In light of all the recent tragedies, and the fact that it’s political season, which basically seems like a large-scale version of “War of the Roses,” I wanted to bring you some inspiration. It’s so easy to get down on humanity when we are bombarded on social media and television with nothing but anger and contempt, poverty, homelessness, and death. Is there hope for the world? Hope for people? Are the down and out doomed to live in despair forever?
I can’t answer for everyone, but I can answer for a wonderful, inspiring woman named Jean Williamson. Jean is a lovely woman whom I’ve met a few times at various events, mainly those honoring the sparkling actress, Barbara Niven, who is a beautiful soul in her own right.
I didn’t really know Jean or her backstory, but she has always had a smiling face and words of encouragement whether in person or through social media. I sent out a call a short time ago asking for contributors for No Strings Attached-ENews and Ms. Williamson heeded my call. She said that she would send me a few articles through the mail and asked if I would take stories that were a little dated. I said yes and encouraged her to send them along.
The envelope I received from Jean contained photocopies of articles that looked like they were from a nursing journal and I thought to myself, “What am I looking for?” as I had no idea what to expect. That’s when I saw it. An article called “The Testing of a Nursing Theory: A Personal View.” I read and read, and then I saw a few other sheets with Jean’s handwritten note asking me to read the background to Eighth Street Bridge, a street newsletter that contained the articles she was giving me to post.
The Eighth Street Bridge was “a street newsletter printed in Sioux Falls, South Dakota. The evolution of the newsletter is depicted along with a discussion of the essence of a learning community. Teaching-learning endeavors associated with the newsletter are explicated and activities of this collaborative community effort are presented in light of Parse’s community change concepts.” Sandra Schmidt Bunkers, RN; PhD; FAAN
Jean is the founder of Eighth Street Bridge. The “newsletter symbolizes the interconnectedness of community. It is a vehicle for collaborative efforts to present the stories of those struggling with community.” I will share these stories with you in the future, but first, I want to share the story of its founder, our newest contributor, Jean Williamson. It is a story of courage, honesty, trust, and love, which is ultimately what our world needs.
The following introduction is the description of a nursing theory, the one that Jean became involved in and consequently prompts her to write her story, “The Test of a Nursing Theory: A Personal View.” I believe you will find Jean’s story as hopeful, honest, and inspiring as I did.
Human Becoming Theory: One Woman’s Experience of Nursing
Gail J. Mitchell, RN; PhD
Chief Nursing Officer,
Sunnybrook & Women’s College Health Sciences Centre;
Assistant Professor, University of Toronto, Canada
For more than a decade nurses have been writing about how Parse’s (1981, 1998) theory of human becoming makes a difference in their practices with individuals and groups. From the nurses’ perspectives, the theory of human becoming has provided opportunity, direction, clarity, freedom, and insight into how they participate in creating quality of life with others. At this point in time there has not been much written about the person’s experience of engaging nurses guided by the human becoming school of thought. Explicating the person’s experience of nursing guided by human becoming is important if nurses are to truly understand the meaning of quality from the individual’s perspective.
This practice column offers one person’s account of human becoming practice. A woman named G. Jean Williamson wanted to express her experience and view of being with nurses guided by the human becoming theory. This woman’s experience happened with nurses who work with The Health Action Model for Partnerships in Community (Crane, Josephson, & Letcher, 1999). The model was developed by nurses in the Department of Nursing at Augustana College in Sioux Falls, South Dakota. Based on Parse’s theory of human becoming, The Health Action Model for Partnerships in Community views the person-community as knowing expert about quality of life and health as a process of relating value priorities. The person-community engaging nurses working with the model has the opportunity to complete a personal health description. The health description invites the person-community to consider and record the meanings, relationships, concerns, plans, hopes, and dreams that relate to life and living. G. Jean Williamson accepted the invitation to reflect on her personal health and to share those reflections. This column presents her views of life situations and her experience of the nurse-person process as it unfolded over time. To the greatest extent possible G. Jean’s words have been left as she wrote them, and they reflect her story and her experience of life and living.
The Test of a Nursing Theory: A Personal View
G. Jean Williamson
Dr. Beverly A. Hall (1993) defines practice theories as “theories that are philosophical, laying out values and procedures for practice that are right, good, and proper, based on given assumptions about humans” (p.10). She continues by defining how these theories will be judged: “The merit of these practice theories will be judged by how well they stand up to the practice test, not by how well they can be explicated or tested with qualitative or quantitative research approaches” (p.10). What then is the practice test? Dr. Hall states, “I definitely regard Parse’s theory as a practice theory—a theory that will live on for its usefulness in setting standards and ethics for practice” (p.10). The usefulness of Parse’s theory will be judged according to how nurses and clients experience its effectiveness.
It is interesting that Dr. Parse (1993) responded to Hall by stating, “I do not call the human becoming theory a practice model, but neither do I subscribe to the notion that it is a practice theory. This term itself connotes that theory comes from practice, whereas, for me, the theory is a frame of reference that guides the nurse’s practice” (p.12). The questions from my view are these: Can Dr. Parse’s theory pass the practice test in its fullest, a Dr. Hall defined it? Can a person testify to its effectiveness? I am able to ask these questions, and I am also able to answer them because of my relationship with an advanced practice nurse living the theory of human becoming. The story told here is a personal one. It is one person’s testifying about the changes brought about by the theory of human becoming.
My Personal Experience
Throughout my life I have always been one step out of line—a bit out of tune and rarely allowed to be who I really was. Rarely did I get to share I felt and thought with any sense of freedom. I loved playing sports. No one could ever tell me why being a girl disqualified me from the team. You had to be a boy. That was the rule—so where did the rules come from? No answer. I remember asking my grandma, “Where was God before He made the whole world?” I remember asking my mom, “Why did God let my uncle die when you said God could heal him?” And why and why? Normal developmental behavior, I thought. But the people to who I was asking the questions were always too busy or didn’t have the answers, so they told me to quit bothering them with such nonsense.
No one could get me to understand how dissecting a frog would contribute to the quality of my life in my later years. So I spent some of my junior high experience in detention for not respecting my teacher. A marriage of “do what you’re told” and “that’s what a wife should be” added to the deterioration of my self-worth—having to go to work even though I had morning sickness—never experiencing any personal sexual satisfaction.
Having been told in hundreds of ways by many different people that I didn’t matter, I began to experience depression. Then the only person who ever listened to me, the only one who ever did things with me—DIED. My Uncle Denny was my limb to life, sanity, and well-being. When he left, so did my will to live an appropriate lifestyle. I drank just to keep from exploding. I had one son at the time. I gave up motherhood. The anger that had always been within me began to surface and at times I was full of rage. I began striking out at people around me, including my son. I drank to keep control.
My first encounter with the mental health system occurred at this time. It was 1971. Because of the medications, I remember very little of my stay in a private psychiatric unit. I remember one situation that reinforced my shame. I was in occupational therapy. (I remember thinking, how is learning to lace moccasins going to help me get an occupation when I get out of here?) I was on so much medication, I could not translate a clear thought on how I was to lace several parts together into the appropriate action. I got very frustrated, cleared the table, and ended up in isolation.
The rage within me would surface in spite of the amounts of medications I was taking. i would always end up in four-point and then five-point restraints. During one of these experiences, a staff person was sitting by me. I asked her fro help. She told me I needed to help myself. A simple question caused her to leave the room. I asked, “When are you son-of-a-bitches ever going to respect me enough to let me the hell out of here so I can take care of myself?” She left the room because my language was inappropriate.
Anti-psychotic drugs, shock treatments (ECT), and group therapy—nothing worked. They (the experts) hadn’t cured me so I was transferred to a state institution. Besides, my insurance had run out.
Because I was a wife and mother, my occupational therapy was a home economics experience. NOBODY ASKED ME IF THIS WAS HELPING ME! By then I realized that I needed to comply. I didn’t want to get locked up. So the next few months were those of compliance for I was too frightened of what might happen if I showed my anger.
At some point I went back to my husband and two sons, and I drank to keep from being locked up. It was difficult to remember that I had two sons. The shock treatments had taken away any memory of my youngest son’s first three years. Then the husband left. The kids left. Everything crowded in. I felt trapped. The pain was so deep. I couldn’t communicate it in any other way than rage. Nobody was listening, really listening. Instead of hurting others physically, I would hit walls to handle the frustration of not being heard.
I quit drinking in 1978. Not drinking intensified the pain—but there were pills. Fourteen hundred milligrams of speed later, there was this moment—just a flash when I knew that the end was good and peaceful and pain-free.
What were they doing? Something was pulling me back. Intensive care brought me back to the pain, to the rage. NO ONE WOULD GIVE ME A REAL ANSWER TO MY QUESTION: “What right did you, and you, and you, have to decide my living or dying?” Four-point restraints kept me in enough shape to be transferred to the psychiatric lock-up unit. Nobody in my family would get involved in family therapy. I didn’t have any friends—no one—no drinking—no drugs.
One experience with the medical community seemed to continue to add to my feeling of not being heard. I was having what I called seizures—small blank spaces in my day. I went through a series of tests. I tried to explain my past history with ECT (shock therapy) but was told very curtly, “This isn’t like that.” Perhaps because of my background, I was referred back for therapy because there was no reason for blank spaces.
I tried to do the right things. I tried to do what they expected of me, not even knowing who “they” were. Because of a gambling addiction, I became homeless in 1992—another addiction to handle the stress. I made progress in the recovery work I did. But I still didn’t fit in because I didn’t believe everything I heard. When I questioned why, I was told I’d never stay sober if I didn’t give up the “whys.”
So I didn’t drink, I didn’t gamble, I didn’t do drugs and I was no longer in any type of abusive relationship. Stripped of my dignity, self-worth and ability to make decisions, I settled into surviving.
In the early spring of 1998, the full impact of being homeless and living in my car was causing me to grieve my losses. I had given up trying to fit in. On a daily basis I decided whether I wanted to live or die—the streets are a good place to be angry. I was telling the whole world to go to hell, but in a way that I would not get locked up.
A Personal Perspective of Nursing
I was maintaining a routine of sorts which included taking a shower at a drop-in center.
On one of the days as I was washing clothes there and waiting for them to dry, this person came up to me and introduced herself. She invited me to a woman’s group that met at the center. There was food there, so eventually I went. The woman’s name was Diane. I watched her in group as she listened to the gals. i wondered what she was doing at a drop-in center. I finally asked what kind of job would make her spend time in a drop-in center. She told me she was part of a project called the Health Action Model for Partnership in Community. The drop-in center was one of the sites of that project.
So she was there because of a job and yet there was something more to it than just a job.
There was something more than the food that kept me coming back to the group. I sat back and watched.
I found out Diane was a nurse. The curious thing about the situation was that the group decided what health issues they wanted to learn about. Those discussions weren’t just about diseases, it was whatever the group wanted—what or who makes a home, a family? Mary Kay facials—how to have fun—how to survive the holidays—whatever the group wanted to discuss. Although it was hard to believe, Diane’s attentions were always focused on each individual as each person spoke. She was able to include those that were reluctant to speak when the time was right.
So here we were, the “suit” and the homeless person. This is our story, at least from my perspective, written in October 1998 in response to the question “What does the Health Action Model Mean to You?”
This is the story, an unlikely story, of a suit and a homeless person. At one time or another the suit had been a teacher, mother, grandmother, graduate student, a supervisor of a state agency, a mountain climber, and a home owner. At one time or another the homeless person had been an alcoholic, locked up in a mental institution, a birthmother, a compulsive gambler and had been chronically depressed all her life. What makes this story unlikely is how the suit and homeless person met and became friends.
One day in March of 1998, the suit and homeless person met at a drop-in center for anyone that needed a daytime place to be safe. The suit had been stopping by as part of her nursing job. She introduced herself to the homeless person. After a time of their paths crossing at the drop-in center, the suit made sure there was food at the group, so the homeless person thought, why not?
The suit came to the meeting but never tried to control the group (how unlikely, I thought). She always made sure the group chose the topic of discussion. The suit gave the homeless person rides, and listened to her, and spent time encouraging her. Then the most unlikely thing of all happened. The suit, knowing the homeless person had been a painter, asked her to do some painting at her home (how unlikely, I thought). And the homeless painter went and got paid.
The suit listened and the homeless person talked of many things—of dreams and regrets, of joys and hurts. And all the time the suit listened and made the homeless person start to believe there were good people in the world.
Over time, there were discussions about a nursing theory, spiritual beliefs and intellectual challenges. Then somewhere in the process, the suit let the homeless person care about her. There were times when anger was shared, and fears, and almost tears. The suit said to the homeless person, “I like having you around” (how unlikely). The suit took the homeless person to meet her boss (how unlikely, I thought). The boss wanted to hear what the homeless person had to say about her life.
The homeless person then became part of the steering committee of the project where nurses practice the nursing theory that the suit and the homeless person talked about. And more people listened to the homeless person. The friendship of the suit and the homeless person grew. When the homeless person got scared and told the suit good-bye, the suit refused to have the friendship end (how unlikely).
This unlikely story of friendship would most likely have been fiction in most parts of the country. Most of time suits don’t pay attention to the homeless and if they do, they certainly don’t take them home. But this is a true story. The suit is an advanced practice nurse by the name of Diane Josephson.
The drop-in center is the Good Shepherd Family Center. The theory is Dr. Parse’s nursing theory of human becoming. The boss is Dr. Sandra Bunkers, project director of The Health Action Model Partnership in Community.
My name is Jean Williamson. I know this is true because I am the homeless person. Because of the true presence that Dr. Parse’s theory teaches, and the way Diane lives it, I have become more of who I really am. Because of her non-judgmental attitude, somewhere in the process I found hope.
There are more unlikely stories here in Sioux Falls, South Dakota. They continue to happen because of Dr. Parse, Dr. Bunkers, Diane, and another advanced practice nurse named Deb Letcher.
There is no real ending to this unlikely story because the unfolding process continues. The not-yet continues to become explicit. The challenge of learning the theory academically gave me a sense of my intellectual self. I found it stimulating and satisfying to nurture a neglected area of my life.
I was more comfortable with conversations about the theory. They offered a distance from the intense focus on me that was part of the true presence experience. I continued to study and read Dr. Parse’s articles and books. I gained an understanding of the theory’s background by reading Rogers’ (1970) work.
What I eventually found was that Dr. Parse had written about things that I believed in before I understood the theory. These things included:
- All of life is a paradoxical pattern.
- All humans share like experiences and needs.
- Quiet speaks its own language.
- All people experience the need to be heard and have their ideas respected.
- Living in the now does not reveal all that is.
Maybe my non-linear thinking was part of someone else’s experience. I didn’t feel alone quite as much. So here I was, knowing the meaning of lingering presence, being honored, experiencing silent emergence and co-creating. I looked at the individual paradoxes in the principles of the theory. I began to experience a sense of community. I continued the process with the nurse, Diane. Slowly I began to recognize some paradoxes in my life experience.
For instance, I was living in my car, confronted with the emotional reality of being homeless. My friends were on the streets. I was leaving behind my beliefs about success, and about what makes people valuable. Here I was without money, purpose, or direction and I found friendships I had never had before. There was a loyalty among the street people that I really appreciated. I had to leave my family and my friends to find something better (connecting-separating).
When I became a member of the Homeless Coalition, I found no homeless people sitting on the committees. So I went to meetings, trying to share the reality of homelessness to the agency people. These meetings allowed me to share with people who wanted to help the homeless, but were never homeless themselves. I got busy and really missed my friends. Being with my friends and walking the streets always gave me a centered feeling (enabling/limiting).
I have always held parts of me in a very secret place. Being hurt, put down, and rejected a number of times, I just couldn’t risk telling who I was or what I really felt. I would share only small parts of my life with people. I could then see how they would react, which gave me a better chance to know what to share next (revealing-concealing).
I met Dr. Parse in May of 1998 at a nursing theory conference. I remember her (lingering presence) and my asking, “Is true presence taught or is it a spiritual gift, or perhaps a combination of both?” I really don’t remember her answer. i was looking around the room, experiencing something. I had no degrees, was certainly dressed a lot more casually than the others, and still felt comfortable (co-creating).
In the middle of all this learning, the process took on yet another dimension. Dr. Bunkers’ research on “How does it feel to be cared for?” became part of my experience, both as a research participant and as a recruiter. For some reason, it was important to me to satisfy my doubts about a universal question that was being asked of persons from a diversity of cultures. In order to help Dr. Bunkers to do her research, I worked at finding many different people to participate—Native Americans, Blacks, Whites, Disabled, and Bisexual.
My question was answered. What I found was:
- Core issues are the same for all people.
- When an advanced practice nurse enters any setting ready to establish true presence, the person will share and show the way.
I began to wonder how this theory experienced in its many forms was equipping me to be a better friend, a better community organizer, a better steering committee member. Was my quality of life improving? What had changed? My fears seemed to be less controlling. Because of the process of being honored, I gained a confidence in my abilities.
Dr. Bunkers’ explanation of community gave me comfort in times when I always felt very alone. I walked into her office and shared this illustration with her. I’m on a desert island and by all outward appearances I am alone, but I stop and look around. I start to make plans for a shelter. Then I realize what my friends back home taught me about survival and I know I will be OK. She said, “That’s community, but you are also experiencing community with the sand and the ocean.”
The Personal Health Description was created to identify one’s hopes and plans for the future and is written in the words of the person. The questions asked of me were, What are your health concerns? (Health is the way persons live their lives. It involves making choices about what is important.) What is life like for you now? What is most important for you? What are your hopes for the future? What are your plans for the future? How can you carry out these plans? What is your specific Health Action Plan?
I was living on the streets when I did the first Health Description, so all the answers to the questions involved staying sane and safe. But even more important than those issues was the fact someone cared about my present and my future. This experience of creating my own Health Action Plan brought the issues of accountability and responsibility to the forefront. I’ve never considered myself either of these and I am gaining an understanding that accountability is standing tall and saying, “This is who I am and this is what I believe.” Responsibility is choosing to follow the best plan for me. All this came about because of my experiences of being validated; I am the expert of my own life.
When the waves of pain in the form of rejection come, I still get angry. But now I also see the paradoxes. Perhaps my family will never understand. When I hurt the most, I see the beauty of the streets. I get centered by eating at the mission and having my 8-year-old friend run up to me excitedly saying, “Jean! Jean, I got my own bedroom!” When that happens, I know the rhythmical patterns are in place.
If I’m having a difficult time and can’t get a “session” with Diane, I remember (lingering presence) what she said: “Don’t give up hope. You’re the expert, Jean. There’s a power, a flow…let it go.” I want to be more aware of all that’s around me so when the tacit becomes explicit, I am able to learn from what’s being offered. I don’t hurry so much anymore.
I wrote the following poem about life.
MORE LIFE NEEDS TO BE, JUST BE.
THE TIME IS ALWAYS HERE,
ONE MOMENT AFTER ANOTHER.
SO WHY DO WE ENTER THE RACE
WHEN NO ONE REALLY WINS?
THERE, A CRAWLING WORM.
THERE, A SMILING BABY.
THERE, A LEAF FALLING FROM A TREE.
WHAT DOES IT TAKE TO FIND
ALL THAT IS THE TACIT
EXPERIENCE OF LIFE?
YOU CAN STOP LONG ENOUGH TO EXPERIENCE
THE FEELING OF GRACE,
THE TOUCH OF COMPASSION,
THE LESSONS OF DEATH.
COME TO THE PLACE OF WELL-BEING
LONG ENOUGH TO FIND
WHO YOU ARE
AND THEN JUST BE.
What is the most difficult to verbalize is the sense of importance I feel. Being honored takes a lot of getting used to . That’s how I feel when I’m around the people involved with the Health Action Model. The fear of disappointing them with the way I act or the way I think is not there as much as it was in the beginning of my experience with them. Their being who they are has given me a new look at life and the people in it.
I go through a grief period at times because I can no longer believe that no one cares, that what I have to say doesn’t matter, that being homeless makes me less than those who are not homeless. At one time I did feel less than—sitting in front of the drop-in center—being passed by people going to work. So I wrote another poem called, WE ARE THE SAME.
Why do you want to come here?
Into the north of the city?
Why does it matter to you?
If you listen real closely,
Will you recognize
Something of yourself?
Because no matter where we
Lay our heads,
Whether upon duck down
We still all have the need
To be loved,
To be respected,
To be trusted,
To be accepted,
Or maybe just to be.
So don’t think you’re better,
More correct in your ways.
Because no matter how good you get
You will always remain
Just what I am.
A HUMAN BEING
But I don’t feel that way today! I’m losing a belief system that led me to alcohol, drugs, gambling, and suicide. The whole process is frightening at times, but I always have the hope of the pebbles of the not-yet. It’s up to me and now I know I can move forward.
For me, the word “test” has always meant pass/fail. Has my sharing helped the theory of human becoming pass the practice test? I believe the answer lies in my version of Thomas Paine’s introduction to Common Sense:
Perhaps the sentiments contained in Dr. Parse’s theory are not yet sufficiently fashionable to procure them in general favor; a long habit of doing something a certain way gives it a superficial appearance of being the best way, and raises at first presentation of change a formidable outcry in defense of custom. But tumult soon subsides. Time makes more converts than reason.
And in Ecclesiastes 3:2-8 I found words of wisdom that I rephrased as follows: The possibles of the not-yet will become explicit.
Crane, J., Josephson, D., & Letcher, D. (1999, November). The human becoming health action model in community. Paper presented at The Seventh Annual International Colloquium on Human Becoming, Loyola University, Chicago.
Hall, B.A. (1993). The theory-research-practice triad: Commentary and response. Nursing Science Quarterly, 6, 10-12
Parse, R. R. (1981). Man-living-health: A theory of nursing. New York: John Wiley.
Parse, R. R. (1993). Response: Theory guides research and practice.
Nursing Science Quarterly, 6, 12
Parse, R. R. (1998). The human becoming school of thought: A perspective for nurses and other health professionals. Thousand Oaks, CA: Sage.
Rogers, M. E. (1970). An introduction to the theoretical basis of nursing. Philadelphia: Davis.