NURSE'S NOTES

Here are some insights from some members of our group regarding the "Human Becoming Theory"

(Group A - The Humanist)

As a nursing educator, human becoming theory was used to enhance my understanding of my experience with my staffs/ students in PSCCH. I describe by initial tension in living simultaneously the uncertainty and the certainty when I was faced with strange but yet familiar teaching situation. The tension has however enabled me to cross from a traditional approach to a human becoming teaching learning paradigm where the students were given opportunities to share their practice encounters with patients by narrating their lived experiences in a clinical reasoning course. As their meanings of nursing surfaced, the staffs began to learn about whom they were, who they are becoming, and who they want to be as nurses and human beings. I view this teaching-learning experience as invaluable. Students at different stages in their nursing careers started a dialogue that led them to listen and learn from each other. Since many of these staffs are nurse leaders, they participate in the decision making process at a policy level. Their understanding of the continuous development of meaning in nursing grew, as did theirsuppport for one another. I was privileged to witness this unfolding as in their development of an understanding of the nursing process and their desire for continuous learning. I have also witnessed my own unfolding as I chose to live with ambiguity, albeit with much uneasiness, I emerged with a different understanding of the teaching-learning process. I believe the human becoming teaching-learning model will be fundamental to the process of my sharing teaching-learning paths with students and colleagues in the future. 

- Shiela B. Bautista

Each of us, nurses, are expected to provide what our clients or patients need but as for Parse’s human becoming theory we are further aided to the prominent notion that the person is the authority and leader of his or her life; thus, client’s choices is the utmost basis of actions. I certainly believe that the person’s well-being will always be upon his comprehension of his condition. It’s not about the specific pathways of the disease process but on the general aspects of causality, process, management and recovery from the infirmity. Each internal or external facet (physiological, social, emotional, spiritual,psychological etc.) will either be a threat or empowerment to the individual; that is, depending again on the perspective of the individual. We are expected to assist them with their permission and lead in attaining what they ought to attain. In my current clinical experience, I’ve met several types of patients and their families who are indecisive in some instances. In lieu to this, we, together with other health care team members, provide and explain options, and as we realize their final decisions, we are expected to understand what the client’s decision means for them, how these decisions rhythmically interact with outside forces which includes the valuing process, and on how the client will openly transcend from the possible consequences of his action, changes in his decisions, or freely reaching out beyond his limits of which these life themes are all bound to the his/her human becoming. This theory is one of the simplest but provides a better avenue of identifying factors or paradoxes that might be hindering the care that we provide to our clients. Viewing the patient as a whole person interacting with his or her environment, allows us to create a stronger rapport or nurse-patient relationship. Fixing the problem doesn’t end there. We nurses can also transcend from it.

- Alexis Aguinaldo

Parse built her Theory of Human becoming over many years and through gradual awakening and building of personal realizations of two things. First, Parse questioned the value of nurses following the medical model for providing nursing care to patients. Second, Parse became aware of the significance of the works of nurse theorist. A nurse using Parse’s theory for practice or research will enter into a relationship with a person, and with expert knowledge and a back and forth sharing of ideas, become part of the person’s understanding of health. Parse’s theory of nursing adds layers of understanding so that both nurse and patient develop a deeper understanding of the person’s health. This adding of layers and mutual exploration of ideas.

- Leilanie Asuncion

This theory emphasizes on the person or the human being. The person exists with the environment practicing cultural and religious beliefs. We nurses usually are task-oriented; we have the tendencies to treat our patients as “patients”. The nurse should take into consideration that a person copes with illness according to their culture and religious beliefs. We fail to acknowledge that even though they are sick, they still have their own faculties to make decisions about their health. The nurse should include the patient in the planning of care; this will make the patient feel that they are also in control in the decision-making process. This way the patient’s confinement will not be viewed as isolation from their daily routine; this also keeps the patients self-esteem. In short, in applying this theory in patient care; the nurses should help the patient achieve live a “quality life.”

- Fatima P. Adao

Nursing is the language of care. An imperative component to help a person achieve his/her own well-being. We as nurses are then challenged to provide the best and holistic approach to our patients in the uttermost possible way. But basically it doesn't stops there, the human becoming theory have shared to us that nurses should be open for every possibilities that the patient might want and not be the one who acts to know everything for a person’s health. We as nurse have to be emphatic and try to discern the implications of the situation basing on our patients understanding. We should not be misguided by our own prerogatives in what approach are we going to take, rather we should always think that our patient may have different meaning from ours regarding to her case and what she need might not what we thought she needs. Our clientele is not solely on the patient but together with his/her family as well. Nursing care should always be rooted to our patient’s choice which can be affected by their experiences and environment. An example I can relate with was when I had an elderly cardiac patient. Although for me, his highest priority at that time was for him to take his medicines, to rest and prevent further complications of his situation, my approach was more on his physiologic needs since her overt presentations are more on this area and that I was also carrying out doctor’s order. He was uncooperative in the care program until one day he shared to me what concerns him more was being away from the family and being hopeless to be with them again. I had to change how should I approach him regarding his highest priority and until then, he was already open and participative in the plan of care.

- Rae Ann Benitez

Individualism and Composure are co existence in this theory. Open to oneself, community and society are the major roles to adapt for a healthy functioning individual. Opening to oneself has been a good point on this theory. Looking at the basis of empowerment of a person, are the POTENTIAL, which are innate to a human person, whether he/she accepts the nature of being adaptive to the community.Nursing is art and science, based on the existing potential of a nurse is CARING, which is one of the innate potential of a professional nurse. In my experience as a nurse locally and abroad, I have adapt the skill to be a PATIENT ADVOCATE by respecting the beliefs, customs and rights of each individual, but within these aspects, I try to submerse the potentiality of a each individual to commence for a good nurse-patient interaction, by assessing what are their immediate needs and building rapport, disseminating proper and relevant information by means of educating for their disease process, empowering their potential to help them to achieve their mutual goal as a person and to their family. The holistic approach and composure are relatively indicative for us as a Professional Nurse. Our patient is not just only the sick or well person. On this aspect the openness of an individual by means of holistic approach and proper composure is the act of our commitment and service to our society. 

- Atenogenes Potito R. Asuncion

Nurse and patient along with all the family members and the whole society co create in changing health patterns. Theory of Human Becoming helps to achieve the optimum well-being of an individual by looking into perspective to transformative approach to all levels of nursing care. Our patient is responsible in making their own decisions however the theory taught us that as a nurse it is really important to include them in the plan of care for better outcome. This understanding will provide us that every human being is constantly interacting with his/her environment. To site an example, as a health educator I should not only concerns with the curative aspects of an individual I should also include the preventive aspects this would comprise the holistically approach to our patient. Thus, this ability to see patient’s perspective allows nurse to “be with” patient and guide them toward desired health outcomes. 

- John Anastacio

This theory of Human Becoming by Parse elevates the standards of nursing education. If this theory will be applied in the mode of teaching, we will have a better grasp of the patient's condition in a more holistic way. This will not only be nursing to care but also promote their over-all well being. It is like opening a new avenue of discipline in terms of the relationship between nurse and patient to provide the best quality of care. 

- Ruby Joyce Bautista

In the nursing practice, Rosemarie Rizzo Parse’s Theory of Human Becoming establishes a nursing relationship with true presence which means that the nurse is “being with” the client with regards to making health decisions that are beneficial to their quality of life. It is done in such way that the client’s values would conduct the outcome though it may be unknown and not pressing on nurse's own value system since the theory assumes that a human remains responsible to his or her actions and that a human’s value priorities are synthesized towards becoming or health. Through this theory, nurses are able to regard the clients not as problems but as partners since it sees the clients as unique human beings who live and evolve mutually with others. Being able to appreciate the client’s perspective about their own health would make them to feel involved and cared for as well. Furthermore, the value of respect which is one of the foundations of the nursing practice is being implemented since the nurse recognizes the patient's involvement in the plan of care thus it increases the morale of the nursing profession as well.

-Elisa Marie F. Baylon

The Theory of Human Becoming gives health practitioners another perspective to consider on how to deal with our patients. Since today’s sciences emphasize the rewards of focusing mainly on physiology, disease processes, and treatment modalities as effects of successful numerous evidenced-based practices, we tend to view our patients as persons with disabilities needing help and assistance. What makes this theory a great help to nursing is its unique application in the acceptance that humans are open and free individuals. As what has been said many times, “Medical doctors cure while nurses care”. When I say care, what I mean is that we should see our patients not as objects of our interventions rather as subjects of our plan of care. By being the subjects, they are made responsible for their own decisions in many aspects of their life including health, fitness, and lifestyle. That is why whenever we do planning of care, first thing that must cross our minds is the active participation of our patients. They should plan and decide with us, rather than we deciding for them. Let us not forget the fact that they are humans capable of making decisions and sound judgments based on their values and lived experiences. Our duties as nurses are to assist them in whatever decision they come up to as long as these decisions would not put their life and health in danger and to accept all the possibilities beyond limitations.

- Romerr Alao

A  nurse’s  primary  role  is  to  render  care,  give  comfort,  alleviate  suffering and provide assistance to her patients in all phases of their journey to recovery from illness to wellness,  the essence of which is healing.  The healing of the whole person is the focus of holistic nursing. The Human Becoming Theory of Rosemarie Rizzo Parse is considered as a Holistic Nursing Theory. When the nurse has considered this type of nursing practice, she or he grows with each experience with each patient considering each person is unique in her or his own way, with the nurse herself/himself included.  The nurse sees each patient experience as different and distinct, yet similar in the way that the focus is on what the patient perceives; his ideals on what is best for himself and his health. As the nurse understands that the interconnectedness of the individual to her/his environment, her/his social, cultural and spiritual values as a person, with their own set of life experiences as well as expectations on how they want to be cared for and be part of their care, and wellness goals they set for themselves (desired health  outcomes),  she/he  integrates  all  these  and  develop  care  plans as appropriate for each, modifying as the patient progress and/or when goals have changed. The nurse-patient relationship is enriched by shared governance to care with  focus  on  identified patient goals, valuing  and acknowledging their  needs significantly equates to the quality of care provisions and thus enhanced quality of life.  The patients are empowered, as they take accountability in making decisions for  their  care.  The  nurse  enhances  herself/himself  in  this  continuous  process,adapting an enriched personal and professional self.

- Janette Daywan Alano

Rosemarie Rizzo Parse States that man is a unitary being in continuous, mutual interaction with the environment. She uses a symbol that contains 3 elements:

• The black and white colors represent the opposite paradox significant to ontology of human becoming, while green represents hope.• The joining in the center of the symbol represents the co-created mutual human universe process at the ontological level, and the nurse-patient process.• and black swirls intertwining represent the human-universe co-creation as an on-going process of becoming She emphasized that the balance between mind, body and spirit is important for the client to achieve optimum health. Her theory  give us an  idea as a nurse on how to enhance the quality of life using the client own perspective and allowing the client to be the authority figure and decision maker. Her theory explains that being with the patient and family by guiding them towards their heath goals is important rather than doing for the patient and family. 

- Mielyn Oliveros Basea

Parse's theory of human becoming entails the provision of care thru knowing and adapting the core values of a patient. This way the nurse can create a path towards achieving the patient's optimum health. The theory is designed to transform, create new ideas and empower to serve people. This is advantageous because it deals with a person holistically or as a whole, however it may not be applicable in emergencies and acute situations. But in this modern day nursing, where people forget to consider one's being, this theory is much needed. Moreover, Parse's human becoming theory is most effective if applied in combination with other theories. 

- Krissa Berango

Parse’s Human Becoming Theory leads the practices of nurses based on how we choose to liveand on how we truly become humans. It is an approach which focuses on the totality of an individualbased on experiences and possibilities that can happen multi-dimensionally.  Being a nurse for almost 3 years and ongoing, I encountered and still experiencing that patient-nurse, or nurse-patient relationships will help you learn a lot of things; things which any reference bookswill not be able to fully teach you. It is thru experiences that BECOMING HUMAN is a subjective process.Different  people  will  have different  relationships  and priorities.  Each individual  is  unique thus theirexperiences differ from one another. Individual differences are not a hindrance to be open and co-exist with  one another.   It  might  be difficult  at  first,  but  with  open  mindedness  and treating individualswithout biases and pre-judgments, it is possible to happen. Rhythmicity is a process as Parse believed asmutual and co-creating. As a nurse, I am able to treat every patient different from each other becausethey are distinctive from one another and each coming from different environmental backgrounds. I canuse this approach to be able to understand better where they are coming from and their principles,priorities and aspirations in life. Human Becoming Theory is powerful in terms of long term care of patients because it can helpbetter understand human perspectives based on the totality of an individual psychologically, biologically,sociologically, and spiritually. But, it can be quite hard to apply in acute and emergency care settingsbecause first-hand information is only accessible.

Mary Anne Balabala

In each theory it may have strengths and weaknesses but the important key point is on how nurses deal with patient using such theory that can be more effective for the patient. Since our main goal is to have a good quality of life. The human becoming theory may not be applicable in some parts of the workplace but I believe this is most effective in areas with long hospitalization stay or in-patient units because they have enough time to really deal and establish rapport with them. The key points of the theory is to let the person or the client who is in the situation to have the authority and freedom to decide what he wants and what he/ she chooses in transforming his health behaviors. The role of the nurse is not to dictate, to agree or disagree to such choices but to be a guide and to be with the patient to listen what the person wants. By understanding the theory, adopting it in our workplace and sharing the theory to our colleagues can be an effective way of being ahead in our approach, for the purpose of helping our clients improve in their way of life. Listening with their concerns, being with them and not just treating them, will be such an accomplishment for the client and for the nurse. In Comparison with other theories like the theory of Jean Watson it is much likely similar because the concept is also involving listening respectively with patient’s concerns and paying attention to their needs. The whole process is the nurse and the client is with much involvement in redirecting the person  in identifying his/her own needs.

- Abigail Ruth Asis

Providing conscientious and scientific-based care are the pillars of nursing service. Nursing care is based on identified problems from our patient as we work interrelated with other health disciplines. But Human Becoming Theory produced scientific awareness that it is not what the heath care team identified problems that should be prioritized. Instead, it must be the perceived by individuals or patients. They have the unique way of structuring meaning of life. They are the active participant and can adapt to any changes. From my experience, perioperative nursing is normally follows a problem-focused care. Institutional policies and procedures are followed in conducting interaction with patients such as physical assessment and interviews. Time is very limited to build a trusting nurse-patient relationship. But with Parse’ s theory, regardless of time or place, exploration of verbal statements of patient is a great factor in helping them with their perceived problems. It is not enough that perioperative nurses will focus on identified problems related to surgery. It must encompass the feeling and decision of the patient. 

     

- Bona Fides Avendano

The Nurses' Role in relation to the Theory of Human Becoming is to help the patients realize their full potentials and at the same time be able to see our patients as an indispensable element in our plan of care. Clearly, we cannot consider sick individuals solely as our patients but we also have to involve his/her family in the plan of care as they pose direct influences in the patient's life. It is an undeniable fact that our patients themselves must be able to make informed decision regarding their care so it is our duty to help them realize this. We also have to make sure that we, as nurses do not impose our own values to our patients but we just have to guide them in making their own decisions that would not only have an impact on their health but more importantly bring positive changes in their way of life.

- Lester Alferez

In the life of every patient that seeks quality care and recovery, nurses’ plays an integral role. The variety of needs and intricate care necessary for an individual to achieve quality of life depends upon his perspective. As the client interacts with the dynamics of life, nurses and healthcare team secures as much as possible that the best care is given. In that instance, we can infer that nurses are angels sent from above.

- Jonathan Albano