Home 9 Sources 9 Textorium 9 Camargo, Pilar. What is it Like for Nurses to Experience the Death of their Patients?

Camargo, Pilar. What is it Like for Nurses to Experience the Death of their Patients?

What is it Like for Nurses to Experience the Death of their Patients?

Camargo, Pilar

It is 6:50 pm. I am about to begin another shift. As I wash my hands, I look into my room 311. The patient, a man, is in his 50s or 60s. He does not look well. His face is pale. Sweaty. I glance at the monitor. Blood pressure is very low; heart rate is normal. The patient is surrounded by 10 IV pumps. A doctor once said, “Pilar, the imminent death of a patient is easy to identify. Just look at how many pumps the patient is hooked up to.” 7:00 pm. I am ready to start my shift. I enter room 311. “Who is he?” I ask the afternoon nurse. “It’s Mr. Ricardo. Do you know him? … How unpredictable life is,” she continues. “This morning he got up as usual. But suddenly he had the worst stomachache. He came to E.R. They operated. Now he is beyond help. We cannot do anything for him. He is dying. He has a medical order not to resuscitate.” As the nurse talks to me, I look at the patient. His hair is grey; his face pale, but with a touch of peace. He seems to be sleeping. I ask my co-worker, “What about the family? Do they understand the situation? Where are they?” “The doctors have spoken with them. His wife was very upset. But she knows what to expect. They may be at home now. She left a phone number, just in case.”

I find myself thinking about my own family. I can imagine how difficult this situation must for his family. I take his hand. It is cold and sweaty. I speak to him. I introduce myself. But I don’t know if he can hear me. In my grandmother’s dying hours, when I spoke to her, she opened her eyes. She looked for my voice. That was amazing. We were not really close. But I felt that she recognized me. That she was thanking me for being there at that moment. I watch the monitor. Blood pressure and heart rate are unchanged. Perhaps he is waiting for something or someone. I am called to the phone. It is his wife. I feel uncomfortable. I do not know what to say. She asks about her husband, “Is he OK?” I repeat the information I was given. Then I tell her, “If you want to come here and stay with him, I can authorize your entry to the hospital.” I hang up and quickly scan my surroundings. All is the same in the ICU. As usual there are the annoying sounds: monitors and ventilators; nurses, therapists, and doctors all in their own world. No one is concerned but me that this man is dying. I walk to the window and look out. Bogota is cold tonight. It is raining and silent. My thought in this moment is simple: life marches on. It does not care who is in its way, who falls and gets trampled. Yet, here in 311 it is a different night. Intense. Bright. And strangely silent. Mr. Ricardo’s heart is fighting for his life. The heart rate continues at 70.

A woman appears. His wife. We walk out of the room. She hesitates, “I know you are his nurse.… I just want to ask you how he is. Is he suffering? Is tonight the night?” I look at her. There is sadness in her eyes. She too is suffering. I feel the cold of the night. The seconds pass like hours. I hear myself say, “Mr. Ricardo’s condition is poor, as Dr. Perez told you today. Yes, maybe tonight is his night. Do you want to stay with him?” She nods, “Yes.” We return to the room. She looks at him, and touches him. Then she turns to me and asks, “Can he hear me? Is he in pain?” “At present he does not have any pain. It may help to talk to him.” She continues rubbing his hand. She kisses his forehead and looks at the monitor. His blood pressure reads 40/23. His heart rate has begun to decrease. She looks up to me: “I do not want to be here when he dies. Please take care of him.” She turns and leaves the room.

Now I am here, with him. Alone with him. I come near to him. In this most intimate moment of his life. I touch him and watch his face. I feel sorrow and some kind of serenity. As I look at him, I hear my mother’s words, “When a person is dying, his face becomes more delicate, more definite.” I now recognize death. I glance at the monitor. Blood pressure is 0/0. Heart rate 45, 42, 30, 25 …. 8:30 pm. He is not suffering any longer…

8:30 pm. My patient is dead. Monitor and IV pumps are stopped one by one. Then the ventilator is turned off, too. I inform Dr. Perez about Mr. Ricardo’s death. Now he is officially dead. Room 311 is closed. His wife waits for news in the hallway. I call her. She looks at me and understands that he is gone. I just say, “I am sorry.” She walks into room 311. And both wife and husband spend one more moment together.

After a while she is ready to let us clean and shroud his body. For this process I take from the bedside table gloves, gauze, blade and transparent film dressing. My hands start a routine: cut stitches when it is necessary, take off, clean and cover each tube, nasogastric drain, catheter, other drains and arterial line. These elements are now unnecessary and are pulled out of him. During the process, some parts of his body begin to turn cold to the touch. Very cold. Then I look at him. He seems as if he is dwelling in a pleasant dream. Mr. Ricardo’s body is relaxed and it seems as if all his worries were left behind. He is shrouded now. Mr. Ricardo is ready for the last encounter with all of his family. Wife, daughter, son, sisters and brother enter room 311. Everybody cries around him, but no one touches him. I have stepped out of room 311. I watch them.

After a while his family knows that it is time to let him go from ICU. His wife turns to me, takes my hand, and says, “Thank you.” For a moment I am in silence, then I say, “You’re welcome.” At that moment I watch as his body leaves the ICU. Before returning to my other patients I take a last scan of room 311. It is now empty and messy. My thought at this moment is simple, “He spent just one hour and half of his life with me, but in that brief time he taught me about life and myself as a nurse. Death is never routine. We were engaged in the last meaningful moment of his life. Now, I ask myself, ”what meaning does his death hold for me, his ICU nurse?”

Nursing on my hands

6:50 pm. I am about to begin another shift. As I wash my hands, I look into my room 311.

I am preparing for another shift. I begin my work with the simple procedure of washing my hands. It seems that when I wash my hands that action lets me enter another world –the world of ICU. In nursing, hand washing is one of the most important procedures in preparing to care for patients. What is the difference between washing my hands at home and washing my hands in ICU? At home I wash my hands after going to the bathroom or after having done some work in the yard. My mother used to tell me, “Pilar, wash your hands before your lunch if you do not want to get sick,” and in time that custom became part of me. I usually wash my hands when I come home. The routine is simple: I just rinse my hands, spread some soap on them and rinse again, really nothing special about it.

But in nursing, my hands are an important part of my work. Washing my hands at home does not change my identity. However, it seems that when I wash my hands in ICU I participate in a transforming procedure. Completing the meticulous process takes me ten minutes in ICU. And it is more than time. It seems that hand washing prepares me as a nurse for new encounters with my patients, because after a while these hands are ready to care for them. As water falls onto my skin and my knowledge of nursing emerges and molds my identity. While I am doing this activity, I look into one of my assigned rooms: room 311 is a part of my work. But room 311 is also recognized as my own: “I look into my room 311.” That ownership is just for one night and it is not a property ownership. Rather it is a relational quality. This is now my room and my patient, for whom I carry responsibility.

Although room 311 becomes part of my expected encounter with someone else, as a preparation to share life or death, it seems like the uniqueness of the moment appears only when nursing action goes beyond that of a simple duty. As nurses we know what our duty is, what we may expect on our shift and how our patients can go from life to death quickly, especially in ICU where life and death are separated by a narrow line. But we never know where and when an unexpected encounter with death will occur. At this moment my reality is just that my hands are clean and I am ready to care for that person who is lying in my room: my patient. I am ready to have a new encounter, a new experience as a nurse.

Seeing the patient

The patient is a man in his 50s or 60s. He does not look well. His face is pale. Sweaty. I glance at the monitor. Blood pressure is very low; heart rate is normal. The patient is surrounded by 10 IV pumps. A doctor once said, “Pilar, the imminent death of a patient is easy to identify. Just look at how many pumps the patient is hooked up to.”

Once, when I was ten, I visited my grandmother at the hospital. That was my first time as a visitor in a hospital. I wanted to see her. She suffered a heart attack and I was worried about her situation. Before our arrival at the hospital my mother explained what to expect about my grandmother’s health and room. My mom described everything there as pumps, sounds, IV lines, and nurses. When we arrived at her room I saw grandma lying in a bed different from her own bed. She laughed and spoke normally. I did not see pumps, IV lines or even nurses. I just saw her, speaking and laughing as always. As a visitor at that time I could not perceive my grandmother as a sick person. She was there but I did not understand why. Later, when we left, I asked my mom, “Why is my grandmother here?”

Many hospital visitors have to confront the same situation of seeing a relative in ICU. For visitors that situation is unusual and stressful. But they may only really see the person as a person, and they may only be vaguely aware of the pumps, sounds or monitors. It seems like we look for the uniqueness of the Other. It is the mere act of seeing as Max van Manen says: “how and what we see depends on who and how we are in the world” (p. 23). Now that I am a nurse, my way to see my patients is different. I see my patients looking for me to understand them as persons with needs and necessities. As a nurse, I am trained to see particular signs that something is wrong with them.

Even the two words, “pale and sweaty,” express my sense that something is wrong. My eyes quickly scan room 311, and both monitor and room confirm my suspicions that something is really “wrong.” Of course, in ICU “wrong” means for me as nurse that the patient is critical. In nursing we perceive not only to distinguish one person from another, but also to “sense” how everything is with our patients. And it is difficult to say when we gain that sense that is characteristic of nursing. It just tells me that something is not right with my patient.

A pale and sweaty face appears in front of me. Natural sounds for me in ICU such as ventilators, monitors, and alarms produce different reactions in ICU. Although I do not know what is wrong, I feel I am in the presence of death. Why? How do I recognize that my patient is dying? I do not know but previous experiences with death in ICU return vividly to my mind. It seems like all my experience and knowledge in ICU returns over and over to confront me with new experiences.

Seeing others when I am off duty is different. Although my sense of nursing is there, I do not see people on streets, in parks or schools, as if I were looking for something wrong. I see people only as passers-by or as people I meet. I see expressions and gestures of the others. I see the individuality of that person, something that distinguishes that woman or that man from others.

Who is he? Or what is he? The meaning of recognition in nursing

7:00 pm. I am ready to start my shift. I enter room 311. “Who is he?” I ask the afternoon nurse. “It’s Mr. Ricardo. Do you know him? … How unpredictable life is,” she says. “This morning he got up as usual. But suddenly he had the worst stomachache. He came to E.R. They operated. Now he is beyond help. We cannot do anything for him. He is dying. He has a medical order not to resuscitate.”

Who is he? Something that distinguishes that person from another one, it is a simple question which makes it possible to attach a name to the face of the other. In nursing the question “Who is he?” sometimes is answered as if it were asking “What is he?” Certainly the latter question is important since it details the medical condition and the progress of the patient. However, when my co-worker answers the question, “Who is he?” she responds with a name as well as a complete description of his health problem. In nursing that question includes identification and description of the situation of the person. It is not a question that is answered with just a name. In nursing we look for who the patient is, what the patient is, and why the patient is here. Those questions are sometimes impersonal but at the same time they show proper descriptions of my patients.

Mr. Ricardo has a story. He is here in ICU because something unfortunate happened to him. Now he is more than who he was; he is now what happened to him with regards to his illness. He has a story that makes his situation unique. Every word of his story becomes part of our story now. “To receive recognition literally means to be known” (p. 38) because that person becomes an individual who requires the concentration of all my attention, knowledge and efforts. As van Manen says, “The more I care for this person, the more I worry, and the more I worry, the stronger my desire to care” (p. 272). Whether I am interested or not, the “who is he” question creates the opportunity to share with someone else. The recognition of the other implies that we are part of the other, share in the other’s world.

As the nurse talks to me, I look at the patient. His hair is grey; his face pale, but with a touch of peace. He seems to be sleeping.

I know that this man who is lying in this bed has his own story. My meeting him is a new encounter. His entire story is new for me. My responsibility is revealed: that person requires my attention. This is the ethical experience of the “otherness” of the other, as van Manen describes. And he has my interest in him. In the end, all our efforts are reduced to the fact of nursing that person. Now the patient of room 311 becomes Mr. Ricardo. He is at this moment a face with a name and story. As Emmanuel Levinas (1969) points out:

The Other remains infinitely transcendent, infinitely foreign; his face in which his epiphany is produced and which appeals to me breaks with the world that can be common to us, whose virtualities are inscribed in our nature and develop by our existence. (p. 515)

Mr. Ricardo’s face is now more familiar to me. I know his name and recognize that he is a unique person. He is not 311’s patient anymore. His face that just minutes ago was foreign to me becomes familiar and we are ready to share our common world. He becomes familiar for me now that I know his story, know what is behind that face and why he is here with me. Getting to know an unconscious or comatose patient is very different from a patient who is awake. An awake patient’s face gives me other significant messages: that person may show me pain, sorrow, or happiness. It is very different from my patient who is unconscious.

Now I look at my patient’s face and a relationship is established between him and me. It is different from other relations because in nursing it is not important whether the patient is intubated or unconscious. His face speaks to me and tells me that he is there with me. How is it possible to do that when my patient is in a coma? We only have to exchange our position with him. It is like taking his position but not in a real way; it just assumes his situation and understands him. It is a relationship of recognition. Although he cannot share his feelings or thoughts, the peace in his face shows me another face of death. As Levinas points out, “The face speaks to me and thereby invites me to a relation incommensurate with a power exercised, be it enjoyment or knowledge” (p. 518). That comatose status gives to him a certain kind of peace. It is like all of our issues; thoughts and suffering are left behind us. I recognize that Mr. Ricardo’s face is teaching me about how unique the moment of his death is.

Being next to him: The meaning of approach in nursing

“What about the family? Do they understand the situation? Where are they?” I find myself thinking about my own family. I cannot imagine how difficult this situation is for his family.

Who has not experienced some kind of identification with another’s problems? For a moment this person is not just someone who is lying in this bed with a medical order not to resuscitate–he could be my father. In this instant, his situation makes me think of my own family. How would I deal with that? My perception of his situation makes me feel empathy for his family. I try to approach and to understand the other’s situation.Death links two people into one experience: his family and my family are the objects of my reflection now. It is as if I share with his family this moment as mine. Although it is not mine, I understand it. As van Manen states: “In the encounter with the other, in this greeting, in this face, we experience and understand the purely ethical before we have involved ourselves in ethics as a form of thinking and reasoning” (p. 273). How is it possible to be touched by a situation that is not intimate or personal? As a nurse I have to be with him. Being next to him means that I recognize his situation, that it is similar to what I may have experienced in the past. As a human being I know what it is to miss or lose someone.

I take his hand. It is cold and sweaty. I speak to him. I introduce myself. But I don’t know if he can hear me. In my grandmother’s dying hours, when I spoke to her, she opened her eyes. She looked for my voice. That was amazing. We were not really close. But I felt that she recognized me. That she was thanking me for being there at that moment.

Approaching someone who is dying is different when it is on a personal as compared to a professional level. And yet, there are similarilties as well. On a personal level, my moment with my grandmother was surrounded by sorrow and hopelessness. In my grandmother’s last moments, even though I wanted to comfort her, I could not. I just could speak with her.

But my words were quite different from the comfort words that I give to the patient. I only said to my grandmother, “Hi.” And I was astonished that I could not believe that she was dying. The moment of her death was perceived by me in a different way. I was afraid. It seems like when the word death is present in my personal life, the nurse’s knowledge is left behind. My grandmother’s death shows me how difficult it is for me as a human being to assume the death of one of my relatives.

But here the moment is different. I just want to take care of him. That approach in some way brings the opportunity to create bonds. How is it possible that from an unexpected relationship bonds grow? Certainly those bonds are not common, and they are different from those that emerge between relatives or friends, because both nurse and patient set up their relationship from mutual unknowns. My approach springs from the simple idea to give him comfort and to let him know that I am his partner in this last moment. My moment as nurse is not surrounded by sorrow. It is a moment of company and respect for the other’s situation. A moment of recognition in which I touch him and speak to him. As Carol Olson (1993) says, “Care is the being of being there” (p. 145). That is my responsibility as nurse. I cannot change his situation but I can share that moment with him. The reality is tangible. His sweaty, cold hand shows me a reality. He is dying. But I do not feel afraid or powerless. I feel that I can be with him. I am his nurse, and I can talk with him. In those moments, approaching includes a feeling of unity as a human being.

Is he OK? Talking about death in nursing

I am called to the phone. It is his wife. I feel most uncomfortable. I do not know what to say. She asks about her husband, “Is he OK?”

I repeat the information I was given. Then I tell her, “If you want to come here and stay with him I can authorize your entry to the hospital.”

The word “death” forces us to recognize our own mortality. Speaking about death seems to break our daily life routine, making it impossible to go forward because we do not consider death as part of life. For me, as a nurse, the word death in ICU acquires a different meaning. Even though death is a common occurrence in ICU, at the same time it is uncommon because each experience is unique and we do not learn how to deal with each one better. There is not a set way to have a conversation about death. It seems like an impossibility to share our experiences; also, it creates an impossibility to talk about death with relatives of the patient. When I receive the call from Mr. Ricardo’s wife, I feel anguish

We are afraid of the fear, we anguish over the anguish, and we tremble. We tremble in that strange repetition that ties an irrefutable past (a shock has been felt, a traumatism has already affected us) to a future that cannot be anticipated; anticipated but unpredictable. (Derrida, 1995, p. 54).

My sense of control is lost; I know what the consequence of Mr. Ricardo’s illness is but in some sense I cannot accept it. For that reason my conversation with her is limited to just repeating the Doctor’s prognosis. Certainly I want to speak more with her. But the words do not flow because the moment of recognition of death is strange and unique. Death shows us our vulnerability and our own end. How can I think of death when I am alive? Death means the end of the world as I know it, the closing of the window of life. The world we know disappears in front of us. We spend all of our life focusing on how to live. But it seems that we rarely think about how to die.

I look at her. There is sadness in her eyes. She too is suffering. I feel the cold of the night. The seconds pass like hours. I hear myself say, “Mr. Ricardo’s condition is poor, as Dr. Perez told you today. Yes, maybe tonight is his night. Do you want to stay with him?” She says, “Yes.” We return to the room.

In ICU the conversation with family is limited to brief personal encounters or telephone calls. But here, more than with a telephone call, the presence of the wife makes it almost impossible to talk about death. The words do not flow. And she is waiting for my answers and more than that, she wants an opportunity to resolve her doubts about her husband’s condition. Why? What is she expecting?

Once a patient said to his daughter: “Do you know, honey, what you will do, if something happens to me tonight? You know what to say to everybody?” In that moment the daughter was astonished at his words. She was not prepared for that sort of conversation. She avoided his eyes. She tried to change the topic. As human beings we leave, and we may miss those precious last moments with the person who is trying to say good bye. We do not know what happens after death. Yet, death is one of the things in our life that we cannot control. To recognize the face of death in someone else is to recognize our own mortality. We think that we are prepared for everything. But life changes the rules of the game all the time. Now we are here. The next minute we do not know what has happened to us.

Loneliness of the experience of death

I watch the monitor. Blood pressure and heart rate are unchanged. Perhaps he is waiting for something or someone.

I look at the monitor and after observing that the heart rate and blood pressure do not change, my thought is focused on the idea that Mr. Ricardo is waiting for something or someone. It is strange that the most important instances of life are lived in complete aloneness: one of those is our birth and the other moment is our death. Even though in birth and death people may be surrounded by family and friends, the specific moment is not shared because nobody can share the moment of his or her first breath or the moment of his or her last breath. It seems that our own humanity is resistant to being social in those moments of life and death. It is as if we do not want to share our most intimate moments. As Derrida (1995) points out:

I can die for the other in a situation where my death gives him a little longer to live, I can save someone by throwing myself in the water or fire in order to temporally snatch him from the jaws of death, I can give her my heart in the literal or figurative sense in order to assure her of a certain longevity. But I cannot die in her place. I cannot give her my life in exchange for her death. (p. 43)

I can share my life, my dreams, my grief and all the things that join me with another person, but at the moment of death the word “share” is left behind. We cannot delegate our death, for this moment just arrives. Where and when it arrives is impossible to know.

Unable to share death, human beings share their lives. As a nurse, I just can be with Mr. Ricardo. I can share those last moments with him. I can rub his skin, control his vital signs, but I cannot die with him. I cannot feel what he is feeling now in those last moments. I am just a watcher. Although I am with him, at the same time, he is alone. As a nurse, I can cross death, but my experience is different from his experience. I could feel some kind of the same feeling when someday I die. But certainly his death teaches me about myself as a nurse.

I hang up and quickly scan my surroundings. All is the same in the ICU. As usual there are the annoying sounds: monitors and ventilators; nurses, therapists, and doctors all in their own world. No one is concerned but me that this man is dying.

I walk to the window and look out. Bogota is cold tonight. It is raining and silent. My thought in this moment is simple: life marches on. It does not care who is in its way, who falls and gets trampled. Yet, here in 311 it is a different night. Intense. Bright. And strangely silent. Mr. Ricardo’s heart is fighting for his life. The heart rate continues at 70.

This is a moment of aloneness. I am alone with my thoughts and although he is with me, Mr. Ricardo is alone with his death. Around us, everybody is busy in other activities. No one seemes to realize that something of grave consequence is happening in room 311: a life is lost.

It seems like the color of the death is reflected in the place where I am. Death comes closer. My room is silent and bright. But nevertheless death becomes significant and different. I look at my surroundings and only find a contrast between the darkness of outside with the brightness and intensity of the room. Both inside and outside have in common the indifference to this man’s death.

Life goes on. As his nurse, I think how difficult it is to be fully aware of the moment of death of someone else. Although his body is barely responding, his heart continues beating for his life. In the end, humanity creates a fine bond between hopefulness and hopelessness, and the body responds to it.

The meaning of the last moment

She kisses his forehead and looks at the monitor. His blood pressure reads 40/23. His heart rate has begun to decrease. She looks up to me: “I do not want to be here when he dies. Please take care of him.” She turns and leaves the room.

Now I am here, with him. Alone with him. I come near to him. In this most intimate moment of his life. I touch him and watch his face. I feel sorrow and some kind of serenity. As I look at him I hear my mother’s words, “When a person is dying his face becomes more delicate more definite.” I now recognize death. I glance at the monitor. Blood pressure is 0/0. Heart rate 45, 42, 30, 25 …

While Mr. Ricardo’s wife is there with him, all his vital signs have begun to decrease. As Derrida (1995) says: “the Other has no reason to give us and nothing to settle in our favor, no reason to share his reason with us” (p. 56). Derrida describes death as beyond reason: reasons do not exist, for it just happens in front of my eyes and I cannot stop it. Overwhelmed by the situation of her husband, his wife leaves the room. She says to me, “Please take care of him,” and I am with him alone in his last moment of life. Once again I look at him and touch him and a feeling of sadness overcomes me in those gestures–because he is dying, and I am with him and yet he is alone. Despite my past experience in ICU as a nurse, this moment is different and unique. Every death is always different and unique. As Derrida points out: “I am still afraid of what already makes me afraid, of what I can neither see nor foresee” (1995, p. 54). It is difficult to face something that I really do not know, something that I can see with my eyes, but is beyond my own humanity.

My patient’s face begins to turn delicate and definite—and I recall my mother’s words about death… Is the uniqueness of the moment of death revealed when we say “good bye?” What is it about the moment of letting go of my patient?

What death precisely is, is very difficult to describe when we limit ourselves to considering the word death as a general theme. Death is unique. Its voice is ready to speak to us. But certainly we tend to be deaf and blind to its call. Death is always changing its face, and the experience in that final moment becomes utterly unique. In ICU the meaning of death is there when we look into the face of a dying patient. And we become aware of our own mortality. For nurses, this is a hard reality, part of our existence and part of our professional and personal life.

References

Derrida, J. (1995). The gift of death. David Wills (translator). Chicago: The University of Chicago Press.

Levinas, E. (1969). The Primacy of the Other. In Moran, D. & Mooney, T.(eds.) The phenomenology reader. New York: Routledge Taylor & Francis.

Olson, C. T. (1993). The life of illness. One woman’s journey. Albany, New York: State University of New York Press.

van Manen, M. (2003). The tone of teaching. London, Ontario: Althouse Press.

van Manen, M. (2002). Care-as-Worry, or “Don’t Worry, Be Happy”. Qualitative Health Research, 12 (2), 264-280.

Related:

Altrows, K.J. Feeling Like an Imposter

Feeling Like an Imposter Altrows, K.J. Dennis Roark had dreamt of being a doctor since the age of nine, when he reconstructed an animal skeleton from bones his family found on their summer vacation. Fourteen years later, in 1982, Roark’s parents waved goodbye to him...

Baldursson, Stefan. The Nature of At-Homeness

The Nature of At-Homeness Baldursson, Stefan Introduction Why should we be concerned with elucidating the experience of “at homeness?” Is there any experience more familiar to us than the experience of our home: the experience of being at home; being away from home;...

Bergum, Vangie. Birthing Pain

Birthing Pain Bergum, Vangie Birth is the art and mystery of women. We regard birth with awe; we are breathless, silent as we await the first breath of the baby. As women we birth, we become mothers, mothers like our own mothers ,like other women who have carried and...

Boger, Tracy. Teachers Watching Students Electronically

Teachers Watching Students Electronically Tracy Boger Over the lunch hour, a fourteen-year old boy and his friends are gathered around a computer in the library, working on a school assignment. Suddenly the screen flashes, and a giant eye fills the screen. Looking...

Bottorff, Joan. The Lived Experience of Being Comforted by a Nurse

The Lived Experience of Being Comforted by a Nurse Bottorff, Joan It is often the little things that count. Helen recalls a time she was at home recovering from a serious illness. A nurse came to see her and offered to “fix her pillow.” The nurse gently removed the...

Burton, Rod. The Experience of Time in the Very Young

The Experience of Time in the Very Young Burton, Rod Dimensions of Time We seem to have reached a point (in time) where we live not only clocktime, but some of us talk as though we were clocks, says Troutner (1974). For the most part, all of us in our culture, whether...

Cane, W B. On the Notion of Special in Crafting

On the Notion of Special in Crafting Cane, W B I have nurtured, persevered with, labored over, a dream for six years now. The dream is 60% complete and at this rate will transform fully into a special object some four years from now. To be brief, the object is a hot...

Clark, Graeme T. To the Edge of Existence: Living through Grief

To the Edge of Existence: Living through Grief Clark, Graeme T. We usually know death from a distance. Death is an unfortunate event which happens to others. When death strikes someone unrelated to us, we may feel a passing sense of loss or upset for their misfortune....

Connolly, Maureen. The Experience of Living with an Absent Child

The Experience of Living with an Absent Child Connolly, Maureen His name is Phillip Thomas. I had to walk him down here. Please could you take him to the hospital where he can get proper care and live in a clean environment. I would take him but I cannot afford it....

Davies, Mark. Loneliness

Loneliness Davies, Mark Loneliness as Searching Its only four in the afternoon, but the overcast sky makes it seem later. I step off a curb, careful to miss the puddle along the gutter. The road is blacker than usual with the pebbles of the asphalt holding the rain in...

Devine, Heather. The Workout: The Phenomenology of Training

The Workout: The Phenomenology of Training Devine, Heather “I train three times a week.” “I work out regularly.” “I’m taking fitness classes.” “I get a lot of exercise.” “I practise for an hour a day.”‘ “Training. Practice. Exercise. Fitness. Working out.” What do...

Evans, Rod. Authority in Educational Administration

Authority in Educational Administration Evans, Rod For those of us who work with children in schools, the question of authority is raised every day in our encounters with children in schools and classrooms. It is raised not in an abstract theoretical way in...

Fahlman, Lila. Understanding Imagination in Child’s Play

Understanding Imagination in Child’s Play Fahlman, Lila The Painting Almost every day, Yorgo paints a picture. Soon he will be coming up the walk, clutching, protecting his precious, painted picture from the elements. His walk and his eyes tell me about his painting,...

Field, Peggy-Anne. Giving an Injection

Giving an Injection Field, Peggy-Anne What is it like to give an injection? What is it like to hurt another human being? What is it like to violate someone else’s body in this way? Here is a personal account of one registered nurse’s experience of giving an injection:...

Flickinger, Aprile. Therapeutic Listening

Therapeutic Listening Flickinger, Aprile How does a therapist listen to people in need? Is there a unique way of therapeutic listening different from the way in which people usually listen to each other? At first glance this may seem an odd question. Listening is a...

Gagnon, Rochelle. Understanding Depression

Understanding Depression Gagnon, Rochelle Sitting in a quiet little coffee shop, I glance at my best friend’s face. She doesn’t look up from her cup, but gazes into the liquid like she may find all her answers there. Even though my friend sits in front of me, I feel...

Goble, Erika. The Experience of Encountering the Sublime

The Experience of Encountering the Sublime Goble, Erika Introduction Moving through the gallery, my eyes slide over the people and then to the paintings. To the left is a portrayal of a battle. I am drawn to the cavalry. Though still – frozen in time, the horses move...

Hawley, Patricia. The Nursing Moment

The Nursing Moment Hawley, Patricia In “Nursing the finest art: An illustrated history”, Donahue (1996) includes a photo of a poster created by Melody Chenevert of a Victorian crazy quilt with the caption “Nursing-a career not measured in years but in moments”. She...

Hewat, Roberta J. Living with an Incessantly Crying Infant

Living with an Incessantly Crying Infant Hewat, Roberta J. It was a beautiful day outside. I had a big table in her bedroom, all the diapers and everything were on it and she was laying there screaming and crying and all I can think about is shaking this child and...

Hove, Philo. Pedagogy in the Face of Wonder

Pedagogy in the Face of Wonder Hove, Philo In this paper I explore some dimensions of the phenomenon of wonder in human life. Such is its subtlety that wonder may be easy to dismiss or ignore; however, the resounding profundity of the ‘stillness of wonder’ (van Manen...

Howard, Dale. The Computer Encounter: First Time Adult Computer Use

The Computer Encounter: First Time Adult Computer Use Howard, Dale We may become no longer free for the kind of thinking that would redeem us from the world we ourselves have created. We may have made ourselves incapable of such thinking. (William Barrett 1978, p....

Howery, Kathy. The Experience of Speaking Through a Machine

The Experience of Speaking Through a Machine Kathy Howery First Words With power compelling, Mind triumphs, Quiet thunder, God, men hear words. Silent, I am no more! (Creech, 1992, p. 70) The author of this poem has never spoken a single intelligible word of through...

Hunsberger, Margaret. The Experience of Re-Reading

The Experience of Re-Reading Hunsberger, Margaret What is it like to re-read? Having had one conversation with the text, why should we seek to return for another? On the other hand, why not? When a human voice speaks to us and we appreciate the conversation, value the...

James, Susan. The Experience of Homebirth

The Experience of Homebirth James, Susan Childbirth in Canada is, for the most part, a medicalized experience. Women who choose to birth their babies at home are by far the exception rather than the rule. In Alberta, in 1981, the College of Physicians and Surgeons...

Johns, David P. Body Awareness and the Gymnastic Movement

Body Awareness and the Gymnastic Movement Johns, David P How do gymnasts and those who aspire to be gymnasts view the physically dangerous task ahead of them each time they mount the apparatus or step onto a free exercise area? Is it possible to be suddenly inspired...

Jubien, Peggy. The Mobile Lecture.

The Mobile Lecture Peggy Jubien Prologue Baxter Wood is one of Hubert Dreyfus’ most devoted students. During lectures on existentialism, Wood hangs on every word, savoring the moments when the 78-year-old philosophy professor pauses to consider a student’s comment or...

Kalyanee, Vorapassu. Block Play: the Creative Openness

Block Play: the Creative Openness Kalyanee, Vorapassu Jordan and Tyler are building a spaceship. “Let’s make a spaceship with a trap door,” Jordan suggests. Large hollow blocks are placed vertically on end forming four walls leaving a small space inside. Jordan...

Kendrick, Maureen E. The Experience of Playing Chase

The Experience of Playing Chase I watch as three-year-old Emma moves from her quiet spot on the floor, where she has been watching television, and stands in the space between the chesterfield and chair. From the other side of the room, I can see the mischievous gleam...

Kim, Mijung. Being Nostalgic

Being Nostalgic Kim, Mijung The purity of nostalgic memories It is a late, lazy morning. The sun is already high and I can feel it’s going to be scorching today. I look out the window. People seem to have already started their daily routines. I hear the sputtering of...

Laing, Marie. Naming our Child

Naming our Child Laing, Marie What terrible names Are Jamie and James Thought Jim. “Peter is sweeter And Patrick is neater” But when he was christened Nobody listened to him. (Robert Wesley-Smith) What is in a name? I think my name; I think the names of those I know...

Lee, Keun-ho. The Experience of Studying in a Foreign Language

The Experience of Studying in a Foreign Language Lee, Keun-ho At present I find myself in a somewhat strange and alienating situation. Labeled as “international student,” I can no longer use my Korean language as the medium of my study. I have to use English to...

Lorback, Colin. Water Experience

Water Experience Lorback, Colin Water in its many forms is essential to all life. It is the medium in which most living cells exist. Our bodies consist of more than two-thirds water which is constantly being eliminated, to be replaced through drinking. Water is also...

Luce-Kapler, Rebecca. Rewriting the Poem

Rewriting the Poem Luce-Kapler, Rebecca After basking in a rereading of Seamus Heaney’s (1996) marvelous poem “Personal Helicon,” I find myself whispering the first line: “As a child, they could not keep me from wells.” And I wonder: what could I not be kept from...

Maeda, Chizuko. Falling Asleep

Falling Asleep Maeda, Chizuko I am lying with my three students, looking at the darkness. It was a few minutes ago that I announced to them that it was time to go to sleep and turned off the light. The romping and chattering which had filled the room until just before...

McPike, Grace. Phenomenological Reflections on the Failing Grade

Phenomenological Reflections on the Failing Grade McPike, Grace We have all become accustomed to a world that incorporates failure into daily life. It is not a pleasing part of our lives, and we remember the hurt that each failure provides. Yet, we perpetuate failure...

Mueller, Peter K. The Joy of Teaching

The Joy of Teaching Mueller, Peter K My grade eleven social studies class is about to enter the room. I enjoy this class, and if someone were to ask me why, I would have a ready answer. This group of students, as a group, seems genuinely interested and involved....

Nungu, Joseph. Homesickness as Quest

Homesickness as Quest Nungu, Joseph It is a cold Friday morning. I am a graduate student in Edmonton, Canada, and my laptop broke when I slipped on a patch of ice. Now I am in a hurry to get to a computer and finish up my assignments. I try to whistle some sweet tune,...

Oldham, Val. Difficulty in the Lifeworld of the Child

Difficulty in the Lifeworld of the Child Oldham, Val To our life according To that principle which counsels us That we must always hold to the difficult Then that which now still seems to us The most alien will become what we Most trust and find most faithful. (R. M....

Olson, Margaret. Room for Learning

Room for Learning Olson, Margaret Every day thousands of teachers and thousands more children spend part of their lives together in classrooms. Every year teachers return to their classroom before school starts to get ready for the day when their new students will...

Pallos-Haden, Katie. I Have Called Thee By Thy Name

I Have Called Thee By Thy Name Pallos-Haden, Katie As a teacher, I used to think it was incredibly important to be able to name kids on the first day of school. This act demonstrated (or so I thought) that I wished to know them and establish a relationship with them....

Paradis, Patricia. The Pedagogical Significance of the Look

The Pedagogical Significance of the Look Paradis, Patricia Eye Contact Eye contact? Oh, yes. All the time. They taught us that in our education courses. You’re supposed to look at the students when you teach them. If you can’t do that, you’re supposed to aim your look...

Ranson Ratusz, Ann. A Mouse in the House

A Mouse in the House Ranson Ratusz, Ann Then the tailor started: for suddenly, interrupting him, from the dresser at the other side of the kitchen came a number of little noises— Tip tap, tip tap, tip tap tip! ‘Now what can that be?’ said the Tailor of Gloucester,...

Redekopp, Dave E. Did You Know That…?

Did You Know That…? Redekopp, Dave E “I probably shouldn’t tell you this, and it may not be true, but I heard that John….” There it begins. The speaker now has the full attention of the listener, knowing that ultimately, this will not be a one-way communication. The...

Reimche, Donna. The Child’s Drawing

The Child’s Drawing Reimche, Donna Interest in children’s drawings is a fairly recent occurrence, of the last thirty or forty years. And yet, children have always drawn, whether in sand or in mud, on wood or on stone, but prior to modern times, few people cherished...

Reynolds, Karen. The Lure of the Loom

The Lure of the Loom Reynolds, Karen We weave in and out of traffic or weave our way through a crowd. We weave tales or great stories, weave bits of humor into our speech, ribbons into our hair… Everybody talks about weaving, uses the word, but only a few know what a...

Robb, Marnie. Deciding to have a Child: A Woman’s Perspective

Deciding to have a Child: A Woman’s Perspective Robb, Marnie While I was chopping the parsley, my friend Sarah matter-of-factly disclosed her decision to have a child. I was excited and wondered how she could sound so casual about this momentuous decision. According...

Shapiro, Alan. Show and Tell: It’s a Window on their Lives

Show and Tell: It’s a Window on their Lives Shapiro, Alan There was a boy named Mark. When he went up in front of the class he got scared and his friends laughed at him and called him names so he didn’t go up again. (Harley, Grade Three) Show’n tell is like you’re in...

Shaw, Stephen. Returning Home

Returning Home Shaw, Stephen We left the house early, David and I, before the household had really begun to stir and show signs of activity. Mum was up, but temporarily, making her first cup of tea to ease herself into the day. Edgar would sleep for several more hours...

Smith, Claire. Letting Go

Letting Go Smith, Claire Much has been written about the sense of hope that children give us as parents. Children fill our lives with care in all senses of the word and engender in us a vital sense of purpose. What happens when we have to separate from our offspring?...

Smith, David. Living with Children

Living with Children Smith, David In our investigations, we wish to understand what it is like to live with children. By defining our subject as this, we immediately limit it in important ways. There are some questions we will not ask. For example, we will not begin...

Smith, Stephen. Seeing a Risk

Seeing a Risk Smith, Stephen I dare you to Go on, Go on I dare you to. Bet you can’t You’re too afraid Go on-I dare you to. The Dare Hazards loom large when we are dared to do something. The dare exposes us to the chance of injury or loss in spite of what we might be...

Spence-Campbell, Susan. Oneself as Another

Oneself as Another Spence-Campbell, Susan As I drive to the theatre, I practice my lines. They have become second nature to me. I say them fast and slow, with an English accent. I feel them in my mouth. I go to the dressing room, I chat with the other actors. Later,...

Sullivan, Mary. Matters of Consequence

Matters of Consequence Sullivan, Mary The bag lady crossing the parking lot is an elementary school teacher making her way to work. The Safeway logo stretches over a bulge of grade 4 journals in one bag. String and coat hangers, sweatsuit and runners poke from...

Underwood, Bill. Grief for Someone Else’s Child

Grief for Someone Else’s Child Underwood, Bill A Question Posed When parents come together at social gatherings, at some point they talk of their children. What is exchanged, on the surface at any rate, are stories or reminiscences that bring to life the “minute...

Underwood, Susan. Touchstone: Finding a Lump in the Breast

Touchstone: Finding a Lump in the Breast Underwood, Susan we never spoke at your deathbed of your death but from here on I want more crazy mourning,more howl, more keening (Rich, 1984) The only deaths by which we are not surprised belong to the dead. The day on which...

Van der Zalm, Jeanne. Pregnancy

Pregnancy Van der Zalm “She’s expecting, you know!” I hear one of my colleagues say to another as I walk past the copy room. I know that she is not speaking of a parcel, a phone call, or a relative’s visit. She is speaking of expecting a child. Expectancy is the...

Weber, Sandra. Playing School

Playing School Weber, Sandra Nursery schools and kindergartens are sometimes referred to as “playschools.” They are not considered the same as “real” schools but are seen rather as places where children get ready for real school by playing or pretending. The label...

Wilde, Sandra. The Experience of Pedagogical Openness

The Experience of Pedagogical Openness Sandra Wilde Waking Up?  It has been a busy evening. Finally, now that the children are asleep, I can begin to write. But it’s late; I’m already tired and I have so much to do. How will I finish my paper tonight? I shake off...

Winning, Anne. Homesickness

Homesickness Winning, Anne The box sat in the middle of the room unopened. I was afraid to open it. I had to steel myself. I had to wait for the moment when I knew I felt strong enough. The box took me back to my living room, to that time when I still had a home in a...

Woitte, Sherry. Learn to Skip and Skip to Learn

Learn to Skip and Skip to Learn Woitte, Sherry Cinderella dressed in yella Went upstairs to kiss her fella How many kisses did she give? One, two, three, four, five . . . I walk by a school playground. Groups of girls are skipping rope on the concrete sidewalks next...

Wu, Zhou. The Lived Experience of Being a Foreigner

The Lived Experience of Being a Foreigner Wu, Zhou Think thou how that this is not our home in this world, in which we are strangers, one not knowing another’s speech and language. (The Diary of Samuel Ward, entry for May 13, 1595) Several years ago, I was in West...

Yeu, Hae-Ryung. Experiencing of the Eyes

Experiencing of the Eyes Yeu, Hae-Ryung It was a steaming hot summer day afternoon. The airport was crowded with the people who were going to leave, their families, their luggage, huggings and farewells.The plane was going to take off about in half an hour.The last...

Yonge, Olive. Giving Constant Care to a Psychiatric Patient

Giving Constant Care to a Psychiatric Patient Yonge, Olive What is it like to give constant care to a psychiatric patient? It may be argued that a person cannot possibly know unless they have the experience of sitting with a patient who is frightened and dangerous....