Abstract
Choosing whether or not to speak or be silent is a paradoxical experience that emerges in the moment. For the discipline of nursing, it is an important value priority found in nurse-person, nurse-group, and nurse-community situations. The discipline of nursing is at a crossroad when contemplating what its place and status will be in the chaotic and ever-changing healthcare and higher educational arenas. The author in this article sheds new light on the future direction for what it means to articulate meaning as a nurse and the ethical consequences of choosing to speak–not speak up for the ever-changing priorities and purposes of the healthcare disciplines.
Keywords
Humanbecoming is a unique humanuniverse paradigm. It is a school of thought with a distinctive ontology, epistemology, and methodologies. The human structures meaning in choosing value priorities with explicit-tacit knowings that are shown in speech, silence, movement, and stillness, while at once configuring rhythmical patterns of relating in the moment. “Languaging is signifying valued images with speaking–being silent and moving–being still” (Parse, 2021, p. 45). Individuals’ ways of expressing themselves are reflective of the existence of other important persons and relationships passed from generation to generation. Persons who have a close association, such as members of the same discipline, group, or institution, have common ties and realities cocreated at once with predecessors, contemporaries, and successors. Members of the discipline of nursing share symbols and value priorities for what it means to have straight-thinking ethical practice, research, and education for those persons who will be the scholars of the discipline in future generations.
Within humanbecoming, paradoxes are always present and are not “problems to be solved or eliminated, but are natural living rhythms” (Parse, 2014, p. 35). Paradoxes are important since they relate to how persons clarify options and choose unique ways of becoming in situation. Persons experience tensions in all choices. Examples of the paradoxical experience may be manifested as crying while happy, laughing when angry, or singing when sad.
Leading-Following and Languaging
The humanbecoming leading-following model (Parse, 2021) describes how nurse leaders and nurses may be imbued with different unique belief systems to be present with the essences and processes in the ever-changing movement of situations. The model encourages innovation and engaging to focus on excellence. Through each unique situation and context facing nurse leaders and nurses, each nurse must choose values, imaged priorities and language their thoughts and actions through speaking–being silent and moving–being still. In making the moment-to-moment decision of whether or not to speak or be silent, ethical consequences unfold for the action or inaction that nurses assume.
In living leading-following, it is important to reflect, in an explicit manner, on the ways in which nurses as leaders experience the ethical consequences of choices and what the implications of those choices may have with regard to the ethos of humanbecoming. Does the ethical thinking of the nurse honor human dignity? Or rather, does the act of speaking up or remaining silent on important issues potentially dishonor those we serve?
Mystery and Languaging
As persons structure meaning in their lives, persons are continuously coming to know–not know the meanings surrounding their actions or choosings. Mystery unfolds with personal situations and contexts as persons seek new knowledge and live personal worldviews. It is the nature of being human to struggle and risk choosing priorities with confirming what one values while at the same time disconfirming other possibilities. Mystery surfaces as “an inexpressible silence as one makes choices and turns away from other possibilities while living with the unpredictability of those choices” (Bunkers, 2019, p. 174).
Mystery and chaos were present throughout the pandemic era; many members of the nursing discipline quietly and unobtrusively left their practice in astonishing numbers. Retirements and the changing of careers are coming silently, often without notice. Disciplinary students of nursing are expressing dissatisfaction and face seemingly insurmountable situations of not being able to be with others face-to-face in the nurse-person relationship. Many students express disappointment with not being able to practice the medical skills and other procedures associated with institutional nursing. Instead, students of the discipline were instructed by faculty members to attend immunization clinics where they could practice motor skills with immunization injections. Dissatisfaction also arose within the ranks of physicians and other healthcare professionals with the ever-looming unpredictability of the lack of personal protective equipment, vaccine mandates, and constant short-staffing while the actions of quarantine were instituted. It has been said that nurse burnout has led to an exodus of nurses leaving the profession. Seasoned faculty scholars as well as practitioners of nursing have chosen to retire early or leave the discipline altogether. This phenomenon has come to be known as and labeled the great resignation. Persons are moving in other directions as budding nurses who lack knowledge and expertise join the discipline uncertain of the not-yet and what is to come.
Ethical Consequences of Speaking–Being Silent
Ethical consequences abound with the need for leaders and scholars of the discipline to speak and not be silent. Honoring human dignity and respecting others is an abiding ethos for the discipline of nursing. As the numbers of resignations rise, other disciplinary scholars must stand up to proclaim and set new direction and movement for nursing as a discipline. Many new and existing degree programs of nursing are now deciding to make curriculum decisions undergirded with a philosophy of a competency-based approach to leadership development and resilience. This minimalist approach is an attempt to attract and retain nurses. However, in doing so, consequences arise over the decisions to remove the disciplines’ ontologies and epistemologies found in its nursing theories as guides for curriculum development. With the rapid expansion of practice and educational doctorates, graduates of these programs are now assuming leadership positions in universities and professional associations. With an ever-changing silent undertaking, a sea change is evolving, and the discipline of nursing is rapidly coming to identify itself as a practice profession rather than a discipline.
In choosing the paradigm swing of silence, scholars of the discipline of nursing are going unheard as practitioners of nursing are setting the course and path for a new generation of nurses. In choosing its pathway, it is the author’s belief that the leaders of nursing should choose the road not taken and continue to mentor budding scholars in the direction of scholarly endeavors—and not just the priorities of the moment to employ large numbers of nurses with minimal competencies.
This article serves as a clarion call to members of the discipline of nursing to not be silent but rather persist in the commitment as proponents for the theoretical ontologies of our history. In acting, we must have patient action. According to Henri Nouwen (Nouwen et al., 1982), patient action is a manifestation of human presence in the midst of a changing world. Patient actions are those actions with others that are potentially healing, consoling, comforting, reconciling, and unifying. They are actions that can be seen and touch the heart of humanity. Patient action is a hard discipline where we, as humans, must learn to value the present moment and at once set a vision for transformation. Members of the discipline of nursing are called to patiently consider our action or inaction and set a new course to honor that which is and is becoming the discipline of nursing.
