to enhance the collecting and understanding of rel-
evant information specific to Rogerian science. In
addition to those mentioned in Part 1, Paletta
(1990) developed a tool consistent with Rogerian
science that measures the subjective awareness of
temporal experience.
The pattern manifestation knowing and appre-
ciation is enhanced through the nurse’s ability to
grasp meaning,create a meaningful connection,and
participate knowinglyin the client’s change process
(Butcher, 1999a). “Grasping meaningentails using
sensitivity, active listening, conveying uncondi-
tional acceptance, while remaining fully open to the
rhythm, movement, intensity, and configuration of
pattern manifestations” (Butcher, 1999a, p. 51).
Through integrality, nurse and client are always
connected in mutual process. However, a meaning-
ful connectionwith the client is facilitated by creat-
ing a rhythm and flow through the intentional
expression of unconditional love, compassion, and
empathy. Together, in mutual process, the nurse
and client explore the meanings, images, symbols,
metaphors, thoughts, insights, intuitions, memo-
ries, hopes, apprehensions, feelings, and dreams as-
sociated with the health situation.
When initial pattern manifestation knowing and
appreciation is complete, the nurse synthesizes all
the pattern information into a meaningful pattern
profile. The pattern profile is an expression of the
person/environment/health situation’s essence. The
nurse weaves together the expressions, perceptions,
and experiences in a way that tells the client’s story.
The pattern profile reveals the hidden meaning
embedded in the client’s human/environmental
mutual field process. Usually the pattern profile
is in a narrative form that describes the essence of
the properties, features, and qualities of the
human/environment/health situation. In addition
to a narrative form, the pattern profile may also
include diagrams, poems, listings, phrases, and/or
metaphors. Interpretations of any measurement
tools may also be incorporated into the pattern
profile.
Voluntary Mutual Patterning
Voluntary mutual patterning is a process of trans-
forming human/environmental field patterning.
The goal of voluntary mutual patterning is to facil-
itate each client’s ability to participate knowingly in
change, harmonize person/environment integral-
ity, and promote healing potentialities, lifestyle
changes, and well-being in the client’s desired di-
rection of change without attachment to predeter-
mined outcomes. The process is mutual in that
both the nurse and the client are changed with each
encounter, each patterning one another and co-
evolving together. “Voluntary” signifies freedom of
choice or action without external compulsion
(Barrett, 1998). The nurse has no investment in
changing the client in a particular way.
Whereas patterning is continuous, voluntary
mutual patterning may begin by sharing the pat-
tern profile with the client. Sharing the pattern pro-
file with the client is a means of validating the
interpretation of pattern information and may
spark further dialogue, revealing new and more in-
depth information. Sharing the pattern profile with
the client facilitates pattern recognition and also
may enhance the client’s knowing participation in
his or her own change process. An increased aware-
ness of one’s own pattern may offer new insight and
increase one’s desire to participate in the change
process. In addition, the nurse and client can con-
tinue to explore goals, options, choices, and volun-
tary mutual patterning strategies as a means to
facilitate the client’s actualization of his or her
human/environmental field potentials.
A wide variety of mutual patterning strate-
gies may be used in Rogerian practice, including
many “interventions” identified in the Nursing
Intervention Classification (McCloskey & Bule-
chek, 2004). However, “interventions,” within a
unitary context, are not linked to nursing diagnoses
and are reconceptualized as voluntary mutual pat-
terning strategies,and the activities are reconceptu-
alizied as patterning activities. Rather than linking
voluntary mutual patterning strategies to nursing
diagnoses, the strategies emerge in dialogue when-
ever possible out of the patterns and themes de-
scribed in the pattern profile. Furthermore, Rogers
(1988, 1992, 1994) placed great emphasis on
modalities that are traditionally viewed as holistic
and noninvasive. In particular, therapeutic touch,
guided imagery, and the use of humor, sound, dia-
logue, affirmations, music, massage, journaling, ex-
pressive emotional writing, exercise, nutrition,
reminiscence, aroma, light, color, artwork, medita-
tion, storytelling, literature, poetry, movement, and
dance are just a few of the voluntary mutually pat-
terning strategies consistent with a unitary perspec-
tive. Sharing of knowledge through health
education and providing health education litera-172 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration