Professional Presence And Influence On Nursing Practice

Society has progressed both socially and technologically as has medicine. This includes our understanding of health and healing as evidenced by Dossey’s three eras of medicine. Era 1, beginning in the 1800’s, reflected the prevailing view that health and illness are totally physical in nature and therapies included surgical procedures and drugs. Era 2, starting in the 1950’s, related to the mind and body. Practitioners began to realize that emotions and feelings can impact health. Era 3, still developing today, began in the 1990’s and builds on the previous eras by adding the spirit and proposes that consciousness is not confined to one’s

Dr. Larry Dossey has recognized three major periods in the history of medicine: Era I medicine (mechanical medicine), Era II medicine (psychosomatic medicine), and Era III medicine (nonlocal medicine). Era I "mechanical medicine" and which started approximately in the 1860s, reflects the prevailing view that health and illness are completely physical in nature, and so all treatments should be physical ones, such as surgical procedures or drugs. In Era I, the mind or consciousness is fundamentally equated with the functioning of the brain. Era II started to take form in the period following World War II. Physicians began to realize, based on scientific evidence, that disease has a "psychosomatic" aspect: that emotions and feelings can influence the body's functions. Psychological stress, for instance, can contribute to high blood pressure, heart attacks, and ulcers. This was an extreme advance over Era I (Dossey, 1999).

Throughout the years there have been various theories and models regarding nursing and healthcare. Doctor Larry Dossey (1982) identified three “Eras” of healthcare as the structure for healthcare in the Western world. Two of which are the Mechanical Model also known as Era I, and the Body/Mind Model known as Era II. Era I began in the 1860’s, the model reflected the view that disease was purely physical in nature and that physical interventions such as medications, surgical procedures, or bloodletting were required to promote healing. Consciousness, thoughts, and beliefs were not considered to be factors in healing but merely side effects of the facets of the

The term environment, as it relates to the metaparadigm perspective, is a multilayered view that can explain the understanding of an individual’s perspective (McEwen & Willis, 2011). More specifically, some may believe the environment related to the nursing profession encompasses any setting in which a therapeutic interaction can occur; that is, a hospital, clinic, nursing home, school, corporation, or home (Tourville & Ingalls, 2003). According to McEwen and Willis (2011), however, this perceived way of identifying the environment only limits its domain by making it fixed, uncompromising, and natural. Although the specific setting in which care disperses is vital to understand the nursing discipline, it is not the only factor influencing the phenomena. Internal and external circumstances are a part of one’s environment, and both play a vital role in identifying and altering one’s perspective and philosophy related to the nursing discipline (McEwen & Willis, 2011). Individuals, such as family members, significant others, and lifelong friends that one interacts with also influence

Professional presence is an analysis of our past, present and future. It is a construct of our knowledge, our influences, our self-awareness and practices. It comes down to how each of us understands what it means to be human and how to care for one another. This is always evolving based on new experiences and knowledge. Through looking over time at the view point of humans, to personality tests, to personal development and lastly looking at optimal healing environments this paper will construct my professional presence and look at ways to improve my ability to care for others.

Inside the body the disturbances are twofold: (a) the relationships between and among the various body parts and biochemical processes; and (b) the relationship between the mind and the body. Outside the body, these relationships are also twofold: (a) the relationship between the individual patient and his or her environment, including the ecological, physical, familial, social, and political nexus of relationships surrounding the patient; and (b) the relationship between the patient and the transcendent.” (Sulmasy, 2002, p.26)

The newest and most recent of Larry Dossey’s Eras is Era III which took shape in the 1990’s. Era III is considered the body, mind, spirit and biopsychosocial model. In this model Dossey explains that healing is not only on a physical level but a conscious level. Dossey states “Consciousness is not confined to an individual body, an individual mind may affect not just their body but also other people around them” (Dossey,L. nd). The Eastern models of TCM (Traditional Chinese Medicine) and the Ayurvedic beliefs about being human and caring for people are similar to Dossey’s theories. These theories underlying belief in how to provide care are the body is made of 5 elements and disease is caused when there is an imbalance between the elements (“Traditional Chinese Medicine: In Depth & What is the Philosophy of Ayurvedic Medicine, nd).

Era II is known as the mind-body model. This model was developed in the 19th century. It is believed to have conscious thought that assist in healing the body. “"Psychosomatic" aspect: that emotions and feelings can influence the body's functions.” (Dossey, n.d., p. 1). With

1)Era I (Physical Body) is based mainly on the physical aspect of health such as “surgery and drugs”. “The mind of consciousness is equated with functioning”, Whereas Era III(bio-psycho-social) is based more on consciousness.

Hospice care is a model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less (Altshuler, 2013). For most nurses, caring for a dying elder (individual aged 65 years and above) is a discrete, time-limited experience that begins with first contact, often in a hospital, emergency room, or long term care facility, and ends with the death itself (Phillips & Reed, 2008).

1. Era I – “Mechanical Medicine” began in the 1860’s. Its focus is on surgical procedures and drugs. The thought was that health and illness are only physical in nature and consciousness is equated to functioning of the brain. Era I thinking in displayed in review of psychiatric care in the early 1900 with the use of frontal lobotomies to cure hysteria. The thought was that performing a surgical procedure on the brain will remove the area that is causing the Hysteria. Era I focuses on performing a procedure or providing a medication to fix the body physically, while Era III takes into account the patients perception of health, their stats of mind and their support

            As electronic health records, have been a former nursing present transition, medication list equally compare in a transition as medication reconciliation is addressing preexisting medications that are no longer being taken by the patient, removed from the patient's medication list. The development of medication reconciliation is becoming the up and coming push to obtaining patient medication list accurately, precisely, and safely beginning in outpatient settings.  Similarly, nursing presences theory supports direct nursing practice to improve direct patient care, safety among medication treatment, as well as engagement to providers with patients (Presence in nursing practice: a concept analysis,

Thesis: The mind-body problem arises because of the lack of evidence when looking for a specific explanation of the interaction of mental and physical states, and the origin and even existence of them.

This essay seeks to identify and analyze a concept of nursing, specifically presence, that has helped Joyce cope with her hospital experience and what environmental factor influenced the student nurse and the medical team that enabled them to care for Joyce.

The belief that we are more than our body-mind experiences is an ancient belief dating back thousands of years. As a by product to this belief, ancient traditional medicine emerged focusing on treating the whole person; body, mind, emotions and spirit. This ancient science also speaks to the power within each person to effect change in their personal life and surroundings. This gives rise to the idea that we can heal our self. However, in order for this to happen, we must embrace a new learning, requiring us to question and investigate our current belief system, to determine if it is serving our highest purpose and best interest. Most of us are locked into beliefs, perceptions and judgments, without considering the existence of