Margaret Newman’s Theory: Health as an Expanding Consciousness
(A Personal Resonance)
Grace Sunga Asagra RN, HN-BC, QRA, MA,
Originally written in Nov, 2005
Revisited in July, 2019
The definition of health and nursing practice had been used and abused for many years. The realities in the present health system from dissatisfaction of patients to burn out of healthcare givers particularly nurses mirrored the contradictions and confusions in the old health paradigm, and brought out light and clarity that redefined health as is in relationship to a bigger, more dynamic and universal concepts beyond what we can perceive.
At the point that the practice of nursing had been standardized, the various respectable nursing theorists coming from different backgrounds and orientation contributed to the birth and evolution of Holistic Nursing.
Florence Nightingale advocated the theory of taking care of a whole person. One is at the center of the interplay of different environments of culture, social, economic, and physical surroundings with the emphasis on cleanliness, music, and arts. Jean Watson’s theory evolved around caring as the core of nursing practice. She believed that caring and sensitivity must emanate from within one’s self before it can be shared with others; meaning, in order for a caregiver to care about others, one must care about himself/herself, first and foremost. As authentic caregivers, we are like vessels needing to be refilled in order to keep giving. There is that point that we have to stand still, in order to refill. That moment is precious and makes a difference in the quality of our services.
Martha Roger’s science of unitary beings considered the individual as a microcosmic energy in a macrocosmic field. No one and nothing is totally independent of, or excluded from another. Each energy field affects influences and merges as it resonates in the environment. The opportunity of merging allows interconnectedness and expansion of the horizon. A person is unique, whole, and a unit while being a part of a greater web of wholeness, uniqueness and unitary system.
As each nursing theory has been experienced form past generations to the present, the yearning for greater understanding and experience leads us to a particular theory that I relate to very strongly. This is Margaret Newman’s theory on health as an expanding consciousness.
What is it?
Moving from the old western perception, health is not perceived as a noun but as a verb. It is not a single dimension, instead it is multi-dimensional. It is not inert, it is moving. It is not fading because it is evolving. It is not before disease, nor after but in between. The emphasis is neither on the past nor the future. It is the present- here and now. It does not isolate. Instead, it allows one to belong. It is not a part, it is whole. It is not a dichotomy, it is a unit. It is not superstitious, it is dialectic. It is not “I” nor “You” but “We” and “Us”. It is not curing, fixing, changing, or adjusting. It is not a trouble free environment. It is not close but wide open. It is not impatient or limiting. It is limitless patience in the moment. It is not the path of most resistance that allows one to fight. It is the path of least resistance that leads one to surrender.
It is about moving forward from old perceptions of health as absence of disease and the practice of a nurse to be caught in the bind of a subordinate role to medical technology. Nursing in the new perception of health, has been evolving to take a stand on the totality – mind, heart, body, soul and spirit. It makes the transformation of the health experience possible. It is loving- kindness, mindfulness, compassion, humanness, inspiration, creativity and passion. It is non-judgmental and unconditional experiences. It is infinite wisdom in finite experiences. It is spirit.
What does it mean to us?
We are being challenged to open ourselves up and re-focus on our journey. We are invited to dance in the rhythm of healing, and that gives us and everything we do a meaning. To dance is to be in the experience. Sensitive to the notes and beats of the music; regular, irregular, high, low, on the beat, off the beat, syncopated and the significant silent pauses. One must be in harmony with the client as a dancing partner as well as with the collaborative staff of “musicians, singers and others” who are part of the health field that make the experience transcend from the “old rules” to the “new rules”. If we have to hang in there, we might as well embrace that, too. In due time, the disorganization and chaos will lead to the choice points of higher organization and order.
In the expansion of one’s consciousness, meaning health, it is viewed as encompassing the complexities of patterns unique to an individual but not separate from a universal consciousness that we cannot even fathom, Disease is just one outward manifestation of a pattern within the realm of a bigger. We look at disease neither separate from the individual, nor some kind of alien invading the body. Disease is just the tip of iceberg when looking at an individual’s pattern, which means information on how, when, where, why a person interact to one’s environment. All of us caregivers/ health care professionals have experiences that awakened us that made us look beyond what we see when we are taking care of our patients/clients/loved ones even if we didn’t not even consciously planned to do so.
Health is looked at regardless of health issues. A person in the worst debilitating situation such as seen in dying patients, those with chronic problems or diagnosed with terminal illnesses, that one is truly a part of the universal process of experiencing interconnectedness to one’s inner self. Tension, crisis, disequilibrium and all of those instances that we least want to experience are equally important forces that trigger and maintain an active interconnection with the environment that allows us to explore growth and transformation.
Everything and everyone that comes across our path is in every way, in any form, and at anytime are meant to teach us or be a source of learning. What makes a difference is how we intend to see, think, feet and act on it. Life has a way of teaching us that we cannot control everything but we can surely control how we respond to everything. Instead of us putting so much effort in changing others, we can spend that energy on us and sooner or later.
How does it unfold?
Intentions make a difference in our care for us and others. The nature of our intentions has a significant role on how the process unfolds. If it is founded on loving kindness, compassion, caring, full presence and openness, truth evolves. If our intentions are not in harmony with the wisdom of life, we will find ourselves in a lot of surprises as we perform our responsibilities. We have to remember not to hold on to the outcomes even when we are trained to have goals and use measurable outcomes to determine failure or success. Our intentions are not the same as goals. Our intentions are not all measurable. They are not the goals, but the springboard for the goals. We may or may not accomplish goals remembering that there is more to what meets the eye. Holography proves that there are no limitations to our perceptions.
Nursing practice, health practice, and shall we say life’s practice, in general, is a way being. It is not the destination that we have to focus on but pay close attention to the how, to the process, to the unfolding that takes place in every moment. All we have to do is give our full presence and return to our hearts and our spirits.
The state of someone’ health provides a moment to reflect and ponder on a lot of issues for the patient, family and staff. In the practice, it is crystal clear that the nurse is not just a provider of therapies, but a facilitator of the unfolding. The nurse is in the environment t, part of it, and yet whole, independent, and yet interdependent, evolved and still evolving. In yoga practice, it is always emphasized that is not the pose that makes yoga practice but how one goes into the pose that makes it a practice. In any level of yoga practice it surely calls one to be fully in the moment. It calls one to accept realities of the body, not to fight it and graciously make the most of the body’s limitations and potentials seasoned with compassion, contentment and balance. Our state of health does not lie to us. We can manipulate it only to some degree. Our compensatory mechanisms, physical or mental, may be our temporary defense, then it reaches its potential to flash realities right in front of us. These are the realities that we have no choice but welcome all – choice or no choice, action or non-action, favored or not favored. We have to practice being present in all our waking and sleeping hours. Whatever rises in the process is always fresh and is the essence of realization for all that is in the health environment. Our role is not to alter it and simply allow the process to flow.
Hurricane Katrina disaster is a good example on health as an expanding consciousness. Within the history of Mississippi River he entire environment (people, nature, politics, economics, culture, values, etc) and its inter and intra-relationship[s to the bigger environment, especially the present disaster, resurfaced a lot of denials, misdiagnosis, prescriptions of bandaging, hatreds, fears, attachments, ignorance, poverty, unemployment, lack of education and other realities that individuals and we as a nation tried to bury. In time, crisis is bound to re-appear in order for healing to take place. We may not like the way it emerges but it is what it is. It is always shocking when the painful process is happening in our own backyard,. We have witnessed how strangers can come together and help one another. It is time to health the wounds buried deeper than the cellular spaces. It is time to face the music. In music harmony, timing is crucial.
When is the right time?
Customer surveys reveal caring as the missing factor of services based on the old paradigm, of health. Recently, there is an ongoing movement of caring consciousness that fuels the hospitals’ desire to be competitive with other institutions. Money is poured out for advertisements and promotions to depict excellent caring services. Educational programs for excellent customer satisfaction are increasingly offered, if not mandated, to staff. Health institutions are trying o impress and imprint “wow” the patients in order to de-stress the process of illness, treatment, procedures, and other related logistics. The irony is that not a lot has valued and acted on programs to “wow” the staff. Timing is everything I suppose. However, survey or no survey, the fact remains that experiences in healthcare are always unfolding everyone’s consciousness. It is a continuing process. As progressive nurses, the healing environment in which we are part of needs our involvement. We cannot be waiting for others to solve our problems. If not us, who will?
Long before one is conceived, the pattern is already in motion. This pattern encompasses the genetic traits of looks, voice and other external manifestations that precede a deeper pattern of relationships, ongoing organization and unfolding consciousness.
The evolution of consciousness exists in the inanimate objects, human beings, astral and spiritual beings. All creation is in constant and instantaneous contact. Our realities are not the same with regards to our timing of expansion. Before we can go to the highest vibration of consciousness, huge fluctuations, and wave have to appear. We can courageously surf those waves unless a tsunami of cleansing occurs before renewal appears.
Disease or any crisis is taken as opportunity for growth, transformation and transmutation. Expressions like: “When it rain, it pours.” “There’s rainbow at the end of the storm.” “There’ s light at the end of the tunnel.” , clearly describes the pattern of health. In order to create order in our closet, we create disorder by pulling things out of our closet, throwing unnecessary or outgrown resources away. Illness, poor health or whatever you call it triggers us to re-think many issues that are beyond our physical needs. In many ethnic cultures, having a chronic illness is definitely a pattern of one’s spirit needing attention. The ill is attended to bty a respecetable elder who is both a medicine man and a high priest. Today, we call for a doctor only for physical reasons, mental reasons or emotional reasons. Let us take notice though that doctors coming from western medicine perspective only are good for critical conditions but we need a lot more other health professionals inclusive of integrative medicine in their orientation and approaches health when it comes to chronic conditions. We seek for a priest, minister, or a rabbi for spiritual reasons. Many times, when, when a patient starts to “act out”, a medicine is given without considering the option that the patient may just be in need of talking to someone. Our interactions with a patient actually become a guidance to reveal the deeper patterns. To accomplish this, we need to put patience into practice. The turtle medicine has a lot to teach us.
What we see in a patient is nothing but a set of information within a system. The patient sees the same thing with us. We all carry underlying patterns that oftentimes we do not want to recognize. If we do, then we are loaded with information that could allow us to facilitate the process of one’s health unfolding. Not just the patient but anyone involves in one’s care at any and every given time. Being in the moment, the here and now, is often the best time to discover realizations intended for us.
Who is in motion?
What makes this theory powerful is that a nurse can make a greater difference in how the consciousness of pattern unfolds. It is foremost that there is the necessity of knowing one’s own pattern in order to enable one to assist responsively. We are blessed that in this profession we can be like water. We can be in the experience but not of the experience. We can transform in any environment. We can be still and let our breaths do the work in the process. We may notice that we breath in and breath out but there is that moment that there is a brief gap that nothing seem to be happening but who knows, that is the possibility that something is happening to help us in our mindfulness practice. We can be like birds – great observers from a distance but not separate from it. We can look keenly at the horizon and figure the maze or puzzle of life.
We can master our sense to help us empathize and experience, pour own unique, authentic wholeness. Whether it feels good to us or not, we have to listen even when there seems to be nothing in which to listen to. We have to see even if there seems nothing to see. We have to smell even when there seems nothing to smell. We have to speak words of love and truth even if it brings tears. We have to touch and feel with compassion and intuition. We have to taste bitter, sweet, pungent, sour, spicy, hot and cold experiences as we glide in openness. Above all we have to acknowledge our inner knowing and surrender to its outcomes. All of these are endless opportunities for us to share love. Everything and everyone is infinitely in motion.
Where does it lead us?
In this day and age of cost-reduction, being patient oriented is constantly pounded on us. It is all good if we take in into the context that it is not the perceived goal of care that’s emphasized but the process of meeting the goal. In between, we have to explore the meaning that gives the health, which give s us life. If it is not met, we must patiently stay in the interaction and wait for the pattern to emerge. This is where the nursing paradigm of no separation of parts dances. As the elders say, the journey is more important than the destination. How we go through all the experiences contribute to the unfolding.
This theory gives us enthusiasm and empowers us to look into the meaning of life, what it means to render unconditional services, and how we are all interconnected. When we, as caregivers, can fully experience the realities of other people’s realities, then the joy of being in the process makes it easy for one to move through and on.
In this era where we are constantly trying to prove things or experience to make everything more scientific, I have learned to appreciate more and more the authenticity of ethnic cultures around the world. Within these communities, their elders and/or healers have been practicing intuitive understanding, a topic that’s been researched in quantum science, socio-cultural and other fields of human interests. As it states, “There is really nothing new under the sun and nothing old under the moon.”
May it be a nurse or the client, what and who is the matter with you, must be addressed. Eventually, the unfolding leads us to gratitude as we experience finite emotions of infinite discriminating wisdom. How blessed can we be!
Why unfold consciousness?
The bottom line is to be in the moment and submit to stillness of the body and mind. In the non-stop monkey mind thought process that we have, there is the opportunity to slow it down and to notice that there is the gap that may seem unnoticeable unless we seek to notice. It’s where one must go through, then swim with the tide and be free. We can let go of being a fixer. Yes it is okay to be organized, be goal oriented but wrap it up by being a dreamer and open to spontaneity. Let the unchangeable and changeable fluctuate to a higher level of consciousness. We can then be in chaos to synchronicity and harmony with all forces. However, if we find ourselves riding on many roller coasters in our lives and we feel the need to scream and cry, let our thunder voices roll; let those tears wash away our sadness. If we are scared, let us breathe in courage and breathe out fear. If we feel like falling, let our breaths soften us and make us resilient when we fall or maybe not. If we are in doubt, breathe in out and breathe in faith. Be less controlling. We might surprise ourselves.
Nurse and Health stand for:
N-Nurture
U-Unfold
R-Reflection/Release/rhythm
S-Sensitivity, self-care, shed off
E-Embrace
A-aware
N-nourish
D-discipline
H-Holism
E-Empathy
A-Accept
L-Love unconditionally
T-Transform
H-Heal
Nursing has no choice but to unfold its unconsciousness. Nursing is healing and healing is us. “We know that.” That’s what most of us will say. Then pet us constantly remember and pay attention to our inner voices, and our intuitions that guide our true essence. Know that nothing is insignificant and maybe nothing is significant. There are no coincidences. It is happening both within us and all around us. Hospitals and other institutions are lagging behind dragging themselves. There is a call to spread our wings and embrace endless possibilities of growth. Look how the vast the sky is.
We are all pebbles thrown into a huge lake or ocean and we are creating ripples and waves that fluctuate, merge, and affect everything in the environment – on, within, above and below the surface. We have a tremendous capacity to take the path of least resistance. We do not to fight our patients for there is nothing for us to prove. We don’t have the need to be right. We don’t have to feel offended. Instead, we have to keep the essence of our being geniuses at a level of perfection in the likeness of the source from whom we emanate and stay connected. We have to look at patients and us as human beings who are capable of compassion and loving kindness. If we, as caring partners can feel this power and magic, our patients will feel the same way. If we or the patients feel otherwise, say to ourselves, “We surrender!” The great Intention is there to take over. How magnificent and beautiful can it be? Aren’t we honored to be earth’s angels with Great Spirit of sisterhood and brotherhood?
It is well and good to study nursing theorists but now I invite us to continue to courageously face the challenge if integration and action. We don’t want to send up with only an experience of intellectual masturbation , no pun intended, that we may just end up in constipation. Let us be willing to go through this profound process of digestion from ingestion to elimination that we may properly nourish ourselves and all our relationships with all beings and beyond.
