UNITARY HEALTH CARE IN GERMANY

Michael Ammende RN, B.A.(Hons.) in German/History of UCL (UK), Diplom-Pflegepädagoge.
Head of the Aus-, Fort- und Weiterbildungsinstitut, Germany

Introduced by Francis C Biley

Michael Ammende can probably be regarded as the leading Rogerian nurse in Germany. He is well known for regularly running highly successful Therapeutic Touch workshops, he has been teaching SUHB in Germany since 1995 and has taught TT to about 600 nurses in Germany, mostly in Southern Bavaria. During 2002, Michael will be teaching SUHB and TT at the department of nursing science at the University of Bremen. He has published extensively on the subject of unitary health care, most notably being responsible for the translation of Martha Rogers' book "An Introduction to the Theoretical Basis of Nursing" into German.

HEALTH PATTERNING by Elizabeth A. M. Barrett

Health Patterning is a process of facilitating unitary well-being by assisting clients with their knowing participation in change. The focus includes lifestyle changes, struggles with illness, and resolution of difficulties in living and dying. In the Health Patterning process, people are helped to become aware of feelings, thoughts, and attitudes within a gentle, life-affirming environmental context that involves meaningful use of theory and associated Health Patterning modalities. These modalities include Therapeutic Touch, imagery, meditation as well as use of sound, light, color, and motion. Meaningful dialogue and centering are integral to many of these approaches as well as knowledgeable caring, authenticity and love. In Health Patterning, transformation of oneself, sparked by a creative, ever changing mutual process with the nurse, becomes a way of actualizing human potentials for change by enhancing awareness of one's capacity for knowing participation. In other words, one comes to recognize one's power and to use it. Power, according to Barrett's theory, is the capacity to participate knowingly in change as characterized by awareness, choices, freedom to act intentionally, and involvement in creating changes. Power is being aware of what one is choosing to do, feeling free to do it, and doing it intentionally. Awareness and freedom to act intentionally guide participation in choices and involvement in creating changes. Power is freedom to make aware choices regarding involvement in life situations, including health promoting changes. Depending on the nature of that awareness and the strength of the choices one makes, and how free one feels to act on their intentions, the range of situations in which one is involved in creating changes as well as the manner in which one knowingly participates vary. In this way, people can knowingly participate in creating their reality. This is Health Patterning.

Health Patterning by Appointment
Elizabeth Ann Manhart Barrett, RN; PhD; FAAN
Upper East Side,
New York, NY
Tel: 212-861-8228

Elizabeth Ann Manhart Barrett, RN; PhD; FAAN is currently Professor Emerita, Hunter-Bellevue School of Nursing, Hunter College, City University of New York and is in private practice of Health Patterning in New York City. She can be reached at eambarrett@att.net and www.drelizabethbarrett.com.

Now available online in PDF format:

"The Theoretical Matrix for a Rogerian Nursing Practice" by E.A.M.Barrett 2000, Theoria: Journal of Nursing Theory, 9 (4) p.3-7. Copyright 2000 by the Swedish Society for Nursing Theories in Practice, Research, and Education. Reprinted with permission.

 NEW PAPER:   Imagery : Experiencing Pandimensional Awareness (added 6 January 2004)

UNITARY HEALTH CARE EXPLAINED by Thomas Cox

Can anyone explain unitary nursing according to Martha Rogers' Science of Unitary Human Beings?

In September 1998, members of the MERogers listserv were asked the above question. Bear (Thomas Cox) at tc_spirit@yahoo.com replied:

Heck, I'll take a stab at the difference it implies...in most theories of contemporary nursing there is an awareness of the holistic nature of the interaction between service provider and patient/client. However, the implications of Rogerian theory is that there are very subtle aspects of energy interchange that need to be attended to. 

So let's take a pretty standard example - what is the difference between giving an injection in and out of Rogerian theory. Outside the context of the theory we imbue the ingredients in the syringe as the major ingredient in the interaction. How the contents of the syringe are delivered is of little relevance. Within the context of Rogerian science from the moment that the "intent" to deliver the contents of the syringe to the pt/client enters our consciousness we are "connected" to the "energy field" of the client. How we fill it, how we approach the client's room, how we enter the room, how we move toward the client, how we respect the intermingling of our energy field with that of the client, how we reach out to touch the client, the manner in which we initiate the actual contact, the manner in which we perturb/perceive the client's energy field, the way we introduce the needle to the client's IV's or body, the way we push the contents, the manner in which we withdraw the needle, the way we touch, stroke or do not touch or stroke the client, the manner in which we withdraw from the client's energy field, leave the room and then refocus on our next engagement with another client and consciously disentangle our own energy field from that of the last client are all significant variables that affect the manner in which the client responds to the interaction and to the delivery of the contents of the syringe.

Now, you might be thinking, yeah but I do this the same for all my patients and I am a caring, sensitive, compassionate nurse/student...but what about your/my energy field - is it distorted from being out all night partying or did you/I spend the evening before clinicals engaged in deep meditation. did you/I arrive at your/my patient's bedside weak and "disturbed" from emotional baggage that you/me are carrying around with you/me or did you/I arrive bright eyed and bushy tailed and focused on your/my own health and well being as well as the health and well being of your/my patient... Many practicing nurses simply seem to believe that their/our own lives can be completely screwed up, their/our own health placed at risk from a variety of unhealthy behaviors (and from what I gather Martha had a few herself) and this will not affect the manner in which they render care to their/our patients... SUHB, more than any other theory of nursing, implies that the "state" of the deliverer of service is a critical component of the "quality" of the interaction and the quality of the care rendered. Now, let's be real. It is hard, especially considering the impact of managed care, cost-containment, increased acuity of in-patient populations, excessive paperwork and confusion about what services are covered and what are not - for any of us to show up for work/clinicals in an optimal "state". But, how far are we going to deviate from optimal? How long might we continue to think that the turmoil we introduce into our own lives is somehow divorced from the effect we are having on our patients/clients and what should we do if we want to practice wholly in accordance with the broadest implications of the theory. My own sense - and only weakly adhered to I must admit, is that I have to learn to live more healthily if I want to encourage others to live more healthily and that encouragement includes how I give that injection even if unaccompanied by any other communication than the subtle intermingling of our energy fields. If you do not believe that such energy fields exist, intertwine, extend beyond the actual physical dimensions of the two physical/ego bodies then you have no responsibility for your energy field's approach/impact on the other party and that may make your practice a lot easier or not...hopefully, my admittedly simplistic explanation will not offend too many people and will prove useful to you as you prepare for patient contact.... one thing I like to do when I am not feeling totally frazzled is "center" myself before I approach a client - in a perfect world I would always be centered before such interaction...I'd also hazard an addenda that Martha was distinctly Einsteinian rather than Newtonian in her sense of energy, motion, time... and that most other nursing theorists are far more Newtonian...at the same time, it is hard, when riding down the street, to apply Einstein's work in a practical way that helps us avoid collisions with other cars...anyone who would like to embellish or replace this shot at an explanation has my blessings...

Thomas Cox MS, MSW - Doctoral student, VCU, Richmond, Virginia

Things from Fran Biley that might be of some use or interest:

Click here to have a look at a paper on energy fields nursing, written by Fran Biley and Catherine Jones and first published as "Energiefldpflege: Eine Untersuchung neuer und wiederentdeckter Grenzlinienfur die Praxis". (Word 6 document; 62K).

Click here (Powerpoint 2000, 348K) or here (zipped ppt, 308K) to see my attempt at representing the concept of time from a Rogerian perspective in (not very good) poetry and illustrations.

Click here to see a presentation on basic Rogerian and SUHB concepts and principles (Powerpoint 2000, beware - 1600K).

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