The 1992 Schering Lecture: "When you can't fix it": A changing view of cancer nursing

Abstract

The dehumanization of patients in health care is a challenge which we as nurses contront in our day-to-day practice. Increasingly complex technology and treatmetn modalities facilitate depersonalization of the care provided to persons with cancer and emphasize the view of human beings as "machines requiring repair". Traditionally, patients have been viewed from a biopsychosocial perspective which includes diagnosis of patient problems and the identirication of interventions to alleviate or "fix" these problems. Patient related health problems are the realm of nursing practice. However, more and more nurses are identifying patient situations which they are unable to "fix", which are reflected in comments such as "I don't know what to say" or "I can't seem to take the suffering away". As we acknowledge patient situations which we cannot "fix", we are challenged to more clearly define our nursing practice.

This presentation will explore the human science perspective as an alternative to the traditional biopsychosocial model. Nursing models with a foundation in this perspective offer nurses the opportunity to "be with" and view persons differently, thus enhancing quality of life. Using a nursing framework based in human science, Parse's theory of Human Becoming, the author will explore the challenges which confront nurses when changing theoretical perspectives. Examples from practice will be used to illustrate the opportunities created when nurses move from a traditional intervention or "fixing" model, to a nursing model with a focus on the meaning of living with cancer from the person's perspective.