The phenomenon of nursing appears in many forms in the real lived world.
It varies with the age of the patient, the pathology or disability, the
kind and degree of help needed, the duration of the need for help, the
patient's location and his potential for obtaining and using help, and
the nurse's perception of the need and her capacities for responding to
it. Nursing varies also in relation to the sociocultural context in
which it occurs. Being one element in an evolving complex system of
health care, nursing is continuously appearing in new specialized forms.
As professionals, we are accustomed to viewing nursing as we practice it
within these specialty contexts--for example, pediatric, medical,
rehabilitation, intensive care, long-term care, community. There seems
to be no end to the proliferation of diversifications. Even the attempts
of practitioners to combine specialties give rise to new specialties,
such as, community mental health nursing and child psychiatric nursing.
So it is difficult to focus on the phenomenon of nursing as an entity
without having one's view colored by a particular clinical, functional,
or societal context. Yet, if we can "bracket" (hold in abeyance) these
adjectival labels and the preconceived viewpoints they signify, we can
consider the thing itself, the act of nursing in its most simple and
general appearance. {12}
Well-Being and More-Being
In this most basic sense, then, disregarding the particular specialized
forms in which it appears, the nursing act always is related to the
health-illness quality of the human condition, or fundamentally, to a
man's personal survival. This is not to say that all instances of
nursing are matters of life and death, but rather that every nursing act
has to do with the quality of a person's living and dying.
That nursing is related to health and illness is self-evident. How it is
related is not so apparent. "Health" is valued as necessary for survival
and is often proposed as the goal of nursing. There are, in actuality,
many instances of nursing that could be described as "health restoring,"
"health sustaining," or "health promoting." Nurses engage in "health
teaching" and "health supervision." On the other hand, there are
instances in which health, taken in its narrowest meaning as freedom
from disease, is not seen as an attainable goal, as evidenced, for
example, in labels given to patients such as "terminal," "hopeless," and
"chronic." Yet in actual practice these humans' conditions call forth
some of the most complete, expert, total, beautiful nursing care.
Nursing, then, as a human response, implies the valuing of some human
potential beyond the narrow concept of health taken as absence of
disease. Nursing's concern is not merely with a person's well-being but
with his more-being, with helping him become more as humanly possible in
his particular life situation.
Human Potential
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