PRACTICE: CLINICAL SUPERVISION
The humanistic nursing approach is useful in clin-
ical supervision. In the process of supervision I try
to understand the “call” of the nurse when she
brings up a clinical issue. This usually is connected
to the “call” of the patient to him or her and some
issue that has arisen around the nurse’s not being
able to hear or respond to that call.
Consider this illustration. Ms. L. was working
with a patient who had recently been told that her
HIV test was positive. Although she did not have
AIDS, she had been exposed to the AIDS virus,
probably through her current boyfriend, who was
purportedly an IV drug abuser. The original issue
that came up was that the nurse was very concerned
that the doctor on the interdisciplinary team, who
was also the patient’s therapist, was not giving the
patient the support that the nurse felt the patient
was calling out for. This nurse and I explored her
perception that the patient did in fact seem to be
reaching out. The nurse and I explored the reaching
out in terms of what the patient was reaching for. It
had been carefully explained to the patient that she
did not have AIDS but that at some point she might
come down with the illness. The patient was told
that there were treatments to retard the disease but
that there were no cures yet. Given this, the doctor,
whose primary function is treatment and cure, was
feeling ill prepared to deal with this patient; it was
perhaps this sense of inadequacy that fostered
avoidant behavior on his part. The nurse and I,
however, came to understand that, in fact, the pa-
tient was not calling for doctoring; she was calling
for nursing care. She was calling for someone to
help her get through this experience in her life.
With this clarified, the nurse and I began to explore
the nurse’s experience of hearing this call. The
nurse spoke of the pain of knowing that this young
woman would die prematurely. She spoke of how
a friend, who reminded her of this patient, had
also died and that when she associated the two she
felt sad.
As we explored the nurse’s angular view, we were
able to identify areas that were unknown. The nurse
had difficulty understanding the need or the role of
the patient’s relationship with her current
boyfriend. We worked on helping the nurse to
bracket her own thoughts and judgments, so that
she could be open to the patient’s experience of
CHAPTER 11 Josephine Paterson and Loretta Zderad’s Humanistic Nursing Theory and Its Applications 135this relationship. Subsequently, the nurse was able
to understand the patient’s intense fear of being
alone. As the nurse began to understand that
choices are humanizing, she began to explore the
need for support systems. And so to expand her
own capability of being a “knowing place” and ex-
panding her angular view, she sought out the help
of the nurse practitioner in our gynecology clinic.
They worked well together with this patient, who
eventually was able to leave the hospital, get a part-
time job, and be all that she could in her current life
situation.
The nurse in the hospital grew from her experi-
ence of working with this patient. Although she is
usually quite reserved and shies away from public
forums, with encouragement she was able to share
the experience with this patient in a large public
forum. She not only shared with other profession-
als the role that she as a nurse played in the treat-
ment of this patient, but she also acknowledged
herself in a group of professionals as a “knowing
place.”
The process enfolded in Humanistic Nursing
Theory is beneficial to supervisors and self-
reflective practitioners in all areas of nursing.
Patients call to us both verbally and nonverbally,
with all sorts of health-related needs. It is impor-
tant to hear the calls and know the process that lets
us understand them. In hearing the calls and
searching our own experiences of who we are, our
personal angular view, we may progress as human-
istic nurses.RESEARCH
In an effort to better understand why some patients
stayed in the day hospital and others left prema-
turely, the nursing staff of a psychiatric day hospi-
tal conducted a phenomenological study that
investigated the experiences of patients as they en-
tered and become engaged in treatment in a day
hospital system.
The initial step in the process of preparing the
nurses for this study was to expand their angular
view by educating them in the phenomenological
method and the unstructured interview style. In
order to promote the openness of the interviewers
to the experience of the patients, we used our group
nursing meetings for the purpose of bracketing our
angular views. In these group meetings we raised