(which draw nutrients and provide carbon diox-
ide), to animals (which can move about and inter-
act freely), to humans (who can reflect and make
in-depth plans regarding how they want to interact
with their environment), and ultimately to spiritual
beings on the spectrum’s other end. Newman sees
death as a transformation point, with a person’s
consciousness continuing to develop beyond the
physical life, becoming a part of a universal con-
sciousness (Newman, 1994a).
Nurses and their clients know that there has
been an expansion of consciousness when there is a
richer, more meaningful quality to their relation-
ships. Relationships that are more open, loving,
caring, connected, and peaceful are a manifestation
of expanding consciousness. These deeper, more
meaningful relationships may be interpersonal, or
they may be relationships with the wider commu-
nity. The nurse and client may also see movement
through Young’s spectrum of evolving conscious-
ness, where people transcend their own egos, dedi-
cate their energy to something greater than the
individual self, and learn to build order against
the trend of disorder.
THE MUTUALITY OF THE NURSE-CLIENT
INTERACTION IN THE PROCESS OF
PATTERN RECOGNITION
We come to the meaning of the whole not by viewing
the pattern from the outside, but by entering into the
evolving pattern as it unfolds.
—M. A. NewmanNursing out of the HEC perspective involves
being fully present to the patient without judg-
ments, goals, or intervention strategies. It involves
Nursing out of the HEC perspective in-
volves being fully present to the patient
without judgments, goals, or intervention
strategies. It involves being with rather
than doing for.being withrather than doing for. It is caring in its
deepest, most respectful sense. It is a mutual
process of attending to that which is meaningful.
The nurse-patient interaction becomes like a
pure reflection pool through which both the
nurse and the patient get a clear picture of their
pattern and come away transformed by the insights
gained.
To illustrate the mutually transforming effect of
the nurse-patient interaction, Newman (1994a) of-
fers the image of a smooth lake into which two
stones are thrown. As the stones hit the water, con-
centric waves circle out until the two patterns reach
one another and interpenetrate. The new pattern of
their interaction ripples back and transforms the
two original circling patterns. Nurses are changed
by their interactions with their patients, just as pa-
tients are changed by their interactions with nurses.
This mutual transformation extends to the sur-
rounding environment and relationships of the
nurse and patient.
In the process of doing this work, it is important
that the nurse sense his or her own pattern.
Newman states: “We have come to see nursing as a
process of relationship that co-evolves as a func-
tion of the interpenetration of the evolving fields of
the nurse, client, and the environment in a self-
organizing, unpredictable way. We recognize the
need for process wisdom, the ability to come from
the center of our truth and act in the immediate
moment” (Newman, 1994b, p. 155). Sensing one’s
own pattern is an essential starting point for the
nurse. In her book Health as Expanding Conscious-
ness, Newman (1994a, pp. 107–109) outlines a
process of focusing to assist nurses as they begin
working in the HEC perspective. It is important
that the nurse be able to practice from the center of
his or her own truth and be fully present to the
patient. The nurse’s consciousness, or pattern, be-
comes like the vibrations of a tuning fork that res-
onate at a centering frequency, and the client has
the opportunity to resonate and tune to that clear
frequency during their interactions (Newman,
1994a; Quinn, 1992). The nurse-patient relation-
ship ideally continues until the patient finds his or
her own rhythmic vibrations without the need of
the stabilizing force of the nurse-patient dialogue.
Newman (1999) points out that the partnership
demands that nurses develop tolerance for uncer-
tainty, disorganization, and dissonance, even
though it may be quite uncomfortable. It is in the
state of disequilibrium that the potential for
growth exists. She states, “The rhythmic relating of
nurse with client at this critical boundary is a win-
dow of opportunity for transformation in the
health experience” (Newman, 1999, p. 229).224 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration