Professional Presence and Influence

Healthcare, and Medicine is advancing more and more each day. As healthcare workers, our understanding of health and healing has improved and changed in the way we care for our patients. Dossey believed in the three eras of medicine. Era 1 began in the 1800s and its focus was solely on the body. The belief that healing and overall health are totally physical. The therapies and treatment were either medications or surgical procedures. The thought that healing all humans based on bodily functions, and how they can be treated will change as time changes. Era 2 began in the 1950s and it focused on the mind and body. Health care providers realized that

Two of the three models of health and healing discussed by Dossey (1999) were Era II Body/Mind Model of the 1950s and Era III Body/Mind/Spirit Model of the 1990s. According to Dossey (1999), post World War II the Medical Doctors noticed that there was proof that the functioning of the human body can be affected by other factors such as stress and emotions which, can lead to diseases such as ulcers and high blood pressure. This model brought to light the realization that treating the human body is complex because when the physical body is not well the mentation of the patient is affected resulting in exacerbation of other

A2. As I discussed above, there are different models of health and healing after which we have patterned our care and practice. Dr. Dossey (n.d.) wrote about three models or Eras, and how the understanding of health and healing, and the practice of medicine, has developed and changed over the last several hundred years. Although Era I was a very important time of medical growth when dealing with the physical part of our human body, I feel that Era III has brought a much more complete way of helping the patient reach a higher state of health and wellness.

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).

Physical Body is centered primarily on the physical facet of health such as drugs and surgery. The mind of consciousness is likened with functioning. Bio-psycho-social is centered more on consciousness. Physical Body focuses predominantly on the human as a Physical Body and what can be done to fix it physically. Bio-psycho-social states that the mind is unlimited and boundless. In Bio-psycho-social the understanding came about that a person’s mental health can affect their physical health as well as the health of other people around them (Dossey).

• “Guardians are concerned citizens who trust authority, join groups, seek security, prize gratitude, and dream of meting out justice”

What does it mean to be human, and how do we as nurses provide care to our patients? According to Jean Watson “The future of nursing is tied back to Nightingales sense of calling guided by a sense of commitment and covenantal ethic of human service; cherishing our phenomena, our subject matter and those we serve. It is when we include caring and love in our work and our life we discover and affirm that nursing, like teaching is more than just a job but a life giving and life receiving career for a lifetime of growth and learning” (Watson, J. 1978). There have been many different

A1. Models of Health and Healing- The candidate provides a logical discussion, with substantial detail, of the differences between 2 models of health and healing as they relate to what it means to be human.

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

Nursing care was unscientific and consisted of assisting patients with usual body functions; and was typically administered by women of a religious order or by women who by nature of their lifestyle frequented hospitals. Hospital care was for the poor and destitute; since home based medical care was better than risking additional infections in the dirty, crowded, and disease-ridden hospitals. During the typhus epidemic of 1852, hospital staff and patients suffered the greatest morbidity and mortality. (Ranade , 199817-19)

Professional presence is something of a nebulous concept. Before this course, I honestly never considered what it was and how my nursing practice was defined by it. During my journey through this course I discovered what it truly meant. “Presence is an intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to spend her/himself on the patient’s behalf’’ (Wingate, 2007). Presence defines how a person interacts with those around them, and particularly in the healthcare field, it’s incredibly important.

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).

One aspect of nursing that has changed since the early 1800’s is nursing education. There was no question about the credibility of the women providing care to soldiers after the war. For many years untrained nurses and consequently nursing students cared the sick without any supervision. In 1873, the need for educated nurses was sought but was opposed by untrained physicians who thought trained nurses would pose a threat to their jobs (Gary & Hott, 1988). “Nurses have evolved

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

It was the twentieth century when two-thousand hospitals were put up in the United States. After the wars ended, there were few nursing jobs because of the large number of nurses. As a result, nursing became an “honorable profession,” which required college degrees. Technological advances were well thought out and processed as nursing began to thrive. People began to study an environment in which the sick healed. Scientists and doctors developed a routine that would help them study the human body more precisely.