; one strives simply to know the self” (Carper, 1978, p.18). The idea pertains to the dynamic nature between nurses and patients and the reciprocal relationships involved in actualizing therapeutic care. Here I realized that the concept of striving to know myself guided me towards nursing. Confronted with experiences that challenged my personal beliefs, I desired a life more congruent with my values. The idea of nursing came about because I saw it as means to do better, for good. As a student nurse, this aspiration continues to be reaffirmed, as I am able to experience my values upheld even in my beginning interactions with the patient and the health care system.
I am drawn to nursing because it is inherently a vehicle for activism – both individual and collective. By that, I mean “taking action to affect social change” (Andrew, n. d.). This phenomenon is ingrained in nursing history. Florence Nightingale was undoubtedly an activist. Heralded as the leader-founder of professional nursing, Nightingale’s sanitation and caring activism propelled her to legendary status based on the lives saved during the Crimean War. Through research and old-fashioned lobbying she affected social policies by sharing life-saving data with government officials. As a teacher she set the groundwork for professional nursing education (Fleming, 2014).
Like Nightingale, Mary Eliza Mahoney affected change when she became the first registered black nurse in 1879. Refusing to succumb to racial inequities of the time (Public Broadcasting Service [PBS], n. d.), Mahoney changed the image of who could provide competent care. I regard both figures as representing an activism that endures today, with the ultimate purpose of addressing a humanitarian need to care for others. Nightingale’s work on sanitation and hygiene started from a need to save wounded soldiers. Mahoney was able to address health care disparities simply because she recognized different presentations of disease among Black Americans. A prime example illustrated in the American Nurse film was that of the visiting nurse Jason Short, whose commitment to care for a marginalized population exposed the struggle with poverty and drug addiction in a part of America not commonly seen in primetime television. Traveling to the remote areas of Appalachia, Jason’s work reminds nurses their potentials and limitations as health care providers as they navigate complex health care systems and diseases with no cure. Each nurse portrayed in the film evoked a certain quality of activism innate to nursing—an action that is motivated out of sincere desire to make a difference versus recognition. I shall take care to remain authentic to this ideal in my pursuit to become a nurse.
Though I see the power of nursing rooted in activism, what is most profound is witnessing the daily practice in unconditional respect and preservation of patient’s dignity portrayed unapologetically in the film. Of course one must remember that a film is only a simulacrum of the real thing called nursing. But, guided by the Caper’s aesthetic way of knowing, I come to know nursing inwardly. Of the five nurses in the film, Tonia Faust resonated with me most because of the palliative care she provided to some of the nation’s worst criminals. Directing the hospice unit for a maximum-security jail in Louisiana, Tonia was not concerned with the morality or ethics of what brought the prisoners there; rather she focused her work in providing quality care where it is needed most. I was moved by the way Tonia respected and dignified each person during her interactions with the terminally, or one can even say, the criminally ill. She listened to each prisoner as they made amends for past wrongdoings and simply cared for them without judgment or reproach. Watching this, I recognize that the humanity of each person is told in stories. As nurses, we become the listeners of the lived experiences of the masses. With this we become so intimately aware of what is wrong or right in the world. This I feel is the foundation of activism.
Although my clinical experiences are limited, there is something remarkable about caring for someone unconditionally. Like many students new to nursing, I am slowly gaining a thoughtful glimpse of aspects of the human condition formerly inaccessible to me. Recently I took care of a patient who was blind and has lost most of his ability to perform the functions of daily living. For this patient, eating, bathing and going to the bathroom now demand expert nursing. Being both an observer and a participant at the bedside, I have the feeling that somewhere along the performance of the simplest of tasks for our patients lays the soul of nursing. For instance, bed bath can be a true test for illustrating the American Nurses Association’s (ANA) Code of Ethics ideal that “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems” (ANA, 2010, internet).
My philosophy of nursing is grounded on the virtues of altruism, activism and unrestricted regard for human dignity. To accomplish this requires authentic knowledge of oneself and the values that motivate ones practice. I was drawn to nursing out of social responsibility, a lofty aim that requires years of practice, collaboration and cooperation. My views on nursing will evolve over time but I am resolute on the principles that brought me here. I envision my nursing practice to build on ideals of impact and cultural and clinical humility. Nurses have the ability to affect positive change globally but the care ultimately starts with the individual. Providing patient-centered acts of service, while maintaining respect and dignity of the patient is the enduring promise of nursing. I look forward to fulfilling that honor.
Note: A Variation of this essay is published in Nursing 2015 Magazine, December 2015.
References: On File