Practice/Theory Exemplar 

Contributor: Yamileth Castaño Mora

Location

This initiative is located within the Faculty of Health of the Universidad del Valle, in the School of Nursing located in the city of Cali, capital of the Department of Valle del Cauca. The Universidad del Valle is a public educational entity, which privileges the access of students from socioeconomic strata 1 to 3 of the city; which means that it provides training opportunities to people who live in conditions of social and economic vulnerability.

Additionally, from the Humanization Line, interventions are carried out in two of the city’s public university hospitals: The Valle Evaristo García University Hospital and the Valle University Psychiatric Departmental Hospital, recognized as reference institutions in the entire area of ​​southwestern Colombia. to the extent that they care for people with equally vulnerable social and economic conditions and who, in addition, are undergoing highly complex disease processes.

In summary, the Humanization Line provides its services favoring the most vulnerable population of students, patients and their family caregivers in the midst of the indicated educational and care contexts.

Key nurses involved in implementation

I will mention as a key nurse of this experience the Coordinator of the Missionary Process of Human Development and Well-being, who was kind enough to integrate me into said space and give rise to the initiative called Humanization Line that I coordinated for a period of 6 consecutive years since the year 2014 until the year 2019 (when I started my doctoral training studies in Nursing).

Martha Cecilia González Hidalgo, Nurse with training in Public Health and recently retired Senior Lecturer in the Adult area of ​​the Universidad del Valle School of Nursing, Art-therapist from the framework of Anthroposophical medicine and nursing, was for almost two decades the coordinator of the Student Counseling Program, which beyond responding to academic situations, provided accompaniment and human and affectionate shelter to the student’s life situations in an integral way. Martha Cecilia was also coordinator of the Missionary Process of Human Development and Well-being and from this place, she favored, promoted and accompanied the birth of the Humanization Line, allowing activities to permeate spaces within the undergraduate and postgraduate courses of the School of Nursing, as well as training practices and some specific services of the Public University Hospitals of the city. Without her vision and solidarity, the Humanization Line would not have been able to emerge.

Yamileth Castaño Mora, precisely the person who shares this narrative, I am a Nurse, Specialist in Higher Teaching, Master in Mental Health and Doctoral Candidate in Nursing; I have been an Assistant Professor at the School of Nursing in the field of Mental Health for 15 years.

As coordinator of the Line, I significantly considered the influence that the biographical narrative has on the student, the patient and their family caregivers, to the extent that, on the one hand, it consolidates nursing knowledge from their own experience and, on the other, , empowers the subject of care to the extent that they value their own strengths in the face of the adversity that the disease represents. Knowing that there is no greater and better knowledge than that which is cultivated in a reflective being, I took into account the linking of artistic actions that would promote the student’s sensitivity to aesthetics in Nursing care. In this way, the conceptual elements that supported the actions of the Humanization Line were integrated.

Date of Implementation

The Humanization Line emerged in 2014, with the integration within the organization chart of the School of Nursing of the Missionary Process of Human Development and Well-being. This line in particular was born in response to a discomfort expressed by some young graduates regarding the perception of dehumanization phenomena in health care, visible in their different work environments. This kind of confrontation or evident gap between the ideal care proposed by the academy and the real care found in care settings, led to the birth and current existence of the Humanization Line of the Universidad del Valle School of Nursing, first of all , as a reflective, ethical and aesthetic initiative to shelter care as a fundamental experience of Nursing praxis. In the belief that humanized care is provided insofar as one has lived and has been the subject of equally humanized care.

Theoretical Framework

This initiative is epistemologically ascribed to the current of thought of postmodernity that, as a movement, responded to the crisis caused by the collapse of modern hope in rationality and technology as mediators to resolve human dilemmas (Espuma, 1991). Under this influence, Nursing gave value to the potential of people to build their own realities (Watson cited by Polifroni & Welch, 1999), some that emerge in a social and cultural fabric, from subjective, tacit and intuitive knowledge; which is supported by local histories, biography and the narrative of the people (Etherington, 2004).

These approaches are included in the perspective or vision of simultaneity or transformative unitary approach proposed by authors such as Newman, Sime & Corcoran (1991) and Fawcett (2005). Under this vision, the human being is unitary, a self-organized holistic field more and different than the sum of its parts; irreducible and identifiable by behavior patterns. When a part is affected, the whole is affected, since the phenomenon of the health experience is lived, in this case of care practices, as a self-organized field embedded within a larger organized field, causing the Professional of Nursing, experience an emotional commitment or empathic feelings with the people you care for. Finally, regarding the interpersonal relationship, the vision of simultaneity allows focusing on the interaction of the Nursing Professional with the person who cares, from the self-realization and healing effect that the care relationship can cause (Bueno, R, L, S. 2011).

From Nursing theories, the Humanization Line has considered Jean Watson’s theory of humanized care, Kristen Swanson’s care theory and the Nursing as loving care by Anne Boykin and Savina Schoenhofer, among other references, I mention those that have been used mainly.

Implementation

The fact of considering the student as the center of the training process and the patient and their family caregivers as the center of the act of care, is a way of evidencing the consonance of the Humanization Line initiative with postmodern forms of thought, which They give a place both in learning and in healing experiences, to the autobiographical narrative of people who go from being passive subjects, to protagonists with the power of agency over their own life experience. In fact, it is the holistic vision of the image of the contextualized and historical human being, which allows humanization actions to consider empathic interaction, healing and horizontal dialogue, as well as the maintenance of rituals in the midst of a materialized life. and fast.

Only to the extent that we turn to a belief in a total, complete, complex, irreducible, sensitive, spiritual, political, artistic and self-possessed human being, is it possible that the actions of the Humanization Line have a meaning for science of nursing; otherwise, the experience would be reduced to a well-intentioned act without foundation.

The humanization line implements its activities from 3 moments:

• Moment 1 of Physical Shelter: which includes the greeting, the establishment of warm interactions and the proposal of body movement activities, breathing exercises, stretching, relaxation and games.
• Moment 2 of Mental Shelter: considers that, integrated into the physical dimension, are vitality and emotions, which are served from activities with a clearly artistic and subtle base, which include reading and healing touch, painting, drawing, making collages, mandalas and share live music.
• Moment 3 of Spiritual Shelter: represents the end and closure of the meeting, which seeks to make visible to all attendees, that which of what was experienced in the intervention takes on value and can be significant to each person. Then, a reflective verse is read, a spontaneous and hopeful conversation is carried out, and some food is shared. Sometimes, a song or a prayer is included at the request of the attendees.

Approach to Evaluation

Given that the experience promoted by the Humanization Line is articulated both in training and care spaces, in both environments there are initially evaluation formats in which the participants: students, patients and their family caregivers can record their feelings and generated by the experience, providing their impressions and quantitative and qualitative evaluation of what was proposed. Both at a training and care level, these evaluations have given very satisfactory results, making the initiative take root definitively and creatively in these environments.

Additionally, the Line inspired the formation of a humanization student group, directly led by young people in training, who seek to promote humanizing actions to the greatest number of training practice spaces and to the Faculty of Health in general. This in itself is a way of showing results, where not only a number of interventions, a series of comments can be referenced, but, more importantly, making visible the way in which the new generations appropriate this type of process. reflective, making them part of their daily lives.

Very relevant is the fact that the Line also considered the promotion of the space as a hotbed of research and it was possible to carry out a descriptive investigation and an institutional internship with results of great relevance for the population of participants and for the services in which such activities were developed. experiences.

Another element that turns out to be an evaluation indicator is the openness towards free and voluntary participation in the activities by patients and their family caregivers, finding that, during the interventions, the care staff of the services gradually became more participatory in these activities. and even replicated some of the activities independently within the care units.

Practice Recommendations

The humanization that as an attribute is part of care, considered the fundamental phenomenon of nursing, runs the risk of being instrumentalized under the pragmatic view that is typical of the current profession. In such a way that making visible, promoting and including in the daily story the premise of being a subject of care in order to promote and develop humanization actions from its own culture, is not only convenient but highly necessary to assume the paradigmatic transition that Nursing requires. These types of processes greatly benefit from formal recognition through the allocation of time in teachers’ work plans for their development, in addition to their explicit consideration in training experiences and care practices.

Today it should be promoted by training plans and health institutions that consider art as a fundamental part of learning and care, have subjects that promote self-knowledge, personal reflection, creative writing, oral-written narrative- textiles and the arts, among others, will greatly favor the critical thinking of future professionals.

It is not less important to have spaces and budgets that support the realization of this type of dynamics and to consider that the already well-recognized gap between the academy and the health services can be corrected through initiatives of this type, achieving that the Students view hospital settings as an extension of their own Alma Mater.

From this point of view, it is mandatory for 21st century nursing to overcome the denial that it has exhibited in recent decades towards the reflection of ethical and aesthetic care, estimating data and everything derived from and consistent with quantitative research as a higher priority.
We are a social science that requires the construction of empirical proposals that, being scientific, do not ignore the contribution of the interpretive world to the knowledge of Nursing.

Theory development recommendations

In Colombia, it is very common to hear students and even professionals stating that care philosophy and models are part of their training process but that they do not usually implement them in their daily practices. Either because the approach of the entity in which they work ignores this type of knowledge or because the professionals themselves prefer to continue with the classic nursing care in which reductionist biomedical dynamics are obeyed. That said, I believe that more than reviewing theoretical content, living experiences to later be reflected on in the light of various currents of thought in Nursing, can help students and professionals feel closer to its appropriation and implementation, because in fact, such knowledge has passed through its own being and already inserted in the professional’s biography, it can make way for the creation / promotion of care models based on the knowledge of the profession that dialogue holistically with other disciplines.

In any case, it is appropriate to show that these types of developments are, first of all, possible, always susceptible to improvement and that they can mainly give rise to the creation of a caring identity of Nursing. All this can lead to encourage the development of nursing theories or strengthen existing ones, to the extent that from the experiences promoted by the Humanization Line, the student and the professional recognize that their greatest expertise comes from their own biographical knowledge arranged in a narrative that mobilizes experiences of scientific and aesthetic care.

Literature

Castaño, Mora, Y. (2022). Because you said so. Nursing Situation Narrative. Culture of Care, 26(62). Retrieved from http://dx.doi.org/10.14198/cuid.2022.62.04

Castaño, Mora, Y (2020). Narratives of care: An experience of teaching accompaniment for Academic Literacy. In Reading and Writing in the Disciplines: Research Experiences in the Classroom at Universidad del Valle (1st ed., pp. 53–64). Valley University.

Castaño, Mora, Y (2015). Summary of Presentation Lanterns at the Hospital: Future of Humanization in the School of Nursing of the Universidad del Valle 2012 – 2014. Page: 79. Third Book International Congress Health Care, Chapter: Experiences in Service.