atmosphere of openness and healing patterning.
Rogers (1966/1994) defined nursing as a humanis-
tic science dedicated to compassionate concern for
human beings. Compassion includes energetic acts
of unconditional love and means (a) recognizing
the interconnectedness of the nurse and client by
being able to fully understand and know the suffer-
ing of another, (b) creating actions designed to
transform injustices, and (c) not only grieving in
another’s sorrow and pain, but also rejoicing in an-
other’s joy (Butcher, 2002b).
Pattern manifestation knowing and appre-
ciation involves focusing on the experiences,
Pattern manifestation knowing and appre-
ciation involves focusing on the experi-
ences, perceptions, and expressions of a
health situation, revealed through a rhyth-
mic flow of communion and dialogue.perceptions, and expressions of a health situation,
revealed through a rhythmic flow of communion
and dialogue. In most situations, the nurse can ini-
tially ask the client to describe his or her health sit-
uation and concern. The dialogue is guided toward
focusing on uncovering the client’s experiences,
perceptions, and expressions related to the health
situation as a means to reaching a deeper under-
standing of unitary field pattern. Humans are con-
stantly all-at-once experiencing, perceiving, and
expressing (Cowling, 1993a). Experience involves
the rawness of living through sensing and being
aware as a source of knowledge and includes any
item or ingredient the client senses (Cowling,
1997). The client’s own observations and descrip-
tion of his or her health situation includes his or
her experiences. “Perceiving is the apprehending of
experience or the ability to reflect while experienc-
ing” (Cowling, 1993a, p. 202). Perception is making
sense of the experience through awareness, appre-
hension, observation, and interpreting. Asking
clients about their concerns, fears, and observations
is a way of apprehending their perceptions.
Expressions are manifestations of experiences and
perceptions that reflect human field patterning. In
addition, expressions are any form of information
that comes forward in the encounter with the
client. All expressions are energetic manifestations
of field pattern. Body language, communication
patterns, gait, behaviors, lab values, and vital
signs are examples of energetic manifestations of
human/environmental field patterning.
Since all information about the client/environ-
ment/health situation is relevant, various health as-
sessment tools, such as the comprehensive holistic
assessment tool developed by Dossey, Guzzetta, and
Keegan (2000), may also be useful in pattern know-
ing and appreciation. However, all information
must be interpreted within a unitary context. A
unitary contextrefers to conceptualizing all infor-
mation as energetic/dynamic manifestations of
pattern emerging from a pandimensional human/
environment mutual process. All information is in-
terconnected, is inseparable from environmental
context, unfolds rhythmically and acausally, and re-
flects the whole. Data are not divided or under-
stood by dividing information into physical,
psychological, social, spiritual, or cultural cate-
gories. Rather, a focus on experiences, perceptions,
and expressions is a synthesis more than and differ-
ent from the sum of parts. From a unitary perspec-
tive, what may be labeled as abnormal processes,
nursing diagnoses, illness or disease are conceptual-
ized as episodes of discordant rhythms or nonhar-
monic resonancy (Bultemeier, 2002).
A unitary perspective in nursing practice leads
to an appreciation of new kinds of information that
may not be considered within other conceptual ap-
proaches to nursing practice. The nurse is open to
using multiple forms of knowing, including pandi-
mensional modes of awareness (intuition, medita-
tive insights, tacit knowing) throughout the pattern
manifestation knowing and appreciation process.
Intuition and tacit knowing are artful ways to en-
able seeing the whole, revealing subtle patterns, and
deepening understanding. Pattern information
concerning time perception, sense of rhythm or
movement, sense of connectedness with the
environment, ideas of one’s own personal myth,
and sense of integrity are relevant indicators of
human/environment/health potentialities (Madrid
& Winstead-Fry, 1986). A person’s hopes and
dreams, communication patterns, sleep-rest
rhythms, comfort-discomfort, waking–beyond
waking experiences, and degree of knowing partic-
ipation in change provide important information
regarding each client’s thoughts and feelings con-
cerning a health situation.
The nurse can also use a number of pattern ap-
praisal scales, as mentioned in Part 1 of this chap-
ter, derived from Rogers’ postulates and principlesCHAPTER 13 Applications of Rogers’ Science of Unitary Human Beings 171