Page 189 - Nursing: The Philosophy and Science of Caring

a d m i ni s t er ing s acr e d n u r s in g ac t s
Both action and nonaction are important for balancing one’s
energy with the environment. Just as breathing in–breathing out,
expanding-contracting, are balancing with one’s breath work, the right-
relation of work-play, action-nonaction is also necessary.
The nurse is often in a caring situation in which changes in the per-
son’s activity-inactivity levels can be observed, altered, and improved.
Most interventions in this area are within the nurse’s realm of autono-
mous professional practices and clinical judgments. Changes in this
need are built into the patient’s plan of care, as they affect the person’s
healing, balance, coping, and energy balance. Whenever anyone is ill,
weak, or hospitalized, there are changes in this need. Even if the per-
son’s previous tolerance for activity may have been high, engaging in
the same activity in the hospital may require more energy.
Sometimes the patient and the nurse have different perceptions
about the extent of change in activity that is necessary to promote self-
regulation, health, and healing. Sometimes adults and children go to
extremes to demonstrate to themselves and others that they are nor-
mal and that this need is not affected by a given diagnosis or condition.
For example, a friend who had chronic coronary heart disease insisted
on playing vigorous games of tennis and continued to ski almost daily,
even though he was aware of his diagnosis and the threat it imposed to
his usual sporting activities. Indeed, he wanted consciously to live life
to the fullest, even with the threat of heart attack and death, which is
what he did as long as he could. He did eventually die of a heart attack,
but it was as if he chose his mode of death and his style of living
beyond advice from health professionals. Thus, this need, along with
others, is tied up with the free will and behavior of individual patients
as their meaning of living and dying. How to live a good life without
restricting oneself is a philosophical, spiritual, and reality decision for
each person, even at the risk of sudden death.
Any change in one’s activity level necessitates a change in percep-
tion of the body’s tolerance for activity-inactivity. Decisions are ulti-
mately freewill choices on behalf of each individual. Health profes-
sionals can advise, educate, coach, and even physically assist with this
basic need, especially when the person is dependent and undergoing
hospitalization, incapacitation, and so on, but the level of activity-

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