Abstract
Policy development, implementation, and maintenance are central to the “carrying-out” of healthcare within organizations and communities. Nurses play an important role in not only developing meaningful policies with constituents but in also providing explanations that “make sense” to all persons involved. This “sense making” may be facilitated by the use of metaphors. In this paper, the author explores Parse’s (2021) community change concepts as metaphors that may enhance policy development and understanding.
It is interesting to think about the ways in which metaphors are a part of the daily lives of all persons in clear and hidden ways. Merriam-Webster (n.d.) defined a metaphor as: a figure of speech in which a word or phrase literally denoting one kind of object or idea is used in place of another to suggest a likeness or analogy between them (as in drowning in money); 2: an object, activity, or idea treated as a metaphor. (para. 1)
Metaphors explain something more “fully.” Nguyen (2016) wrote that “metaphors are more than devices; they’re central to how we understand the world. They don’t belong solely to language, but help us to reason and understand what’s around us” (para. 2). This means that metaphors assist persons to “see” something that was once “vaguely noticeable” or “challenging to understand.” Metaphors open the world in ways that shape understanding of what is and what may be. In light of developing something new in the design world, Nguyen (2016) further explained that: Metaphors are useful in design because a large part of the craft is about seeing things in a new light. And when things are seen in a new light, new solutions may reveal themselves. Metaphors do more than cloak something in a poetic veil: like design, they broaden our minds and help us learn how to see. What does one thing have to do with another thing? And how best to explain a connection when we make it? Through metaphors, of course. (para. 3)
With this idea of making “connections,” metaphors provide links to ideas that may otherwise stay unspoken, not understood, and in a way, not relatable to persons’ lives. Within policy development, implementation, and maintenance, metaphors provide a way for persons to “see” a policy and how it may work before it is implemented or “tested” within an organization or community. Lakoff and Johnson (1980) wrote that “metaphor is pervasive in everyday life, not just in language, but in thought and action. Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature” (p. 454). All persons make sense of the world through conceptual systems that provide a structure to what is experienced. Lakoff and Johnson (1980) described how important metaphors and conceptual systems are: The concepts that govern our thought are not just matters of the intellect. They also govern our everyday functioning, down to the most mundane details. Our concepts structure what we perceive, how we get around in the world, and how we relate to other people. Our conceptual system thus plays a central role in defining our everyday realities. If we are right in suggesting that our conceptual system is largely metaphorical, then the way we think, what we experience, and what we do every day is very much a matter of metaphor. (p. 454).
Within nursing, conceptual systems that explain unique nursing concepts and constructs serve as the “worldview” for nurses to “make sense” of the discipline of nursing. Nursing conceptual systems and theories serve as the foundation for policies that nurses develop to guide practice. These policies may be developed and “seen” with new possibilities through the use of metaphors.
The Humanbecoming Paradigm
Parse’s (2021) humanbecoming paradigm is composed of an ontology, epistemology, sciencing, and living the art. The ontology or belief system of humanbecoming is grounded in humanuniverse as “indivisible, unpredictable, everchanging” (Parse, 2021, p. 28). Philosophical assumptions, ethos, postulates, and principles comprise the humanbecoming ontology. There are three assumptions about humanuniverse, three focused on ethos, and three about living quality. The nine assumptions “mean humanuniverse is a cocreation that cannot be divided. It is not a static entity, but rather continuously moving in unrepeatable, unforeseeable ways without a wrinkle” (Parse, 2021, p. 33). Parse (2021) wrote that “the ethos of humanbecoming is the sentiment and straight thinking that informs the enduring truths of reverence, awe, betrayal, and shame, in venerating treasured presence” (p. 33). Living quality is “the all-at-onceness of the truth for the moment, which is all there is” (Parse, 2021, p. 33).
The humanbecoming assumptions serve as the underpinning for the principles of humanbecoming, which are:
Structuring meaning is the imaging and valuing of languaging.
Configuring rhythmical patterns is the revealing-concealing and enabling-limiting of connecting-separating.
Cotranscending with possibles is the powering and originating of transforming. (Parse, 2021, p. 39)
Parse (2021) wrote that these principles “bring to light the idea of living paradox as fundamental to humanbecoming. A paradox is an apparent opposite. With humanbecoming, a paradox is an intricate rhythm expressed as a pattern preference” (p. 39). With these principles and paradoxes, persons shape chosen patterns that are known and not-known, while moving-on with each now moment with certainty-uncertainty about what may be. Persons cocreate meaning with each choice, as choices unfold with more choices.
Humanbecoming Community Change Concepts and Health Policy
Humanbecoming has been used to guide the development of health policies in a variety of settings. “Humanbecoming can be used as a guide to expanding nurses’ involvement in health policy” (Poirier, 2012, p. 106). It is vital to reflect on the ways policies impact healthcare organizations and communities; communities are comprised of “person as community” and “group as community.” From a humanbecoming perspective, “when people come together as a group, the individual communities bring their histories to the emerging now, and this creates an entity of coevolving histories, which confirms individual as community and group as community” (Parse, 2021, p. 151). There are three community change concepts: moving-initiating, anchoring-shifting, and pondering-shaping (Parse, 2003, 2012, 2021). Parse (2003) wrote that these concepts are “rhythms [that] arise in all day-to-day relationships as new meanings unfold with shifting patterns in cocreating what is possible” (p. 23). The community change concepts may be viewed as metaphors that “actually change the way we think of a concept” (Burkley, 2017, para. 7).
Moving-Initiating Community Change
In moving-initiating change, “community (individual and group) is discarding-creating with the becoming visible-invisible becoming of the emerging now. The discarding and at-once creating refers to barriers that cannot be moved without erecting new ones” (Parse, 2021, pp. 152-153). Moving-initiating processes arise with the “discarding” previous thoughts and creating new images about policies. The processes are tunneling, driving, laddering, boating, swimming, submarining, ballooning, motorflying, and swinging (Parse, 2021, p. 152). These processes may be seen as “action” metaphors; in that, persons may easily visualize what is occurring when these actions take place. These actions arise out of policies that focus on change. Parse (2003) stated that the processes were “conceptualized during the author’s [Parse] experience at the Checkpoint Charlie Museum in Berlin, Germany, near the Brandenburg Gate. . . . The museum contains pictures and artifacts depicting the ways people attempted to cross the border by land, water, and air” (p. 24). These processes are unique in that they vividly describe change as initiating movement with descriptive “active” images.
“Tunneling is digging under, piercing the depths in cocreating situations for deliberately earthing and unearthing ideas, objects, and events” (Parse, 2021, p. 152). The metaphor here is “tunneling is digging under”; this shapes a picture of communities uncovering innovative healthcare tactics, while all-at-once covering up “old” practices of healthcare that are not valued within the community, as individual and group. “Driving is forging directly with intensity in cocreating the shifting patterns of diversity” (Parse, 2021, p. 152). Driving is pushing new ideas and practices forward with strength; where “driving is pushing” is the metaphor for a community’s fortifying forward movement toward change. “Laddering is climbing multidirectionally in planning and executing strategies” (Parse, 2021, p. 152). The “laddering is climbing” metaphor is change that moves in directions that are expected and unexpected; laddering is the up and down movement of policy change within the levels of an organization or community. “Boating is steering while navigating the calm-turbulence of shifting waves and wind, harnessing moments of buoyancy, yet always with ambiguity” (Parse, 2021, p. 152). “Boating is steering” as metaphor for the “calm” instances of starting new policies amid the unsteadiness that comes with new policies. “Swimming is gliding with diverse currents in keeping afloat with sureness-unsureness” (Parse, 2021, p. 152). The “swimming is gliding” metaphor relates to how new policies are not often the only matters of concern to communities or healthcare agencies; person as community and groups as community live with many other priorities all-at-once. “Submarining is immersing in a high pressure enveloping at great depth with the shifting of what is known and not-yet known explicitly” (Parse, 2021, p. 152). “Submarining is immersing” as metaphor arises as communities experience the “pressure” of new policies and the changes they bring within healthcare agencies and communities. “Ballooning is drifting vigilantly with the pattern of the whole in a buoyant surgence-release, while shifting winds cocreate the unexpected” (Parse, 2021, p. 152). The metaphor of “ballooning is drifting” is prudently observing the ups and downs of policy change, while all-the-while staying above the fray of dissent to continually honor the community’s values and beliefs. “Motorflying is propelling persistently with the gravity of weaving winds” (Parse, 2021, p. 152). “Motorflying is propelling” as metaphor is advancing change regardless of any twists and turns that may arise in healthcare or communities. “Swinging is soaring in undulating suspension with gusts of shifting winds in swingshifting to and fro in a bold leaping beyond” (Parse, 2021, p. 152). The metaphor “swinging is soaring” is when person as community and group as community attend to the pushes and pulls of policy change; it is staying with the agreed upon community or organizational values embedded in the change.
Anchoring-Shifting Community Change
Parse (2021) wrote that in anchoring-shifting change, “community (individual and group) is persisting-diversifying with the becoming visible-invisible becoming of the emerging now. Persisting-diversifying is anchoring with tradition and shifting with new experiences, and it is what ongoing change means in light of the pattern of the whole” (p. 154). The processes of anchoring-shifting are: savoring-sacrificing and revering-liberating. Parse (2021) described these processes: Savoring is delighting in something treasured while all-at-once forgoing it. It is relishing being with others, ideas, objects, or events that are appealing to community, whereas sacrificing is giving up something of worth. Savoring- sacrificing is shown as threads of constancy amid diversity become transparent in speech, silence, movement, and stillness. (p. 154)
As metaphor, “savoring is delighting” is how communities find joy in the new possibilities of change, while the metaphor “savoring- sacrificing is shown as threads of constancy amid diversity” arises as communities come to terms with what may be lost or “let go,” as new policies replace what had been.
Parse (2021) described revering-liberating as “honoring and respecting others and ideas while cocreating a buoyant freeing. The respecting is of the predecessors, contemporaries, and successors alive with the personal histories of the constituents, as they push and resist with the familiar-unfamiliar in anchoring-shifting” (p. 154). The revering-liberating metaphor is regard for others and their ideas; it is freeing communities and organizations from ties to previous policies and values.
Pondering-Shaping Community Change
In pondering-shaping change, Parse (2021) wrote that: Community (individual and group) is contemplating-configuring with the emerging now. Contemplating and at once configuring is with the imaged possibles present with the communities’ illimitable experiences. Contemplating-configuring is humanuniverse connecting-separating in cocreating new meaning in deep thought as careful shapeshifting arises with certainties amid the inevitable uncertainties of choosing directions in the context of the becoming visible-invisible becoming of the emerging now. (p. 155)
The processes of pondering-shaping are: considering-composing and dialoguing-listening. Parse (2021) wrote that: Considering-composing is concentrating with deliberate intent or deep meditation in all-at-once living creating anew with the becoming visible-invisible becoming of the emerging now. Considering is deliberately ruminating about others, ideas, objects, and events that are important with the everchanging becoming visible-invisible becoming of the emerging now. (p. 155)
The “considering-composing is concentrating with deliberate intent” metaphor is thinking about how community and healthcare agency beliefs and values shape future policies; the choosing reflects the meaning of values and beliefs.
In 2003, Parse described dialoguing-listening as “unconditional witnessing with all-at-once speaking−being silent and moving−being still” (p. 39). She (2021) further wrote that: Dialoguing with community in pondering-shaping arises with the discourse of comingling personal histories. Listening with pondering-shaping emerges with the solemn regard integral with coming to know something in depth for a clearer understanding, yet knowing that all understanding is only for the moment as it is bridled with the mystery of that which cannot be known explicitly. (p. 155)
The metaphor of “dialoguing-listening is unconditional witnessing” provides a new “picture” about how vital all constituents involved are provided opportunities to be heard about what is important to them as new policies are developed; it is the chance for persons to voice what is important and influence the direction of the healthcare agency or community.
Summary
In this paper, the author explored Parse’s (2021) community change concepts as metaphors that enhance policy development and understanding. These metaphors provide nurses with novel ways of seeing and comprehending policies in light of nursing theoretical concepts. “Nurses who follow the humanbecoming school of thought have the expertise and skill to explore possible ways to be with challenges while focusing on the overall vision of person-centered care and quality of life” (Poirier, 2012, p. 109). The unique theoretical knowledge base of nurses expands their thinking to “see” beyond what is “there” to cocreate opportunities with communities and healthcare agencies that are sustained. “Since health policy decision-making is guided by beliefs and values about humans and health, nursing knowledge should contribute significantly to the standards of practice that are set forth in these policies” (Parse, 2007, p. 105).
