Contributor: Ellen E. Swanson
Return to Main Mandala Page & Index
In the linear or hierarchical approach, we tend to focus on data, facts, and validity of information. That is a more heady approach and is necessary and can be life-saving. However, there are heart and gut approaches that can also be life-saving. Have you noticed that there are times when the data and facts just don’t add up, and you have a sense something just isn’t right. Sometimes lives are also saved because we listen from the heart and gut, with body intelligence. Some have called this the felt sense. Explore the works of Eugene Gendlin and Peter Levine to dig further into this concept. They describe it as a physical awareness, a bodily response. It is a type of knowledge.
Let’s take this opportunity to practice the felt sense as an exercise in the holistic nursing theory concepts of self-care and self-responsibility. Study the two models below, the traditional linear organizational chart and the circular mandala organizational model.
What do you feel? Where do you feel it? Do you have a lump in your gut? Do your legs feel heavy? Does your heart ache? Notice your breathing as you sit with each figure. Do your hands or feet feel cold or hot as you do this? Do you feel immobilized when you encounter one of the visuals, but not the other? Is there pressure in your head?
Accessing your felt sense is a process. It takes time to access it—and we think we don’t have time in our current frantic lifestyles. Don’t rush this. Come back to it. It can also save your life or someone else’s life, as noted in the stories below.
Just the Facts, Mam
It all started my first year of practice in 1969. I worked the 3-11 shift on a unit with three hallways. It was a small hospital in a town of about 25,000, and a very progressive hospital for that time. One of the three hallways was for “minimal care” patients. These were people coming in for minor surgeries or testing procedures requiring preps that are now done at home.
One of my patients on the minimal care wing had a D&C and hemorrhoidectomy that day. Several hours into the shift, although her vital signs remained normal and her pad was dry, I felt like something wasn’t quite right. I called her physician and told him about the normal data and my (felt) sense of something not being right. He chose to rely on the data. I called him two more times during the shift with the same concerns. The data remained fine, but the unease I felt increased with each passing hour. I informed the oncoming nurse and went home at the end of my shift.
When I returned to work the next day, the patient was not there. I immediately asked about her. She had been taken back to surgery during the night and was transferred to the surgical unit afterward. No sooner did I learn this than her physician came onto the unit looking for me. He came up to me and said, “Miss Hernley, from now on I will listen to you the first time you call.”
Here is what had transpired. The patient had a large hematoma in the rectal area that was blocking off the distal end of the cervix, not allowing a uterine hemorrhage to drain. Add to this the fact that the rectal hematoma was pressing on her vagus nerve, and that explained why there were no vital sign changes indicating shock.
We have relied on the facts and metrics, head intelligence, allowing them to trump body intelligence and the felt sense. There are consequences that can be life threatening as well as relationship threatening.
A Wise Foot
I was half way home. The hail started, and I could see the hailstones were getting bigger and bigger. I knew car damage was a given at that point. I saw two trees ahead and pulled under one to get some protection from the canopy. Another driver had pulled under the first tree. I listened to the hail on my car roof and watched it on hers. I could tell she was getting more protection than I was. I looked up and saw the canopy of her tree was much bigger than the tree I was under. There were about two car lengths between us. I decided I should pull up and get more of the protection under the larger canopy of her tree.
I just sat there. My foot would not leave the brake. I couldn’t figure out why I wasn’t pulling forward. I questioned myself several times. Within about 60 seconds, her tree came down, and the huge trunk landed at a perfect angle right between our cars. If I had pulled forward, I would have been crushed. As it was, I simply got hit by the tips of the small branches at the top of the tree. Only my hood was somewhat damaged, besides the hail damage to the paint. Sometimes the body is wiser than the head.
Holistic nursing concepts source:
Frisch, N. (2013). Nursing theory in holistic nursing practice. In B. Dossey & L. Keegan (Eds.) Holistic nursing a handbook for practice, 6th Ed. (pp. 117-128). Burlington, MA: Jones and Bartlett Learning.