August 25, 2023 • 57 mins
On this episode my guests include Drs. Marie Gill, Jane Flanagan, and Margaret “Maggie” Pharris. Our conversation centered around dialogue and its importance and Dr. Margaret Newman’s theory – Health as Expanding Consciousness (HEC). Dr. Newman was a nursing theorist who is an alumna of the University of Tennessee Health Science Center College of Nursing, and a former faculty member of the College of Nursing. The UTHSC CON recently dedicated the Dr. Margaret A. Newman Center for Nursing Theory. Our discussion on this episode delves into the HEC theory, the future direction of the Center, and a bit about Dr. Newman herself.
Resources: https://uthsc.edu/nursing/community-partnerships/nursingtheorycenter.php
https://nursology.net/nurse-theories/newmans-theory-of-health-as-expanding-consciousness/#:~:text=Brief%20Description,death%20associated%20with%20chronic%20illness
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297232/
Resources: https://uthsc.edu/nursing/community-partnerships/nursingtheorycenter.php
https://nursology.net/nurse-theories/newmans-theory-of-health-as-expanding-consciousness/#:~:text=Brief%20Description,death%20associated%20with%20chronic%20illness
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297232/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to That's Healthful, a podcastabout health and advocacy with a special focus
on rural and vulnerable populations. Nowhere's your host, family nurse practitioner and
health advocate, doctor Lisa Beasley.I'm Lisa Beasley, the host of That's
Helpful. Welcome today to my guestsdoctors Marie Gill, Jane Flanagan, and
(00:21):
Margaret Maggie Ferris. Our conversation todaywill center around dialogue and its importance and
doctor Margaret A. Newman's theory healthas expanding consciousness. Doctor Newman was a
nursing theorist who is an alumna ofthe University of Tennessee Health Science Center,
College of Nursing and a former facultymember of the College of Nursing as well.
And we recently dedicated the Doctor MargaretA. Newman Center for Nursing Theory
(00:45):
on our campus at the UTHSC.And as we've had some dialogue recently on
this podcast about nursing theory and thecenter, we want to expand a bit
on doctor Newman's theory and that's whatwe'll talk about today. But first i'd
like each of you to briefly tellus a bit about yourself and maybe briefly
describe how you knew or what yourconnection is with doctor Newman. If we
(01:07):
can start with doctor gil Hi,Lisa, thank you for inviting us to
participate in this podcast. I aman associate professor and the director of the
Margaret A. Newman Center for NursingTheory at UTSC. I have known Margaret
Newman only in a very short timeframe as a student. As a doctoral
(01:33):
student at UTSC, I was askedto pick her up from her home and
bring her to the campus for adialogue, which she frequently did with students.
It was just part of her habitof being able to engage with students.
So keep in mind, you know, I had been doing a lot
(01:57):
of study about theory. Although Iwasn't as familiar with health as expanding consciousness,
I knew that I was going tobe in the presence of one of
nursing's finest theorists. So I wasnervous. And I remember pulling up to
her home and there she was waitingfor me, just right on time,
(02:20):
and I went out, and youknow, I opened the door for her,
and she just she thanked me.But I kind of got the feeling
that you know, she probably couldhave opened her own door, but that's
okay. I opened the door forher and introduced myself. She got in
the car and we drove to campus, which took maybe oh ten minutes or
so, not long. But duringthat conversation, or during that time rather,
(02:44):
we had some great conversation and shemade me feel at ease. From
the moment of our greeting. Youknow, I was concerned about what am
I going to say, and shejust put me at ease, and she
asked me questions a lot about myresearch interest and more about me and my
(03:07):
work as a nurse. So wehad a lovely conversation, and then we
got to repeat more of that conversationafter her a dialogue with the students which
I attended, and on the triphome, you know, we had some
more wonderful conversations. So it wasan exciting time for me and my life.
(03:27):
Little did I know that fast forwardyears years ahead, I would be
part of representing this Newman Center forNursing Theory. So I'm just delighted to
be in this role. I ama forever, lifelong learner in the areas
of nursing theory, nursing research,education, life in general, and so
(03:51):
I'm just really glad to have thisopportunity to serve. Thank you so much.
And how about you, doctor Ferris. Thanks doctor Beasley. It's a
pleasure to be here. And Ireally admire the work you've done with this
podcast, and I know that Murrayand Jane know how much I appreciated their
work as well. I first gotto know doctor Newman in the late eighties
(04:13):
early nineties. I was a graduatestudent at the University of Minnesota and took
classes from her, and it wasso hard to begin to understand your theory
at the beginning, and she continuedworking with us as a class. At
the same time, I was doingsome public health work through our mayor at
that time, pulled together some leadersfrom the community to look at the rising
(04:36):
youth homside rate and we bored overall sorts of data, epidemiological data,
and about these kids who were committingmurder, and at the end we could
only conclude that they didn't murder onTuesday nights and that they usually used a
gun. And we had we justdidn't know what was going on. And
just at about that same time,Margaret's theory was beginning to gel and it
(05:00):
was kind of like when you goto the eye doctor and you put on
all these different lenses and finally oneclick and see very clearly. And that
was what it was like for me. Is I could see that Margaret's theory
would help me understand this rising youthhomicide rate, and indeed it did,
so I based I switched topics formy dissertation and based my study on woman's
(05:24):
theory working with kids who were convictedand murder and then take that out to
the community and developed a process ofcommunity pattern recognition. I then went on
with that process, and Margaret wasstill living in Saint Paul. I was
the person she would call on ifshe had like a cataract surgery. I'd
go and I'd stay with her.So I had just some really wonderful time
(05:46):
with her, personal time with heras well as we took our findings of
the transcripts from women among women withdiabetes and also African American woman's diabetes,
and she could see she helped usunderstand insights. And she also what I
appreciate about Margaret as a doctoral studentin relationship with other doctoral students, she
did not she never said no,you don't have it right or no,
(06:10):
you should be this is the waythe theory is. She was always so
curious and interested in the arising insightsas we dialogue, and she created a
dialogue group of US doctoral students.So I just feel so honored to have
been on this journey and been partof the dialogues ongoing dialogue since that time.
I love the way you described goingto the eye doctor, and the
(06:33):
lens is some is this better oris this better? And when it clears
up and it's finally crystal clear,and that's the that's the lens for you.
I think that's a perfect way todescribe that. Doctor Flanagan, Please
tell us about yourself and your connectionwith doctor Newman. Wonderful. Thank you
doctor Beasley for this podcast, andI'm excited to be a part of this.
I just want to say my firstintroduction to Margaret Newman. I think
(06:58):
I relate to what Marie had saidabout loving nursing theory, and I loved
a lot of nursing theory, butI was particularly attracted to Orgiarian science is
probably the best way to describe it. And as much as I like orgarian
science for many of its ideas,one of the challenges of rggarian science is
like, how do you actually putthat into practice? And so actually,
when I was exposed to probably thelens idea is a really good one.
(07:20):
When I was exposed to Margaret Newman'swork through my dissertation advisor was actually part
of my doctoral dissertation, our doctoralwork through doctor Dorothy Jones, I was
exposed to Margaret Newman, and itwas sort of like, this was what
I This is the search I've beenon as a nurse because I've really I
love nursing, but I always havefelt that nurses don't really get to really
(07:42):
enact what it is that we saywe're about in many situations. If we're
really about healing in the journey andabout knowing our patients, like how do
we actually do that? And manytimes in practice it becomes you do this
checklist, do that checklist, andit becomes very removed from knowing the patient.
And yet as one who is youhad people in my life with chronic
(08:03):
illness, something that Margaret Newman sortof based her theory in many ways with
their experiences with her mother, Buthaving dealt with people in my own life
with that, there was so muchmore to the person, and it was
so much more than just the windowof a hospitalization. Margaret Newman really gave
me permission in one way to sortof begin to say, so, tell
me who are you, what's importantto you, what gives you meaning?
(08:24):
And there's so much need for that, and so many people now are claiming
that, you know, like,well we'll find out about the meaning for
patients, and yet this is reallynurse's home. That Margaret said it so
simply, so beautifully that it's almostcomplex, right. I think I relate
to what Maggie said. It's like, how do you get you? How
do I really just go in theroom and say, who are the important
people and meaningful events in your life? And that's going to like lead to
(08:46):
a dialogue with this person? Butpeople are actually craving to be known,
and so it's actually really quite beautiful. But it's hard to believe something so
simple can work so well. AndI think, me what I have found
with it is just, you know, it's all those gaps in care that
we know exist and in finding outwhat people say, what's meaningful and what
(09:07):
they're looking for in the journey isnot really being met by what we call
our you know, a very profitdriven system, especially in the United States.
So I think, you know,what I did is part of my
dissertation work was follow surgical patients andwe implemented a program preopitively where patients.
We were using the Margaret Newman's theoryto get to know our patients and in
(09:28):
getting to know them, found outsome of them were having surgery because they
needed a break, They needed abreak from life, and it was an
elective surgery, but they were sobogged down with caregiving responsibilities, are other
responsibilities that they said, you know, this little surgery that I'm having not
such a bad option. At leastI'll get some time off and I'll be
able to figure out what I needto reset my life or you know,
(09:50):
redo what I'm doing now, andthat that's just not appropriated, right,
that's just a high risk way ofgetting the time needed. So I think
that it really open my eyes andit's continue to open my eyes and matter
what population. I just met witha team this morning. We used this
work, Margaret Newman's theory, itwith liver transplant patients and it just comes
screaming through that there need to beknown greater than their disease, and to
(10:13):
understand who they are and not bestigmatized, and to how to promote healing.
Just really Mirgaret Newman allows for that, and I think that's the simplicity.
And I think the way I've gottento know Migaret over time is through
her dialogues. And again, somethingso simple, and as Marie publicly knows
from trying to run this first dialogue, you know, since the center has
opened, it's also complex because ittakes patience to say we're just going to
(10:39):
come together and talk about it andjust let the flow. But you know,
we're usually so agenda driven that havingthis idea of flowing conversation is just
really challenging. But it works.And that's pretty much where I want to
leave off, so we can getinto other ideas, but it's I just
want to say, I'm very fortunateto have been exposed and it has really
live and by nursing career for listenerswho may not be familiar with dialogue,
(11:03):
Can you explain the purpose of adialogue and why dialogue is important and particularly
for nursing. I'll start with that. Margaret Newman Phune. The process of
dialogue is leading to new ways ofseeing and understanding phenomena of interest, leading
to new ways of moving and beingin the world. And I would say
that dialogue is a particular importance tonurses now in the face of vast societal
(11:28):
differences, divisions, and the corporisationof healthcare and the growing trends and challenges
to health particulate for the most vulnerable. So for nurses, I think dialogue
can open up a way for usto move forward in a way that that
we can live in integrity. Sodialogue just to define what the dialogue process
(11:50):
is. It goes deeper than communication. The Latin roots of communication mean to
make something common. So industry andtechnology use communication very helpful. For example,
Jane, I could talk you throughhow to start an IV or Marie
I could talk to you about howare the if you had diabetes, what
are the side effects you should lookfor? Clear communication is helpful, but
(12:13):
dialogue because then we have common understandingof what needs to be done or what
needs to be watched for. Dialogueis also different from discussion, which,
like percussion or concussion, involves beatingsomething rapidly, going back and forth,
breaking things up. It reveals variouspoints of view, but it does not
get us very far. In dialogue, we did not attempt to make common
(12:37):
ideas we already know. Rather,the participants in a dialogue are making something
new together, coming to a newunderstanding, without an agenda or a goal
in mind. In order for thisto happen, people must listen deeply to
each other, without prejudice or withoutan attempt to influence each other. The
focus of dialogue is on truth andcoherence. Dropping old idea, he is,
(13:00):
letting go of intentions and coming toa new understanding or something that is
different, which has been co createdwithin the dialogue. The Greek word dialogs
is the base for dialogue, andit means meaning flowing through a collective,
letting the meanings sinking thoughts emerge fromthis tacit ground. Periods of silence are
embraced as tacit ground from which newthoughts can emerge. So Newman drew on
(13:24):
the work of David Bohm, aquantum physicist who wrote and spoke extensively about
a hidden wholeness. Bom developed processof dialogue and actually invited Margaret into that
dialogue process, and over the pastseveral decades, as we mentioned before,
We've had dialogues with Margaret every twoto three years, usually in Memphis,
but also in Boston. I thinkone was in Minnesota. She invited students,
(13:48):
colleagues, and HEC scholars, healthhas Explaining consciousness scholars into the dialogue
process. She never sought to controlor directed, as I said before,
she knew that inside would arise throughthe dialogue process, which begins just by
explaining. So if we're going tohave a dialogue, if you did in
in Memphis, we begin by justsaying what I just said about what dialogue
(14:11):
is and what it is not.And then it usually involves twelve to forty
people, but that's not a setamount. It could be fewer people.
One could say that the process ofworking with a client doing pattern recognition is
a dialogue in and of itself.But if you're going to have a formal
dialogue, usually they are about twelveto fifteen people. At least. There's
no leader, there's no agendaa,there may be a facilitator. It was
(14:35):
a broad question to get the groupgoing, and it involves people sitting in
a circle, which allows for directcommunication between all participants, and it typically
lasts about two hours. Participants areencouraged to be fully present, to listen
deeply, to avoid a stance ofdefending, which involves understanding your own reactive
(14:56):
tendencies. Participants are encouraged to assumea stance of relax on judgmental curiosity,
consider their own intuition, to trustthe processselves and each other, and to
give space embrace moments of silence.It's in that silence that new thoughts can
arise and the group attends to evolveand shared meaning. Newman's focus on meaning
(15:16):
and homeless enabled her to be ableto open, to be open to where
the theory was going. She neversaid no, you don't have this right.
She listened deeply in a spirit ofcuriosity and openness. She trusted that
the theory of HEC would unfold throughcontinue dialogue among scholars of health is expanding
consciousness. So that's the general ofa rather in depth overview of what is
(15:39):
dialogue. And Marline Smith did thatwith us to start us off on the
dialogue. And in Memphis on Maythirtieth, I think is when we had
our first first dialogue. And we'lltalk more about that. Doctor Gill,
you had something you want to add, Yeah, I just really appreciate Maggie's
(16:00):
nice explanation of a dialogue in ourdialogue that we had in Memphis following the
dedication of the Margaret Newman Center forNursing Theory. As Maggie mentioned, doctor
Marline Smith gave an introduction to thedialogue and what it was and how to
(16:21):
experience it, what kind of alittle bit what to expect, which was
so nice because in the room ofparticipants, and we had about twenty five
or so in that room, wehad people who were newbies, they were
brand new to dialogue, and Iwas one of those people, and so
we also had experienced people who haddone numerous dialogues, and that was just
(16:45):
such a nice combination. But whenI heard the explanation of dialogue, even
though I did my homework beforehand,so I had an understanding, but when
I heard the explanation, just asMaggie described, and also as Marlane Smith
described prior to the dialogue opening,it just gave me an ease and relief.
(17:07):
You know, I really thought thisis going to be fun, and
it was. It was so insightful. And as we will get into some
discussion a little bit later and talkabout some of the insights that were gained,
you know, through these series ofconversation, these dialogues rather and learning
about the difference between a discussion anda dialogue. It's it's they're different.
(17:32):
I also really appreciated the understanding ofhow silence is so helpful in guiding the
next series of words or thoughts thatcame. And I think that we're too
often this is just my personal opinionand experiences that you know, as a
society, we are in such arush to get things done that we don't
(17:57):
really take time to listen and alsoto listen intently, and also to really
appreciate silence for what it is andfor what it brings to us and our
thoughts. Right, we often feellike we have to fill those silences because
they become awkward. So what wasthe primary focus of the Health as Expanding
(18:19):
Consciousness or HGC dialogue that occurred followingthe official opening of the Doctor Margaret Ain'tuman
Center for Nursing Theory. I'll takethat one. I think the purpose of
the idea of it was to actuallyhave the first gathering and obviously the celebration
of the center. So I thinkthat was just a huge piece of it
and being able to have the dedicationand to have us all come together.
(18:41):
But I think what was wonderful aboutit was it was a group of us,
as Marie alluded to, some whowere new to it and some who
are not new to it. AndI think that's always been the focus of
the dialogue, is to bring othersalong and bring them into that. So
it was actually really nice to seethat we had those of us who have
(19:02):
been at these before and being apot of that, and then those who
were new to it to be apot of it. It was definitely gave
me pause anyway, and I'm sureit gave others a pause just to sort
of not have Margaret there leading thatdialogue, because we were like, can
we do this without her? Wesure that like her. Her wonderful way
of being at the table was shereally didn't say very much at all,
(19:23):
And the idea of like would wefeel the need to fill space and would
we fail the need to have adiscussion and not a dialogue was kind of
I think something that probably, althoughI don't think any of us actually expressed
it, we're wondering could we dowhat she has done so simply and so
beautifully, but being the wonderful mentorthat she was, we actually did really
(19:44):
come together and do and have abeautiful dialogue and it was exciting. Doctor
Endo from Japan came with her toher colleagues, and you know, again
people from University of Tennessee who weren'tfamiliar with it, we're familiar with it.
So I think it was just niceto have a group of us and
then others from really many different potswho came together to have genuinely a dialogue
(20:07):
and say like, Okay, whereare we now? And I think one
of the focus of that particular meetingwas to say where are we and what
do we hope to see for thefuture? What can the center be and
how do we have a dialogue aboutthat? So it was dialoguing about one
piece of it was utilizing the theoryand how we're doing that, but then
another piece of it is what arethe future directions for the center and where
(20:30):
do we hope to see that goand really just being truly a center for
really spreading the word on this particulartype of theory and how we can expand
it and work together. I thinkan exciting piece came out about the VA
system within We probably will discuss thisa little bit more about the VA system
in Tennessee and how they're looking forthis sort of work to be a piece
(20:53):
of what is happening in nursing care. But I do think that when we're
dealing with a very metrics profit drivensystem, and it was interesting to have
our colleagues from Japan who do notdeal with that same system, and nursing
is very clear about what nursing is. But when we deal with our very
profit driven system, nursing is gettinga little bit obliterated. And I guess
part of the problem is, youknow, nurses are not staying in the
(21:15):
profession in the United States. They'releaving as fast as they come in,
and a two year you know,leaving the profession after two years is a
serious concern. And I think,you know, one of the things that
I like to say is like,you know, why are they leaving?
And they'll basically tell you, Ididn't sign up for this. I didn't
sign up from production based care.I signed up to know my patients and
to care for my patients. SoI think it's a real you know,
(21:37):
as much as it feels like it'sin crisis, now, and this is
obviously a post COVID world. Ifeel like it's a real opportunity for nursing
to say we're here and this iswhat it is that we do, and
it really to spread that word aboutthat, because not only are our patient's
craving yet without the doubt, nursesthat we're trying to retain are craving it
as well. And that when theylearn how to do this and they understand
(21:59):
that this is a way for themto go, I think it just makes
a really big difference in the waythat they then proceed with their career.
So I think so much opportunity inthis being a center for where that can
grow and develop becomes critically important.So in general, who were some of
the participants Doctor gil in the dialogue? I think that the participants really assembled
in a way that almost mimiced ahomecoming for some people. There were gatherings
(22:26):
of nursing theorist, scientist, educators, and clinicians from all over the United
States and within our College of Nursinghere at UTHSC. We also were joined
by scholars from Japan. As Janespoke of doctor Amiko Indo and several of
(22:48):
her colleagues joined us in the dialogue, which we were thrilled to have them
there and to see them. Forme personally, having the advisor reboard members
for the Newman Center for Nursing Theory, for which Jane and Maggie both are
members of that board, I hadnever met them in person, so I
(23:10):
was very excited. I felt likeI was meeting some family members that were
from a long distance or something.But it was a very exciting time for
me personally. We also had afew PhD students who participated in the dialogue.
One of the students is actually usinghealthless Expanding Consciousness in her dissertation.
(23:33):
So it was a great gathering offolks and we had a very good time
and a very engaging dialogue. Whatwere the leading questions asked that began the
dialogue? Well, to begin,I think I'd like to just walk us
through the sections of the dialogue,if you will, and how the dialogue
(24:00):
kind of rolled in. One dialoguekind of folded into another dialogue in the
different sections that we initiated. Sothe first section that we addressed, or
basically three different areas in the firstarea was a dialogue on the reflections on
(24:22):
HEC through doctor Newman's lens for nursinga discipline for today. So this was
part one of the current use ofnursing theory. And Maggie facilitated this dialogue
with the guiding question or leading questionthat she initiated was what for you are
(24:48):
the meaningful manifestations of HEC at thistime when I first heard the question,
first of all, I recognize someof Margaret Newman's language in the question right
away, and it also that questionin response, another question came up,
(25:10):
and just to clarify some terms,and I thought, well, this is
wonderful because now we are all kindof what I would say, getting on
the same page. And then thedialogue just unfolded, just like Maggie described
in terms of trusting the process.And I was at a bit of a
(25:32):
relief as well, because I'm alittle bit agenda driven, so but when
I saw this beautiful thing unfolding,it was delightful. We had that dialogue
which ended about, like I said, about two hours or so later,
and so the evening time we finished. Then the next morning we resumed the
(25:56):
dialogue and rolled into what I wouldcall part two, and Jane was the
facilitator for Part two. Part twowas the reflections on hec through Doctor Newman's
lens for nursing a discipline for thefuture, Part two future Insights. And
(26:17):
so Jane asked a couple of questionsto get the dialogue started, and you
know, resume from where we youknow, just where we picked off from
the evening before, and she askedthe question what does this praxis mean?
And so we may get into talkinga little bit later about what is praxis,
but she asked us what does thispraxis mean? And that generated conversation
(26:42):
and then her next question was whatdoes development of consciousness mean? That,
too, reflected in doctor Newman's theory, precipitated a lot of dialogue and a
lot of exchange of a very ideas. Then after again about two hours,
(27:03):
then we had a break and weled into the final dialogue, which I
led the final dialogue, and thissession was advancing the legacy of Margaret Newman,
recognizing evolving patterns, and the primaryquestion that I asked was what are
(27:26):
the ways to develop the center movingforward to advance Margaret Newman's legacy. So
that precipitated in a lot of richdiscussion a lot of insight for me.
I'm going to use the word suggestions, recommendations, I don't know if that's
really what they were, but alot of thoughts that were shared about how
(27:48):
to advance the center, which wasvery timely for me and for you as
the director. It was timely forme, it's very timely for our college
as the center is now on thecusp of the growth and the development into
what it needs to be. Sothis discussion really helped me to frame up,
(28:11):
along with the advisory board, toframe up future projects and priority projects
which we can talk about. Sowhat reflections did participants share during the dialogue
on the current use of nursing theoryfrom the perspective of doctor Newman's HGC theory.
You know, as I was reflectionreflecting on that question, Lisa and
(28:33):
for listeners, Lisa sent out somequestions beforehand. I was thinking about the
dialogue and how the first really twodialogues we were really focusing in on this
system of healthcare, and as Iwrote on some just some points that people
made as we're going on, butthe context of us coming together was in
(28:57):
the context of a whole lot ofgrief. Three years of the pandemic,
and since our last dialogue, MargaretNewman had died, Melody Waller, the
first director of the Newman Center,had died, and on their great strings
on nursing due to COVID. SoI think, just to think about us
(29:18):
coming together for the first time nothaving been able to collectively mourn those losses
in that situation, it's important,I think, to acknowledge that. And
Jane, you started the first session, after I propose the question, you
started by pointing out that the theorytells us there's a way to go,
and that was so I think reassuringto people, yes, there's a way
(29:41):
to go, because many of thepeople in that room since we were together
the last time, had to moveinto management or had to move into an
administration, and we're getting further awayfrom their passion in nursing. And then
Mary Antonelli stressed that the HC premiseof evolution thrives and instability and tention.
HEC invites nurses to embrace chaos andtrust that patients, care providers, and
(30:06):
society will re organize at a higherlevel if we collectively and collaboratively focus on
what's most meaningful. So those weresome of the ideas that were coming up.
Ginger Composi then reflect upon how newnurses were in school during the pandemic
and maybe didn't get that relational pieceof the core of nursing, and that
there's a bit of push to getback to business as usual, getting back
(30:30):
to normal. And even in thesecond dialogue, Dottie Jones questioned, you
know, how does this fit intoa new normal. The core of nursing
is ground in relationship. Dottie isstressed establishing new relationships and people get back
together. It takes a long time. The old pre pandemic culture is gone
and there's an opening for new beginningsreshaping systems of care. Dotty pondered,
(30:52):
how can we reconsider the role canfarm these give meds to free up nurses
to nurse. There's a lot ofthat gene were at the time of chaos,
and in accordance with the theory,we can re envision how we want
to model nursing care and make itbetter and break out of the old mode.
And I think that second session endedwith Amico Endo questioning how do we
(31:15):
teach nurses to understand and recognize theirown care paradigms. Now for listeners to
this podcast, there were some postersessions and just so that you know,
in Japan there's a large Newman Societyfor Nursing and with a few hundred members
exploring how care and management models canbe based on health is expanding consciousness and
(31:38):
as Jane mentioned, Japan doesn't havethe constraints in terms of corporization of the
healthcare environment as we in the UnitedStates are facing. Makia Cato, Functutory
Prefectoral Central Hospital presented her work crossdifferent care settings looking at how do we
(31:59):
incorporate the model of helping patients identifymeaning in their lives and their current predicament
and the caring nursing partnership in thatrole. And Yoko kusha Hashi from shoon
On University Medical Sciences in Japan hasworked with nursing managers to help them identify
(32:20):
their own care pattern as managers fornurses. She presented that work and another
another profound work was from Catherine Rosawho has developed a relate scale tested cross
by studies to measure outcomes of patientperceptions of the nurse patient relationship and measuring
nurse sensitive care. So there arethose are some of the current work that's
(32:42):
being done that came to our attention. There's a lot more going on.
I know Jane is is advising somereally promising doctoral students who have worked with
doctor Newman, and Jane can elaborateon the future projects that we had identified.
Touching upon that point, I dothink that the future it does lie
in us being proud of what thistheory offers us as nurses and getting that
(33:07):
word out. I think of backto Maggie's work. You know now the
nih N i n R is callingfor, you know, social determinants of
health, as if this was anew idea, and I think nurses have
always been focused on social determinants ofhealth and what is happening in our communities.
It's almost like much of this workhas almost been ahead of itself,
ahead of time. It's been soagainst It's a simple theory that is complex,
(33:30):
but at the same time a littleahead of its time. I think
I don't think people were ready tohear what it is that this theory offers,
and when we do get to knowpeople in their circumstances and what is
it that's contributing to their whole story. I think that that allows us to
then say this is what nurses voicesare, and this is what we can
contribute to this situation. But we'resort of in this, at least in
(33:53):
the United States, we're in thislittle bit of a crisis mode of you
know, we're very efficient, we'revery profit driven. We've done very well
with that, but there is like, what is that that wasn't care?
It was a procedure, but itwasn't care. And I think that there
is now a call to bring backthe care and I think that nurses can
lead the way for that. Soyou know, when again the NI and
(34:15):
L looks at you know what,we're going to look at the story and
the person in the community participatory actionresearch. One of my doctoral students said
to me, you know, I'mreading about Margaret Newman and she was talking
about participatory action research way back whenno one was talking about participatory action research.
That is what her theory is about. And I'm like, good for
you, like write that up,like let's talk about this because we do
(34:36):
need to claim it. And Ido think that's a piece of what came
out of this dialogue is being ableto claim what it is that Margaret has
offered us and then move that forwardin an agenda that is out of the
bigger system and what is it thatnurses can contribute? And I think that
was the exciting piece of it.When you know, to get Maggie's point
about Catherine Rosa when she was talkingabout the relate scale, I mean,
(34:57):
this is something that you know ina lodge. Northeastern Medical Center has really
been embraced. I mean people arelike, we need to understand this.
This is actually what we're trying toget at, Like we need to know
what that relationship is. And it'sbeing driven by Margaret Newman's theory and the
work that she had, the preliminarywork that she did and then the testing
of the tool and all of thatwork, and people have embraced it.
(35:17):
And she was presenting to a groupof physicians and it was incredibly well received,
like this is something we need totout, we need to let people
know about this. So I thinkwhat we have is a theory that blossomed
I think in a small core,but not necessarily out there in a larger
world. And I think the Centerreally allows this to get out having it
(35:37):
be centered somewhere where this is theplace where you can come to understand this
theory and how do you then takethat out. I think that was the
exciting part of the dialogue is thatwe kind of said what is the future
and we did talk about I meanmany ideas, but one of them being
that this would be the center thatpeople would come to to learn how to
do this. The scholars and theadvisory panel would be available to help people
(35:58):
work through that. Since that dialogue, I've been contacted by two people to
say, I'm interested in this,would you be willing to talk to me
more about it? So it generatedthat and I think that that's really what
we hope to have come out ofthe center. So I think that the
idea that you know, by wordof mouth, someone might be like,
this is what I wanted to do, but I don't have anyone who can
guide me. That's fine. Andthen it can be a center for helping
(36:21):
nurse educators who really probably miss thisas part of their education to be able
to then learn about it, cometo the center and learn about it,
and then to be able to thengo out and teach it. When I
introduce this to my students, thisyou know, it is always kind of
going back to Maggie's original comment aboutthe lens. It's almost they see clearly,
like, yeah, this is whatI want to do, and then
(36:42):
they sometimes divert down paths of likewhat's fundable and what's what's going to advance
my career fastest, and how doI do this? So sometimes I lose
them and sometimes I win them back, but it is it's an ongoing challenge
because there are these almost competing ideasabout what nursing is, and I think
some of the issues get into what'sfundable rather than what's meaningful, and then
(37:06):
how do you build on what's meaningfulto then make it fundable? Right,
So I think that that becomes reallycritically important and help guide people because it's
a lonely journey. Sometimes if everybody'sdoing I'm going to check A one c's
and I'm going to see if Ican improve those. But there's not really
clear why it was a nurse asopposed to anyone else. You know,
it could be done by artificial intelligence, I think sometimes so I'm not so
sure that there's a role in that. But if there's about a dialogue,
(37:28):
you can't take a dialogue, youcan't put that in artificial intelligence. So
there's a role from nursing because ofthe dialogue and the basis of this theory
that really gives us a future.And having u s C be the center
for that where people can come andlearn, develop and grow just as incredibly
exciting to me as far as afuture. And I think that we had
many ideas that came out of that. Definitely it being a center is one
(37:52):
of them, and I think wecan grow that. I think that's awesome.
As far as funding goes, thereare so many opportunities. As you
were mentioning, or maybe it wasdoctor Gil social determinants which I like to
call drivers more than determinants, butthat's not what they're called, but those
drivers of health. There are somany funding opportunities now coming out for those
(38:13):
drivers of health. And you're sayingwe as nurses, and this theory touched
on that or was ahead of itselfand bringing that to the forefront those issues
to the forefront. Absolutely, Iagree, I mean it was, It's
definitely something. I mean when wetalk about the idea, I think we
alluded to this earlier about expanding consciousnessand what that means. We've talked about
(38:35):
this at the dialogue. You know, I think Margaret has been criticized for
like, you know, consciousness that'sin the mind, and it's you know,
she's it was never in the mind. It's much bigger than that,
you know. So just like justthose cool concepts of what the theory actually
means, I think can be challengingfor people, but I do think it
does guide us. It gives usa future in a direction to go.
And to your point about social determinantsor social drivers, I think we need
(38:59):
to say what we mean when wesay what we say, and how can
we be clear about what nursing's roleis in that? And we've always had
it, but we don't always havethe language. So this sent to be
in a place where people can developthe language and the ideas and almost have
a support network for moving forward withit. I think is going to be
critical. Doctor gill as the directorof the Newman Center for Nursing Theory,
(39:21):
what priority projects have you identified asa result from these dialogues and what's the
approximate period for implementation for those?Well, Lisa, I had so many
wonderful ideas that were generated during thedialogue, and from that information I came
up with the next priority projects interms of also working in conjunction with the
(39:45):
Advisory Board, and I constructed fivepillars that kind of broadly speak to the
recommendations that came out of the dialogue. So I'd like to take some time
just to go over those things.Some of the priority projects were already part
of the strategic plan for the center, but then some of these projects are
(40:09):
new, and so I do havea timeline attached to most of the projects.
However, I understand that projects ofthis nature sometimes simply take longer than
we expect, so trying to doas best as I can with anticipating the
timeline. The first pillar is inregards to the Newman Library and Resources,
(40:35):
which I've already have begun that workstarting, oh, I guess as early
as shortly after I've arrived in thisnew position back in October of twenty two
and then into January started working witha lot of this work in regards to
the Newman Library and Resources. Soone of the things we really talked about
(41:00):
out was continuing to work on thedigital library of the Newman Archive collection.
The archive collection, which is housedin the UTHSC Library, has about I
believe approximately fifteens cubic fifteen cubic feetof information of different items in the collection.
(41:25):
The collection is managed by Jennifer Langford, who is the archivist, and
I also help in that process ofmanaging the collections. So the digital library
is something we're building right now andout of doctor Newman's collection, which there
(41:45):
are oh, let me see ifI can name thinks. There are recordings
of her presentations and lectures. Thereare a number of published and unpublished manuscripts,
some of her initial grant proposals andresearch proposals, a lot of letters
(42:06):
that she's had for correspondence with others. There is a collection of photos,
art, and a very large andI say very large collection of books,
and efforts to get all of thisdigitized. Some of the items won't be
able to be digitized, so theywould be available to people who want to
(42:30):
come directly to U THHC and gointo the archive and begin to explore and
learn, maybe even to conduct research. This is something we could make plans
for people who are wanting to geta first site view of all of these
items, but otherwise we are strivingto create this digital library and have it
(42:54):
accessible to the public so that manypeople can have access to Margaret Newman's work.
The next thing we are working onas we digitize this library, which
there are many things already available,we are also working on creating more of
a full service web page expansion.We're looking to see what is the best
(43:19):
way we can expand this web pageand make it easily accessible. Another thing
that came directly out of the dialoguewas to create a newsletter, and this
newsletter would be about the center,about things going on in the Center,
about work with Health is Expanding Consciousness, and let that newsletter be something available
(43:45):
not only to our clinical partners locally, but also make it available globally so
that people can see what is goingon. Another recommendation that came out of
the dialogue was to gather a libraryof papers that have been published on Health
(44:07):
is Expanding Consciousness and studies that haveused Health is Expanding Consciousness, as well
as dissertations that were led by Healthis Expanding Consciousness, and to assemble this
as a library, but then totake it one step further by inviting other
HEC scholars or others who would beinterested in doing a content analysis of these
(44:32):
works to identify gaps, things thatwe would want to look at as we
move forward, and also just tosee the theme of what these works have
been about. The next pillar ison scholarship and research, and so the
scholarship and research has already in essencehas begun, but I have claimed this
(44:57):
to start in the fall of twentythree. In addition to podcasts and papers
and blogs and things of that nature, we are looking to do something called
demonstration projects. And the demonstration projectsare really to look at or examine healing
of patients who have chronic pain andlooking at chronic pain management, and also
(45:23):
increasing or looking at the well beingof people with chronic disease. So this
particular recommendation came directly out of thedialogue and in those there are a few
that were mentioned, so I wouldlike to talk just briefly about them.
And this again is in the infancystage. We're just now beginning to look
(45:44):
at how we can proceed. Oneof the projects, the demonstration projects,
would be using Helvis Expanding Consciousness andpartnering perhaps with the Veterans Administration here locally
in Memphis to look at the impacton veterans well being. And so this
(46:04):
would be a demonstration project that wecould maybe take place on a dedicated education
unit, maybe regarding spinal cord injuryor others. Really, there are a
lot of options if the interest isthere to proceed. Another area is with
our sickle Cell boot Camp. Sowe already have a center for excellence in
(46:28):
our College of Nursing regarding sickle cell. We are looking at possibly a demonstration
project there with patients who have adiagnosis of sickle cell. Another area is
also within our Centers of Excellence,and that is with the HIV clinics.
We have a faculty on here whoare working in those areas and who do
(46:51):
research, and so there's an opportunityfor that. And then finally we talked
about one of our newest projects forthe College of Nursing, for which of
course Lisa is a part of,and that is the Mobile Health Unit,
which is looking at giving care toothers who live in rural areas and the
(47:14):
possibility of perhaps involving a health isexpanding consciousness approach or approach to looking at
how that care is delivered. Thisparticular unit, which I know you could
talk more about this, Lisa thanI, but this particular unit will be
staffed with nurse practitioners. There willbe students from the BSN program, so
(47:40):
we'll have undergraduate students who will havegraduate students who will be nurse practitioners students.
And this is a wonderful unit thatwill be headed to some of the
most underserved counties in the state ofTennessee. So we don't know there are
some options there that maybe to consider. The next pillar is the collaboration and
(48:02):
education with help is expanding consciousness,and I think both Jane and Maggie have
already mentioned that in Japan there isa large network of a healthless expanding consciousness
society of scholars who already have usedhealthless expanding consciousness in their work. And
(48:22):
my hope is that the center herein Memphis can do some collaboration with the
wonderful work that these Japanese scholars havealready undertaken, and they can give us
some guidance on ways that we couldperhaps move forward with further collaborations. We're
(48:43):
looking at collaboration and education with ourCollege of Nursing faculty and staff, and
that has already started. So justshortly after we had the dedication of the
Center for nursing theory and also thedialogue, the HC Dialogue back in May
(49:05):
of twenty three. On May thirtiethand thirty first, I started setting up
meetings with faculty and staff to talkabout the Newman Center and talk about healthless
expanding consciousness and tried in my bestto present the theory in a way that
was practical. And as we've alreadymentioned, the theory itself is complex and
(49:30):
yet simplistic, So how does onefind that to find that line of how
you communicate that? So my effortsare to try to get information out to
our faculty and staff. We arealso looking at developing a Margaret a Newman
Recognition award. So I think thiskind of goes back to what you were
(49:53):
mentioning earlier, Lisa, about sometype of an award. Now what that
looks like, I don't know,but with guidance and assembly of a team,
we could come up with some ideasaround that particular award. The next
pillar is the curriculum integration, andthis would be curriculum integration for theory and
(50:15):
theory related concepts planned for the fallof twenty three through spring of twenty four.
Now for listeners who are familiar withthe AACN, you already know that
the aacn's New Essentials has outlined oneof the standards to incorporate or integrate theory
(50:37):
and theoretical concepts across curriculus. Sothis particular pillar was already part of the
strategic plan that the center will beinvolved with moving forward. And then finally,
the last pillar is the Summer Institute. This would be the Healthless Expanding
(50:58):
Consciousness. Summer Institute hopes to startlooking at developing this in the fall of
twenty four. So Jane already spoketo this just a little bit, and
I'm so glad you mentioned it,Jane, because this is a grand opportunity
to set up an experiential learning environmentfor people to come and learn more about
(51:21):
how to use health is Expanding Consciousnessin practice particularly, but also in research
to learn more about theory appreciation,nursing theory appreciation, nursing theory development,
and nursing theory evaluation, for whichI would invite guest theorists to come and
(51:43):
speak about different theories, but withan emphasis on health is Expanding Consciousness.
So the Summer Institute would be moreof a training and immersion type of activity,
So, Lisa, I think thatkind of sums up some of the
next priority projects. I guess youcan tell by the explanation that we are
(52:05):
going to be really busy and havea lot on our landscape. And I'm
so grateful that I don't get todo this by myself. I have wonderful
teams, wonderful links to scholars whoare so supportive, and honestly, I
can't wait to see what happens next. In consideration of all the possibilities.
(52:28):
As we've been talking, the mobileHealth Unit and what we're doing out in
these areas came to my mind beforeyou even mentioned it. I thought there
has to be a way to makethis connection with those folks out in those
rural communities that we're serving through thismobile health unit, and it's really an
exciting thing that we're doing. Whatother last thoughts do you have, Doctor
(52:53):
fair as, doctor Flanagan and doctorGil what other last thoughts do you have
about dialogue and maybe even doctor Newman'stheory. I just think this is it's
exciting because I think what we've talkedabout is that it's been three years of
really a tough time for nursing andpeople in general, and this coming together
(53:13):
was like a reunion and also awelcoming to those you know, who were
excited and wanted to be a partof this, and welcoming to even those
who couldn't make it. And Ithink we really have a place to go
now. And I think it's reallyon the cusp of like just that tip
of excitement just to be able tobe able to move forward and see where
we go with this center, andyou know, relisted many different ideas that
(53:34):
we can begin to work on.It's exciting. It's exciting to be able
to be at the forefront of this, to be I have this center that's
dedicated to this through Margaret's generosity,and just what a welcome thing for nursing.
It's really going to be an opportunity. I'm really grateful for this time
to think about the potential of dialogueand encourage listeners to think about their own
(53:55):
situations and the context within which theywere and where there might be a potential
for dialogue to get them to anew place in terms of care delivery.
I also, as we've been reflectingtogether and thinking about the power of the
story of the many studies that havebeen done using Margaret's theory of health is
(54:15):
expanding consciousness and would hope that listenersand am excited that there will be a
summer institute where people can come togetherand learn from other folks about the power
of this theory to transform people's lives, people who are facing health challenges,
to be able to see new potentialin the way they're moving through times of
(54:40):
challenge, and also for communities tobe able to reshape. So thanks for
this dialogue at least coming together andbeginning to think about what we could do
in the future. Absolutely, absolutelythank you all for being here. Doctor
gil I think I don't know thatI that Margaret Newman would be hopefully excited
(55:04):
about what's happening, and that shewould maybe urge us on to continue to
develop her theory, like I don'tthink she intended it for its just to
stop where she left it, andI think she would be excited to hear
of the interest and what the theorycould do for nursing. I know that
(55:27):
in my reading and studying about helplessExpanding Consciousness, I came across something of
that when Margaret Newman was talking aboutconsciousness and helpless expanding consciousness she said that,
and I'm not quoting, so Imay not get this exactly right.
She said that love is the highestlevel of consciousness. And I thought,
(55:51):
Wow, what a great time forus in nursing and in healthcare to think
about the concept of love and caringand what that means to our profession,
what it means to us as adiscipline, and maybe kind of returning to
that type of thought. And Iknow that nursing does not own caring.
(56:16):
You know, certainly other disciplines arepart of caring, but caring is foundational
to nursing practice. And so Ithink that the Center will be a place
where these thoughts can grow and beable to be shared globally and have a
(56:40):
large impact. So I'm excited onceagain about the possibilities. Thank you all
for being here today. Again.My guests have been doctors Marie Gill,
Jane Flanagan, and Margaret Maggie Ferris, and we've been talking about dialogue and
its importance and doctor Margaret new Men'stheory health as expanding consciousness. You've been
(57:02):
listening to the That's Helpful podcast withyour host, doctor Lisa Beasley, a
family nurse practitioner and healthcare advocate viewsexpressed on this podcast, or the views
and opinions of the hosts and guests, and are not affiliated with any facility
or institution that may have been mentionedin this episode. Dshelpful dot com.
(57:22):
For more information or to hear priorepisodes, follow at now Helpful on Twitter,
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wherever you listen or screen your favoritepodcasts. Music for this episode it's provided
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(57:44):
visit Devin Music dot weebly dot com
Welcome to That's Healthful, a podcastabout health and advocacy with a special focus
on rural and vulnerable populations. Nowhere's your host, family nurse practitioner and
health advocate, doctor Lisa Beasley.I'm Lisa Beasley, the host of That's
Helpful. Welcome today to my guestsdoctors Marie Gill, Jane Flanagan, and
(00:21):
Margaret Maggie Ferris. Our conversation todaywill center around dialogue and its importance and
doctor Margaret A. Newman's theory healthas expanding consciousness. Doctor Newman was a
nursing theorist who is an alumna ofthe University of Tennessee Health Science Center,
College of Nursing and a former facultymember of the College of Nursing as well.
And we recently dedicated the Doctor MargaretA. Newman Center for Nursing Theory
(00:45):
on our campus at the UTHSC.And as we've had some dialogue recently on
this podcast about nursing theory and thecenter, we want to expand a bit
on doctor Newman's theory and that's whatwe'll talk about today. But first i'd
like each of you to briefly tellus a bit about yourself and maybe briefly
describe how you knew or what yourconnection is with doctor Newman. If we
(01:07):
can start with doctor gil Hi,Lisa, thank you for inviting us to
participate in this podcast. I aman associate professor and the director of the
Margaret A. Newman Center for NursingTheory at UTSC. I have known Margaret
Newman only in a very short timeframe as a student. As a doctoral
(01:33):
student at UTSC, I was askedto pick her up from her home and
bring her to the campus for adialogue, which she frequently did with students.
It was just part of her habitof being able to engage with students.
So keep in mind, you know, I had been doing a lot
(01:57):
of study about theory. Although Iwasn't as familiar with health as expanding consciousness,
I knew that I was going tobe in the presence of one of
nursing's finest theorists. So I wasnervous. And I remember pulling up to
her home and there she was waitingfor me, just right on time,
(02:20):
and I went out, and youknow, I opened the door for her,
and she just she thanked me.But I kind of got the feeling
that you know, she probably couldhave opened her own door, but that's
okay. I opened the door forher and introduced myself. She got in
the car and we drove to campus, which took maybe oh ten minutes or
so, not long. But duringthat conversation, or during that time rather,
(02:44):
we had some great conversation and shemade me feel at ease. From
the moment of our greeting. Youknow, I was concerned about what am
I going to say, and shejust put me at ease, and she
asked me questions a lot about myresearch interest and more about me and my
(03:07):
work as a nurse. So wehad a lovely conversation, and then we
got to repeat more of that conversationafter her a dialogue with the students which
I attended, and on the triphome, you know, we had some
more wonderful conversations. So it wasan exciting time for me and my life.
(03:27):
Little did I know that fast forwardyears years ahead, I would be
part of representing this Newman Center forNursing Theory. So I'm just delighted to
be in this role. I ama forever, lifelong learner in the areas
of nursing theory, nursing research,education, life in general, and so
(03:51):
I'm just really glad to have thisopportunity to serve. Thank you so much.
And how about you, doctor Ferris. Thanks doctor Beasley. It's a
pleasure to be here. And Ireally admire the work you've done with this
podcast, and I know that Murrayand Jane know how much I appreciated their
work as well. I first gotto know doctor Newman in the late eighties
(04:13):
early nineties. I was a graduatestudent at the University of Minnesota and took
classes from her, and it wasso hard to begin to understand your theory
at the beginning, and she continuedworking with us as a class. At
the same time, I was doingsome public health work through our mayor at
that time, pulled together some leadersfrom the community to look at the rising
(04:36):
youth homside rate and we bored overall sorts of data, epidemiological data,
and about these kids who were committingmurder, and at the end we could
only conclude that they didn't murder onTuesday nights and that they usually used a
gun. And we had we justdidn't know what was going on. And
just at about that same time,Margaret's theory was beginning to gel and it
(05:00):
was kind of like when you goto the eye doctor and you put on
all these different lenses and finally oneclick and see very clearly. And that
was what it was like for me. Is I could see that Margaret's theory
would help me understand this rising youthhomicide rate, and indeed it did,
so I based I switched topics formy dissertation and based my study on woman's
(05:24):
theory working with kids who were convictedand murder and then take that out to
the community and developed a process ofcommunity pattern recognition. I then went on
with that process, and Margaret wasstill living in Saint Paul. I was
the person she would call on ifshe had like a cataract surgery. I'd
go and I'd stay with her.So I had just some really wonderful time
(05:46):
with her, personal time with heras well as we took our findings of
the transcripts from women among women withdiabetes and also African American woman's diabetes,
and she could see she helped usunderstand insights. And she also what I
appreciate about Margaret as a doctoral studentin relationship with other doctoral students, she
did not she never said no,you don't have it right or no,
(06:10):
you should be this is the waythe theory is. She was always so
curious and interested in the arising insightsas we dialogue, and she created a
dialogue group of US doctoral students.So I just feel so honored to have
been on this journey and been partof the dialogues ongoing dialogue since that time.
I love the way you described goingto the eye doctor, and the
(06:33):
lens is some is this better oris this better? And when it clears
up and it's finally crystal clear,and that's the that's the lens for you.
I think that's a perfect way todescribe that. Doctor Flanagan, Please
tell us about yourself and your connectionwith doctor Newman. Wonderful. Thank you
doctor Beasley for this podcast, andI'm excited to be a part of this.
I just want to say my firstintroduction to Margaret Newman. I think
(06:58):
I relate to what Marie had saidabout loving nursing theory, and I loved
a lot of nursing theory, butI was particularly attracted to Orgiarian science is
probably the best way to describe it. And as much as I like orgarian
science for many of its ideas,one of the challenges of rggarian science is
like, how do you actually putthat into practice? And so actually,
when I was exposed to probably thelens idea is a really good one.
(07:20):
When I was exposed to Margaret Newman'swork through my dissertation advisor was actually part
of my doctoral dissertation, our doctoralwork through doctor Dorothy Jones, I was
exposed to Margaret Newman, and itwas sort of like, this was what
I This is the search I've beenon as a nurse because I've really I
love nursing, but I always havefelt that nurses don't really get to really
(07:42):
enact what it is that we saywe're about in many situations. If we're
really about healing in the journey andabout knowing our patients, like how do
we actually do that? And manytimes in practice it becomes you do this
checklist, do that checklist, andit becomes very removed from knowing the patient.
And yet as one who is youhad people in my life with chronic
(08:03):
illness, something that Margaret Newman sortof based her theory in many ways with
their experiences with her mother, Buthaving dealt with people in my own life
with that, there was so muchmore to the person, and it was
so much more than just the windowof a hospitalization. Margaret Newman really gave
me permission in one way to sortof begin to say, so, tell
me who are you, what's importantto you, what gives you meaning?
(08:24):
And there's so much need for that, and so many people now are claiming
that, you know, like,well we'll find out about the meaning for
patients, and yet this is reallynurse's home. That Margaret said it so
simply, so beautifully that it's almostcomplex, right. I think I relate
to what Maggie said. It's like, how do you get you? How
do I really just go in theroom and say, who are the important
people and meaningful events in your life? And that's going to like lead to
(08:46):
a dialogue with this person? Butpeople are actually craving to be known,
and so it's actually really quite beautiful. But it's hard to believe something so
simple can work so well. AndI think, me what I have found
with it is just, you know, it's all those gaps in care that
we know exist and in finding outwhat people say, what's meaningful and what
(09:07):
they're looking for in the journey isnot really being met by what we call
our you know, a very profitdriven system, especially in the United States.
So I think, you know,what I did is part of my
dissertation work was follow surgical patients andwe implemented a program preopitively where patients.
We were using the Margaret Newman's theoryto get to know our patients and in
(09:28):
getting to know them, found outsome of them were having surgery because they
needed a break, They needed abreak from life, and it was an
elective surgery, but they were sobogged down with caregiving responsibilities, are other
responsibilities that they said, you know, this little surgery that I'm having not
such a bad option. At leastI'll get some time off and I'll be
able to figure out what I needto reset my life or you know,
(09:50):
redo what I'm doing now, andthat that's just not appropriated, right,
that's just a high risk way ofgetting the time needed. So I think
that it really open my eyes andit's continue to open my eyes and matter
what population. I just met witha team this morning. We used this
work, Margaret Newman's theory, itwith liver transplant patients and it just comes
screaming through that there need to beknown greater than their disease, and to
(10:13):
understand who they are and not bestigmatized, and to how to promote healing.
Just really Mirgaret Newman allows for that, and I think that's the simplicity.
And I think the way I've gottento know Migaret over time is through
her dialogues. And again, somethingso simple, and as Marie publicly knows
from trying to run this first dialogue, you know, since the center has
opened, it's also complex because ittakes patience to say we're just going to
(10:39):
come together and talk about it andjust let the flow. But you know,
we're usually so agenda driven that havingthis idea of flowing conversation is just
really challenging. But it works.And that's pretty much where I want to
leave off, so we can getinto other ideas, but it's I just
want to say, I'm very fortunateto have been exposed and it has really
live and by nursing career for listenerswho may not be familiar with dialogue,
(11:03):
Can you explain the purpose of adialogue and why dialogue is important and particularly
for nursing. I'll start with that. Margaret Newman Phune. The process of
dialogue is leading to new ways ofseeing and understanding phenomena of interest, leading
to new ways of moving and beingin the world. And I would say
that dialogue is a particular importance tonurses now in the face of vast societal
(11:28):
differences, divisions, and the corporisationof healthcare and the growing trends and challenges
to health particulate for the most vulnerable. So for nurses, I think dialogue
can open up a way for usto move forward in a way that that
we can live in integrity. Sodialogue just to define what the dialogue process
(11:50):
is. It goes deeper than communication. The Latin roots of communication mean to
make something common. So industry andtechnology use communication very helpful. For example,
Jane, I could talk you throughhow to start an IV or Marie
I could talk to you about howare the if you had diabetes, what
are the side effects you should lookfor? Clear communication is helpful, but
(12:13):
dialogue because then we have common understandingof what needs to be done or what
needs to be watched for. Dialogueis also different from discussion, which,
like percussion or concussion, involves beatingsomething rapidly, going back and forth,
breaking things up. It reveals variouspoints of view, but it does not
get us very far. In dialogue, we did not attempt to make common
(12:37):
ideas we already know. Rather,the participants in a dialogue are making something
new together, coming to a newunderstanding, without an agenda or a goal
in mind. In order for thisto happen, people must listen deeply to
each other, without prejudice or withoutan attempt to influence each other. The
focus of dialogue is on truth andcoherence. Dropping old idea, he is,
(13:00):
letting go of intentions and coming toa new understanding or something that is
different, which has been co createdwithin the dialogue. The Greek word dialogs
is the base for dialogue, andit means meaning flowing through a collective,
letting the meanings sinking thoughts emerge fromthis tacit ground. Periods of silence are
embraced as tacit ground from which newthoughts can emerge. So Newman drew on
(13:24):
the work of David Bohm, aquantum physicist who wrote and spoke extensively about
a hidden wholeness. Bom developed processof dialogue and actually invited Margaret into that
dialogue process, and over the pastseveral decades, as we mentioned before,
We've had dialogues with Margaret every twoto three years, usually in Memphis,
but also in Boston. I thinkone was in Minnesota. She invited students,
(13:48):
colleagues, and HEC scholars, healthhas Explaining consciousness scholars into the dialogue
process. She never sought to controlor directed, as I said before,
she knew that inside would arise throughthe dialogue process, which begins just by
explaining. So if we're going tohave a dialogue, if you did in
in Memphis, we begin by justsaying what I just said about what dialogue
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is and what it is not.And then it usually involves twelve to forty
people, but that's not a setamount. It could be fewer people.
One could say that the process ofworking with a client doing pattern recognition is
a dialogue in and of itself.But if you're going to have a formal
dialogue, usually they are about twelveto fifteen people. At least. There's
no leader, there's no agendaa,there may be a facilitator. It was
(14:35):
a broad question to get the groupgoing, and it involves people sitting in
a circle, which allows for directcommunication between all participants, and it typically
lasts about two hours. Participants areencouraged to be fully present, to listen
deeply, to avoid a stance ofdefending, which involves understanding your own reactive
(14:56):
tendencies. Participants are encouraged to assumea stance of relax on judgmental curiosity,
consider their own intuition, to trustthe processselves and each other, and to
give space embrace moments of silence.It's in that silence that new thoughts can
arise and the group attends to evolveand shared meaning. Newman's focus on meaning
(15:16):
and homeless enabled her to be ableto open, to be open to where
the theory was going. She neversaid no, you don't have this right.
She listened deeply in a spirit ofcuriosity and openness. She trusted that
the theory of HEC would unfold throughcontinue dialogue among scholars of health is expanding
consciousness. So that's the general ofa rather in depth overview of what is
(15:39):
dialogue. And Marline Smith did thatwith us to start us off on the
dialogue. And in Memphis on Maythirtieth, I think is when we had
our first first dialogue. And we'lltalk more about that. Doctor Gill,
you had something you want to add, Yeah, I just really appreciate Maggie's
(16:00):
nice explanation of a dialogue in ourdialogue that we had in Memphis following the
dedication of the Margaret Newman Center forNursing Theory. As Maggie mentioned, doctor
Marline Smith gave an introduction to thedialogue and what it was and how to
(16:21):
experience it, what kind of alittle bit what to expect, which was
so nice because in the room ofparticipants, and we had about twenty five
or so in that room, wehad people who were newbies, they were
brand new to dialogue, and Iwas one of those people, and so
we also had experienced people who haddone numerous dialogues, and that was just
(16:45):
such a nice combination. But whenI heard the explanation of dialogue, even
though I did my homework beforehand,so I had an understanding, but when
I heard the explanation, just asMaggie described, and also as Marlane Smith
described prior to the dialogue opening,it just gave me an ease and relief.
(17:07):
You know, I really thought thisis going to be fun, and
it was. It was so insightful. And as we will get into some
discussion a little bit later and talkabout some of the insights that were gained,
you know, through these series ofconversation, these dialogues rather and learning
about the difference between a discussion anda dialogue. It's it's they're different.
(17:32):
I also really appreciated the understanding ofhow silence is so helpful in guiding the
next series of words or thoughts thatcame. And I think that we're too
often this is just my personal opinionand experiences that you know, as a
society, we are in such arush to get things done that we don't
(17:57):
really take time to listen and alsoto listen intently, and also to really
appreciate silence for what it is andfor what it brings to us and our
thoughts. Right, we often feellike we have to fill those silences because
they become awkward. So what wasthe primary focus of the Health as Expanding
(18:19):
Consciousness or HGC dialogue that occurred followingthe official opening of the Doctor Margaret Ain'tuman
Center for Nursing Theory. I'll takethat one. I think the purpose of
the idea of it was to actuallyhave the first gathering and obviously the celebration
of the center. So I thinkthat was just a huge piece of it
and being able to have the dedicationand to have us all come together.
(18:41):
But I think what was wonderful aboutit was it was a group of us,
as Marie alluded to, some whowere new to it and some who
are not new to it. AndI think that's always been the focus of
the dialogue, is to bring othersalong and bring them into that. So
it was actually really nice to seethat we had those of us who have
(19:02):
been at these before and being apot of that, and then those who
were new to it to be apot of it. It was definitely gave
me pause anyway, and I'm sureit gave others a pause just to sort
of not have Margaret there leading thatdialogue, because we were like, can
we do this without her? Wesure that like her. Her wonderful way
of being at the table was shereally didn't say very much at all,
(19:23):
And the idea of like would wefeel the need to fill space and would
we fail the need to have adiscussion and not a dialogue was kind of
I think something that probably, althoughI don't think any of us actually expressed
it, we're wondering could we dowhat she has done so simply and so
beautifully, but being the wonderful mentorthat she was, we actually did really
(19:44):
come together and do and have abeautiful dialogue and it was exciting. Doctor
Endo from Japan came with her toher colleagues, and you know, again
people from University of Tennessee who weren'tfamiliar with it, we're familiar with it.
So I think it was just niceto have a group of us and
then others from really many different potswho came together to have genuinely a dialogue
(20:07):
and say like, Okay, whereare we now? And I think one
of the focus of that particular meetingwas to say where are we and what
do we hope to see for thefuture? What can the center be and
how do we have a dialogue aboutthat? So it was dialoguing about one
piece of it was utilizing the theoryand how we're doing that, but then
another piece of it is what arethe future directions for the center and where
(20:30):
do we hope to see that goand really just being truly a center for
really spreading the word on this particulartype of theory and how we can expand
it and work together. I thinkan exciting piece came out about the VA
system within We probably will discuss thisa little bit more about the VA system
in Tennessee and how they're looking forthis sort of work to be a piece
(20:53):
of what is happening in nursing care. But I do think that when we're
dealing with a very metrics profit drivensystem, and it was interesting to have
our colleagues from Japan who do notdeal with that same system, and nursing
is very clear about what nursing is. But when we deal with our very
profit driven system, nursing is gettinga little bit obliterated. And I guess
part of the problem is, youknow, nurses are not staying in the
(21:15):
profession in the United States. They'releaving as fast as they come in,
and a two year you know,leaving the profession after two years is a
serious concern. And I think,you know, one of the things that
I like to say is like,you know, why are they leaving?
And they'll basically tell you, Ididn't sign up for this. I didn't
sign up from production based care.I signed up to know my patients and
to care for my patients. SoI think it's a real you know,
(21:37):
as much as it feels like it'sin crisis, now, and this is
obviously a post COVID world. Ifeel like it's a real opportunity for nursing
to say we're here and this iswhat it is that we do, and
it really to spread that word aboutthat, because not only are our patient's
craving yet without the doubt, nursesthat we're trying to retain are craving it
as well. And that when theylearn how to do this and they understand
(21:59):
that this is a way for themto go, I think it just makes
a really big difference in the waythat they then proceed with their career.
So I think so much opportunity inthis being a center for where that can
grow and develop becomes critically important.So in general, who were some of
the participants Doctor gil in the dialogue? I think that the participants really assembled
in a way that almost mimiced ahomecoming for some people. There were gatherings
(22:26):
of nursing theorist, scientist, educators, and clinicians from all over the United
States and within our College of Nursinghere at UTHSC. We also were joined
by scholars from Japan. As Janespoke of doctor Amiko Indo and several of
(22:48):
her colleagues joined us in the dialogue, which we were thrilled to have them
there and to see them. Forme personally, having the advisor reboard members
for the Newman Center for Nursing Theory, for which Jane and Maggie both are
members of that board, I hadnever met them in person, so I
(23:10):
was very excited. I felt likeI was meeting some family members that were
from a long distance or something.But it was a very exciting time for
me personally. We also had afew PhD students who participated in the dialogue.
One of the students is actually usinghealthless Expanding Consciousness in her dissertation.
(23:33):
So it was a great gathering offolks and we had a very good time
and a very engaging dialogue. Whatwere the leading questions asked that began the
dialogue? Well, to begin,I think I'd like to just walk us
through the sections of the dialogue,if you will, and how the dialogue
(24:00):
kind of rolled in. One dialoguekind of folded into another dialogue in the
different sections that we initiated. Sothe first section that we addressed, or
basically three different areas in the firstarea was a dialogue on the reflections on
(24:22):
HEC through doctor Newman's lens for nursinga discipline for today. So this was
part one of the current use ofnursing theory. And Maggie facilitated this dialogue
with the guiding question or leading questionthat she initiated was what for you are
(24:48):
the meaningful manifestations of HEC at thistime when I first heard the question,
first of all, I recognize someof Margaret Newman's language in the question right
away, and it also that questionin response, another question came up,
(25:10):
and just to clarify some terms,and I thought, well, this is
wonderful because now we are all kindof what I would say, getting on
the same page. And then thedialogue just unfolded, just like Maggie described
in terms of trusting the process.And I was at a bit of a
(25:32):
relief as well, because I'm alittle bit agenda driven, so but when
I saw this beautiful thing unfolding,it was delightful. We had that dialogue
which ended about, like I said, about two hours or so later,
and so the evening time we finished. Then the next morning we resumed the
(25:56):
dialogue and rolled into what I wouldcall part two, and Jane was the
facilitator for Part two. Part twowas the reflections on hec through Doctor Newman's
lens for nursing a discipline for thefuture, Part two future Insights. And
(26:17):
so Jane asked a couple of questionsto get the dialogue started, and you
know, resume from where we youknow, just where we picked off from
the evening before, and she askedthe question what does this praxis mean?
And so we may get into talkinga little bit later about what is praxis,
but she asked us what does thispraxis mean? And that generated conversation
(26:42):
and then her next question was whatdoes development of consciousness mean? That,
too, reflected in doctor Newman's theory, precipitated a lot of dialogue and a
lot of exchange of a very ideas. Then after again about two hours,
(27:03):
then we had a break and weled into the final dialogue, which I
led the final dialogue, and thissession was advancing the legacy of Margaret Newman,
recognizing evolving patterns, and the primaryquestion that I asked was what are
(27:26):
the ways to develop the center movingforward to advance Margaret Newman's legacy. So
that precipitated in a lot of richdiscussion a lot of insight for me.
I'm going to use the word suggestions, recommendations, I don't know if that's
really what they were, but alot of thoughts that were shared about how
(27:48):
to advance the center, which wasvery timely for me and for you as
the director. It was timely forme, it's very timely for our college
as the center is now on thecusp of the growth and the development into
what it needs to be. Sothis discussion really helped me to frame up,
(28:11):
along with the advisory board, toframe up future projects and priority projects
which we can talk about. Sowhat reflections did participants share during the dialogue
on the current use of nursing theoryfrom the perspective of doctor Newman's HGC theory.
You know, as I was reflectionreflecting on that question, Lisa and
(28:33):
for listeners, Lisa sent out somequestions beforehand. I was thinking about the
dialogue and how the first really twodialogues we were really focusing in on this
system of healthcare, and as Iwrote on some just some points that people
made as we're going on, butthe context of us coming together was in
(28:57):
the context of a whole lot ofgrief. Three years of the pandemic,
and since our last dialogue, MargaretNewman had died, Melody Waller, the
first director of the Newman Center,had died, and on their great strings
on nursing due to COVID. SoI think, just to think about us
(29:18):
coming together for the first time nothaving been able to collectively mourn those losses
in that situation, it's important,I think, to acknowledge that. And
Jane, you started the first session, after I propose the question, you
started by pointing out that the theorytells us there's a way to go,
and that was so I think reassuringto people, yes, there's a way
(29:41):
to go, because many of thepeople in that room since we were together
the last time, had to moveinto management or had to move into an
administration, and we're getting further awayfrom their passion in nursing. And then
Mary Antonelli stressed that the HC premiseof evolution thrives and instability and tention.
HEC invites nurses to embrace chaos andtrust that patients, care providers, and
(30:06):
society will re organize at a higherlevel if we collectively and collaboratively focus on
what's most meaningful. So those weresome of the ideas that were coming up.
Ginger Composi then reflect upon how newnurses were in school during the pandemic
and maybe didn't get that relational pieceof the core of nursing, and that
there's a bit of push to getback to business as usual, getting back
(30:30):
to normal. And even in thesecond dialogue, Dottie Jones questioned, you
know, how does this fit intoa new normal. The core of nursing
is ground in relationship. Dottie isstressed establishing new relationships and people get back
together. It takes a long time. The old pre pandemic culture is gone
and there's an opening for new beginningsreshaping systems of care. Dotty pondered,
(30:52):
how can we reconsider the role canfarm these give meds to free up nurses
to nurse. There's a lot ofthat gene were at the time of chaos,
and in accordance with the theory,we can re envision how we want
to model nursing care and make itbetter and break out of the old mode.
And I think that second session endedwith Amico Endo questioning how do we
(31:15):
teach nurses to understand and recognize theirown care paradigms. Now for listeners to
this podcast, there were some postersessions and just so that you know,
in Japan there's a large Newman Societyfor Nursing and with a few hundred members
exploring how care and management models canbe based on health is expanding consciousness and
(31:38):
as Jane mentioned, Japan doesn't havethe constraints in terms of corporization of the
healthcare environment as we in the UnitedStates are facing. Makia Cato, Functutory
Prefectoral Central Hospital presented her work crossdifferent care settings looking at how do we
(31:59):
incorporate the model of helping patients identifymeaning in their lives and their current predicament
and the caring nursing partnership in thatrole. And Yoko kusha Hashi from shoon
On University Medical Sciences in Japan hasworked with nursing managers to help them identify
(32:20):
their own care pattern as managers fornurses. She presented that work and another
another profound work was from Catherine Rosawho has developed a relate scale tested cross
by studies to measure outcomes of patientperceptions of the nurse patient relationship and measuring
nurse sensitive care. So there arethose are some of the current work that's
(32:42):
being done that came to our attention. There's a lot more going on.
I know Jane is is advising somereally promising doctoral students who have worked with
doctor Newman, and Jane can elaborateon the future projects that we had identified.
Touching upon that point, I dothink that the future it does lie
in us being proud of what thistheory offers us as nurses and getting that
(33:07):
word out. I think of backto Maggie's work. You know now the
nih N i n R is callingfor, you know, social determinants of
health, as if this was anew idea, and I think nurses have
always been focused on social determinants ofhealth and what is happening in our communities.
It's almost like much of this workhas almost been ahead of itself,
ahead of time. It's been soagainst It's a simple theory that is complex,
(33:30):
but at the same time a littleahead of its time. I think
I don't think people were ready tohear what it is that this theory offers,
and when we do get to knowpeople in their circumstances and what is
it that's contributing to their whole story. I think that that allows us to
then say this is what nurses voicesare, and this is what we can
contribute to this situation. But we'resort of in this, at least in
(33:53):
the United States, we're in thislittle bit of a crisis mode of you
know, we're very efficient, we'revery profit driven. We've done very well
with that, but there is like, what is that that wasn't care?
It was a procedure, but itwasn't care. And I think that there
is now a call to bring backthe care and I think that nurses can
lead the way for that. Soyou know, when again the NI and
(34:15):
L looks at you know what,we're going to look at the story and
the person in the community participatory actionresearch. One of my doctoral students said
to me, you know, I'mreading about Margaret Newman and she was talking
about participatory action research way back whenno one was talking about participatory action research.
That is what her theory is about. And I'm like, good for
you, like write that up,like let's talk about this because we do
(34:36):
need to claim it. And Ido think that's a piece of what came
out of this dialogue is being ableto claim what it is that Margaret has
offered us and then move that forwardin an agenda that is out of the
bigger system and what is it thatnurses can contribute? And I think that
was the exciting piece of it.When you know, to get Maggie's point
about Catherine Rosa when she was talkingabout the relate scale, I mean,
(34:57):
this is something that you know ina lodge. Northeastern Medical Center has really
been embraced. I mean people arelike, we need to understand this.
This is actually what we're trying toget at, Like we need to know
what that relationship is. And it'sbeing driven by Margaret Newman's theory and the
work that she had, the preliminarywork that she did and then the testing
of the tool and all of thatwork, and people have embraced it.
(35:17):
And she was presenting to a groupof physicians and it was incredibly well received,
like this is something we need totout, we need to let people
know about this. So I thinkwhat we have is a theory that blossomed
I think in a small core,but not necessarily out there in a larger
world. And I think the Centerreally allows this to get out having it
(35:37):
be centered somewhere where this is theplace where you can come to understand this
theory and how do you then takethat out. I think that was the
exciting part of the dialogue is thatwe kind of said what is the future
and we did talk about I meanmany ideas, but one of them being
that this would be the center thatpeople would come to to learn how to
do this. The scholars and theadvisory panel would be available to help people
(35:58):
work through that. Since that dialogue, I've been contacted by two people to
say, I'm interested in this,would you be willing to talk to me
more about it? So it generatedthat and I think that that's really what
we hope to have come out ofthe center. So I think that the
idea that you know, by wordof mouth, someone might be like,
this is what I wanted to do, but I don't have anyone who can
guide me. That's fine. Andthen it can be a center for helping
(36:21):
nurse educators who really probably miss thisas part of their education to be able
to then learn about it, cometo the center and learn about it,
and then to be able to thengo out and teach it. When I
introduce this to my students, thisyou know, it is always kind of
going back to Maggie's original comment aboutthe lens. It's almost they see clearly,
like, yeah, this is whatI want to do, and then
(36:42):
they sometimes divert down paths of likewhat's fundable and what's what's going to advance
my career fastest, and how doI do this? So sometimes I lose
them and sometimes I win them back, but it is it's an ongoing challenge
because there are these almost competing ideasabout what nursing is, and I think
some of the issues get into what'sfundable rather than what's meaningful, and then
(37:06):
how do you build on what's meaningfulto then make it fundable? Right,
So I think that that becomes reallycritically important and help guide people because it's
a lonely journey. Sometimes if everybody'sdoing I'm going to check A one c's
and I'm going to see if Ican improve those. But there's not really
clear why it was a nurse asopposed to anyone else. You know,
it could be done by artificial intelligence, I think sometimes so I'm not so
sure that there's a role in that. But if there's about a dialogue,
(37:28):
you can't take a dialogue, youcan't put that in artificial intelligence. So
there's a role from nursing because ofthe dialogue and the basis of this theory
that really gives us a future.And having u s C be the center
for that where people can come andlearn, develop and grow just as incredibly
exciting to me as far as afuture. And I think that we had
many ideas that came out of that. Definitely it being a center is one
(37:52):
of them, and I think wecan grow that. I think that's awesome.
As far as funding goes, thereare so many opportunities. As you
were mentioning, or maybe it wasdoctor Gil social determinants which I like to
call drivers more than determinants, butthat's not what they're called, but those
drivers of health. There are somany funding opportunities now coming out for those
(38:13):
drivers of health. And you're sayingwe as nurses, and this theory touched
on that or was ahead of itselfand bringing that to the forefront those issues
to the forefront. Absolutely, Iagree, I mean it was, It's
definitely something. I mean when wetalk about the idea, I think we
alluded to this earlier about expanding consciousnessand what that means. We've talked about
(38:35):
this at the dialogue. You know, I think Margaret has been criticized for
like, you know, consciousness that'sin the mind, and it's you know,
she's it was never in the mind. It's much bigger than that,
you know. So just like justthose cool concepts of what the theory actually
means, I think can be challengingfor people, but I do think it
does guide us. It gives usa future in a direction to go.
And to your point about social determinantsor social drivers, I think we need
(38:59):
to say what we mean when wesay what we say, and how can
we be clear about what nursing's roleis in that? And we've always had
it, but we don't always havethe language. So this sent to be
in a place where people can developthe language and the ideas and almost have
a support network for moving forward withit. I think is going to be
critical. Doctor gill as the directorof the Newman Center for Nursing Theory,
(39:21):
what priority projects have you identified asa result from these dialogues and what's the
approximate period for implementation for those?Well, Lisa, I had so many
wonderful ideas that were generated during thedialogue, and from that information I came
up with the next priority projects interms of also working in conjunction with the
(39:45):
Advisory Board, and I constructed fivepillars that kind of broadly speak to the
recommendations that came out of the dialogue. So I'd like to take some time
just to go over those things.Some of the priority projects were already part
of the strategic plan for the center, but then some of these projects are
(40:09):
new, and so I do havea timeline attached to most of the projects.
However, I understand that projects ofthis nature sometimes simply take longer than
we expect, so trying to doas best as I can with anticipating the
timeline. The first pillar is inregards to the Newman Library and Resources,
(40:35):
which I've already have begun that workstarting, oh, I guess as early
as shortly after I've arrived in thisnew position back in October of twenty two
and then into January started working witha lot of this work in regards to
the Newman Library and Resources. Soone of the things we really talked about
(41:00):
out was continuing to work on thedigital library of the Newman Archive collection.
The archive collection, which is housedin the UTHSC Library, has about I
believe approximately fifteens cubic fifteen cubic feetof information of different items in the collection.
(41:25):
The collection is managed by Jennifer Langford, who is the archivist, and
I also help in that process ofmanaging the collections. So the digital library
is something we're building right now andout of doctor Newman's collection, which there
(41:45):
are oh, let me see ifI can name thinks. There are recordings
of her presentations and lectures. Thereare a number of published and unpublished manuscripts,
some of her initial grant proposals andresearch proposals, a lot of letters
(42:06):
that she's had for correspondence with others. There is a collection of photos,
art, and a very large andI say very large collection of books,
and efforts to get all of thisdigitized. Some of the items won't be
able to be digitized, so theywould be available to people who want to
(42:30):
come directly to U THHC and gointo the archive and begin to explore and
learn, maybe even to conduct research. This is something we could make plans
for people who are wanting to geta first site view of all of these
items, but otherwise we are strivingto create this digital library and have it
(42:54):
accessible to the public so that manypeople can have access to Margaret Newman's work.
The next thing we are working onas we digitize this library, which
there are many things already available,we are also working on creating more of
a full service web page expansion.We're looking to see what is the best
(43:19):
way we can expand this web pageand make it easily accessible. Another thing
that came directly out of the dialoguewas to create a newsletter, and this
newsletter would be about the center,about things going on in the Center,
about work with Health is Expanding Consciousness, and let that newsletter be something available
(43:45):
not only to our clinical partners locally, but also make it available globally so
that people can see what is goingon. Another recommendation that came out of
the dialogue was to gather a libraryof papers that have been published on Health
(44:07):
is Expanding Consciousness and studies that haveused Health is Expanding Consciousness, as well
as dissertations that were led by Healthis Expanding Consciousness, and to assemble this
as a library, but then totake it one step further by inviting other
HEC scholars or others who would beinterested in doing a content analysis of these
(44:32):
works to identify gaps, things thatwe would want to look at as we
move forward, and also just tosee the theme of what these works have
been about. The next pillar ison scholarship and research, and so the
scholarship and research has already in essencehas begun, but I have claimed this
(44:57):
to start in the fall of twentythree. In addition to podcasts and papers
and blogs and things of that nature, we are looking to do something called
demonstration projects. And the demonstration projectsare really to look at or examine healing
of patients who have chronic pain andlooking at chronic pain management, and also
(45:23):
increasing or looking at the well beingof people with chronic disease. So this
particular recommendation came directly out of thedialogue and in those there are a few
that were mentioned, so I wouldlike to talk just briefly about them.
And this again is in the infancystage. We're just now beginning to look
(45:44):
at how we can proceed. Oneof the projects, the demonstration projects,
would be using Helvis Expanding Consciousness andpartnering perhaps with the Veterans Administration here locally
in Memphis to look at the impacton veterans well being. And so this
(46:04):
would be a demonstration project that wecould maybe take place on a dedicated education
unit, maybe regarding spinal cord injuryor others. Really, there are a
lot of options if the interest isthere to proceed. Another area is with
our sickle Cell boot Camp. Sowe already have a center for excellence in
(46:28):
our College of Nursing regarding sickle cell. We are looking at possibly a demonstration
project there with patients who have adiagnosis of sickle cell. Another area is
also within our Centers of Excellence,and that is with the HIV clinics.
We have a faculty on here whoare working in those areas and who do
(46:51):
research, and so there's an opportunityfor that. And then finally we talked
about one of our newest projects forthe College of Nursing, for which of
course Lisa is a part of,and that is the Mobile Health Unit,
which is looking at giving care toothers who live in rural areas and the
(47:14):
possibility of perhaps involving a health isexpanding consciousness approach or approach to looking at
how that care is delivered. Thisparticular unit, which I know you could
talk more about this, Lisa thanI, but this particular unit will be
staffed with nurse practitioners. There willbe students from the BSN program, so
(47:40):
we'll have undergraduate students who will havegraduate students who will be nurse practitioners students.
And this is a wonderful unit thatwill be headed to some of the
most underserved counties in the state ofTennessee. So we don't know there are
some options there that maybe to consider. The next pillar is the collaboration and
(48:02):
education with help is expanding consciousness,and I think both Jane and Maggie have
already mentioned that in Japan there isa large network of a healthless expanding consciousness
society of scholars who already have usedhealthless expanding consciousness in their work. And
(48:22):
my hope is that the center herein Memphis can do some collaboration with the
wonderful work that these Japanese scholars havealready undertaken, and they can give us
some guidance on ways that we couldperhaps move forward with further collaborations. We're
(48:43):
looking at collaboration and education with ourCollege of Nursing faculty and staff, and
that has already started. So justshortly after we had the dedication of the
Center for nursing theory and also thedialogue, the HC Dialogue back in May
(49:05):
of twenty three. On May thirtiethand thirty first, I started setting up
meetings with faculty and staff to talkabout the Newman Center and talk about healthless
expanding consciousness and tried in my bestto present the theory in a way that
was practical. And as we've alreadymentioned, the theory itself is complex and
(49:30):
yet simplistic, So how does onefind that to find that line of how
you communicate that? So my effortsare to try to get information out to
our faculty and staff. We arealso looking at developing a Margaret a Newman
Recognition award. So I think thiskind of goes back to what you were
(49:53):
mentioning earlier, Lisa, about sometype of an award. Now what that
looks like, I don't know,but with guidance and assembly of a team,
we could come up with some ideasaround that particular award. The next
pillar is the curriculum integration, andthis would be curriculum integration for theory and
(50:15):
theory related concepts planned for the fallof twenty three through spring of twenty four.
Now for listeners who are familiar withthe AACN, you already know that
the aacn's New Essentials has outlined oneof the standards to incorporate or integrate theory
(50:37):
and theoretical concepts across curriculus. Sothis particular pillar was already part of the
strategic plan that the center will beinvolved with moving forward. And then finally,
the last pillar is the Summer Institute. This would be the Healthless Expanding
(50:58):
Consciousness. Summer Institute hopes to startlooking at developing this in the fall of
twenty four. So Jane already spoketo this just a little bit, and
I'm so glad you mentioned it,Jane, because this is a grand opportunity
to set up an experiential learning environmentfor people to come and learn more about
(51:21):
how to use health is Expanding Consciousnessin practice particularly, but also in research
to learn more about theory appreciation,nursing theory appreciation, nursing theory development,
and nursing theory evaluation, for whichI would invite guest theorists to come and
(51:43):
speak about different theories, but withan emphasis on health is Expanding Consciousness.
So the Summer Institute would be moreof a training and immersion type of activity,
So, Lisa, I think thatkind of sums up some of the
next priority projects. I guess youcan tell by the explanation that we are
(52:05):
going to be really busy and havea lot on our landscape. And I'm
so grateful that I don't get todo this by myself. I have wonderful
teams, wonderful links to scholars whoare so supportive, and honestly, I
can't wait to see what happens next. In consideration of all the possibilities.
(52:28):
As we've been talking, the mobileHealth Unit and what we're doing out in
these areas came to my mind beforeyou even mentioned it. I thought there
has to be a way to makethis connection with those folks out in those
rural communities that we're serving through thismobile health unit, and it's really an
exciting thing that we're doing. Whatother last thoughts do you have, Doctor
(52:53):
fair as, doctor Flanagan and doctorGil what other last thoughts do you have
about dialogue and maybe even doctor Newman'stheory. I just think this is it's
exciting because I think what we've talkedabout is that it's been three years of
really a tough time for nursing andpeople in general, and this coming together
(53:13):
was like a reunion and also awelcoming to those you know, who were
excited and wanted to be a partof this, and welcoming to even those
who couldn't make it. And Ithink we really have a place to go
now. And I think it's reallyon the cusp of like just that tip
of excitement just to be able tobe able to move forward and see where
we go with this center, andyou know, relisted many different ideas that
(53:34):
we can begin to work on.It's exciting. It's exciting to be able
to be at the forefront of this, to be I have this center that's
dedicated to this through Margaret's generosity,and just what a welcome thing for nursing.
It's really going to be an opportunity. I'm really grateful for this time
to think about the potential of dialogueand encourage listeners to think about their own
(53:55):
situations and the context within which theywere and where there might be a potential
for dialogue to get them to anew place in terms of care delivery.
I also, as we've been reflectingtogether and thinking about the power of the
story of the many studies that havebeen done using Margaret's theory of health is
(54:15):
expanding consciousness and would hope that listenersand am excited that there will be a
summer institute where people can come togetherand learn from other folks about the power
of this theory to transform people's lives, people who are facing health challenges,
to be able to see new potentialin the way they're moving through times of
(54:40):
challenge, and also for communities tobe able to reshape. So thanks for
this dialogue at least coming together andbeginning to think about what we could do
in the future. Absolutely, absolutelythank you all for being here. Doctor
gil I think I don't know thatI that Margaret Newman would be hopefully excited
(55:04):
about what's happening, and that shewould maybe urge us on to continue to
develop her theory, like I don'tthink she intended it for its just to
stop where she left it, andI think she would be excited to hear
of the interest and what the theorycould do for nursing. I know that
(55:27):
in my reading and studying about helplessExpanding Consciousness, I came across something of
that when Margaret Newman was talking aboutconsciousness and helpless expanding consciousness she said that,
and I'm not quoting, so Imay not get this exactly right.
She said that love is the highestlevel of consciousness. And I thought,
(55:51):
Wow, what a great time forus in nursing and in healthcare to think
about the concept of love and caringand what that means to our profession,
what it means to us as adiscipline, and maybe kind of returning to
that type of thought. And Iknow that nursing does not own caring.
(56:16):
You know, certainly other disciplines arepart of caring, but caring is foundational
to nursing practice. And so Ithink that the Center will be a place
where these thoughts can grow and beable to be shared globally and have a
(56:40):
large impact. So I'm excited onceagain about the possibilities. Thank you all
for being here today. Again.My guests have been doctors Marie Gill,
Jane Flanagan, and Margaret Maggie Ferris, and we've been talking about dialogue and
its importance and doctor Margaret new Men'stheory health as expanding consciousness. You've been
(57:02):
listening to the That's Helpful podcast withyour host, doctor Lisa Beasley, a
family nurse practitioner and healthcare advocate viewsexpressed on this podcast, or the views
and opinions of the hosts and guests, and are not affiliated with any facility
or institution that may have been mentionedin this episode. Dshelpful dot com.
(57:22):
For more information or to hear priorepisodes, follow at now Helpful on Twitter,
and That's Helpful on Facebook and Instagram. Like or comment on an episode
wherever you listen or screen your favoritepodcasts. Music for this episode it's provided
by local memphissinger, musician and songwriterDevon Yennik. For more of Devon's music,
(57:44):
visit Devin Music dot weebly dot com
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