Page 194 - Nursing: The Philosophy and Science of Caring

a dmi ni st ering sacr e d nu rs i ng a ct s
tread on country lanes and city streets. Their route is our life’s
course. Now they are waiting for us, there, by the bed, a silent but
futile invitation. The faces with which they look at me completely
explain my condition; I no longer belong to the life which nonethe-
less is still mine; my street, my road, lies outside the horizon of my
existence.
(reprinted from J. h. van den Berg, Psychology of the
sickbed [1966]:23–35. By permission of duquesne university press.)
Van den Berg’s existential experience helps us grasp the subjective
experience of a person undergoing a change in activity level as a result
of sudden illness. A change in activity interferes with the person’s
ability to meet basic needs, to engage in daily living experiences and
activities that are taken for granted. Such existential understanding of
the transformation that occurs when one’s activity is restricted and
the person is confined elicits a very reflective, if not contemplative,
view of the world, in which everything is heightened and more acute.
Nightingale wrote about the importance of the nurse being aware of
and attentive to small noxious stimuli such as noise, smells, and so
forth, those forces that press in on someone. When one’s experien-
tial-subjective senses are confined to the sickroom and aroused by the
intensity of everything slowing down, everything comes into sharper
focus, to the extent that the smallest things begin to take on more
significance.
Such changes lead to the need for help from another, a subjective
and realistic vulnerability of having to be dependent on someone else
to meet the most basic functioning required for moving through the
day. When these changes occur, the person is likely to become occu-
pied with meeting his or her needs and possibly imposing on others in
an embarrassing way. Thus, the activity-inactivity need is existential,
complex, and often confusing when altered.
In reality, a person is embedded in a relationship with his or her
environment, with nature—with “the beauty of the forest, with the
sea, the light, the sky” (Martinsen 2006:136), the mountains. With
respect to the activity-inactivity need, one is connected not only with
nature but also to place, including architectural space and furnishings
that surround the individual, especially when considering the sickbed.

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