Cancer patients' perceptions of nursing: Expectations & realities, a phenomenological study.

PURPOSE: Determining the perception and expectations of cancer patients will inform nurses' understanding of how to conduct nursing care to meet patients' needs. Studies have mainly used quantitative methods to understand nursing image from the perspective of the public and the profession, and there are no recent studies to date on nursing image from the perspective of cancer patients. The aim of this qualitative study was to explore cancer patients' experiences and perceptions of nursing within the conceptual framework of Watson's Human Care Theory. METHODS: In total, 19 phenomenological semi-structured interviews were conducted with cancer patients between November 2022 and January 2023. Data were analyzed using Assarroudi et al.'s content analysis. RESULTS: Three themes emerged from the phenomenological analysis of the interviews: (1) nursing image, (2) expectations, and (3) realities. Patients stated that nurses act as assistants and that health services cannot be provided without them. Under the main theme of 'expectations,' five subthemes emerged: psychosocial care, physical care, ethics, individual characteristics, and no expectations, while the theme of 'realities' contained two subthemes: (1) satisfaction with nurse behaviors, and (2) dissatisfaction with nurse behaviors. CONCLUSIONS: Our study provides important insight for nurses working with cancer patients in the management of patient care and treatment. Empowering cancer nurses will increase patient care satisfaction. We recommend the implementation of programs designed to support nurses and improve nursing communication skills. We also recommend that the technical and psychosocial aspects of nursing care should be considered as a whole.

The Effect of Home-Based Telehealth and Postpartum Care Given According to Watson's Theory of Human Caring on the Improvement in the Emotional State of the Mother During the Pandemic Process: A Case Report.

Objective: The purpose of this case report was to evaluate the effect of telehealth and postpartum care provided to a mother with maternal depression according to Watson's Theory of Human Caring during the pandemic on the improvement in the mother's emotional state and to evaluate the applicability of the model. Methods: Edinburgh Postnatal Depression Scale was administered to eight women who responded to the announcement made on social media, and verbal and written permission was obtained from the mother with the highest scale score. A total of six video calls were made with the mother via WhatsApp, twice a week in the first week after postnatal discharge and once a week in the next 4 weeks, in accordance with the form drawn up according to Watson's Theory of Human Caring. Results: In this study, it was observed that home-based telehealth and postpartum care provided using Watson's Theory of Human Caring, which includes a holistic approach, was very useful, and the care provided according to the model provided a positive improvement in the emotional state of the mother with depression. Conclusions: It was concluded that telehealth and postpartum care is useful in home-based care in extraordinary situations/quarantine conditions such as pandemic; care can also be provided in the form of telehealth service according to Watson's Theory of Human Caring to mothers with depression; and care provides positive improvement in the emotional state of mothers.

[Human Caring at Different Stages After Disasters].

Disasters, including natural disasters and man-made ones, occur rather frequently in recent years. Disasters bring destruction to the resources and expectations of local residents and cause varying degrees of physical and mental damage to the victims, some of whom suffered persistent post-traumatic stress disorder (PTSD). Human caring is the essence and core of nursing. Giving consideration to the needs and wishes of patients, the nursing staff respect the personal values of patients, give patients sincere attention and care, satisfy the reasonable needs of patients, protect the dignity of patients, stimulate patients' positive inner drive, alleviate their physical and mental pain, and facilitate the smooth recovery of patients. However, very few studies have been done to look into the human caring at various stages after a disaster hit and there is little relevant guidance available. Herein, we examined the characteristics and needs of victims of disasters in the post-disaster response stage and recovery stage and elaborated on specific and feasible measures for the implementation of human caring after disasters, including prehospital emergency care, which includes on-the-site emergency care and transportation of patients, in-hospital treatment, which includes an environment of human caring and human caring for patients and their families, especially for the special-needs populations, and post-hospital recovery stage, which includes post-hospital continuing and community-based human caring. We intend to provide guidance and reference for the practice of human caring when major disasters occur.

Impact of Watson's human caring-based health promotion program on caregivers of individuals with schizophrenia.

BACKGROUND: Caring for people with schizophrenia is accompanied by challenges that impact caregiver health. We conducted this study to explore the effect of a Caring Science-Based health promotion program on the sense of coherence and well-being among caregivers of persons with schizophrenia. METHODS: This randomized clinical trial with the Solomon four-group design was conducted on 72 caregivers randomly allocated into two intervention and two control groups. A health promotion program based on Watson's theory was performed individually through five face-to-face sessions and a four-week follow-up. Settings were the psychiatric centers of the three educational, specialty, and subspecialty Ibn-e-Sina, Moharary, and Hafez hospitals affiliated with Shiraz University of Medical Sciences (SUMS), south of Iran. The data were collected using a demographic information form, the Sense of Coherence Scale, and the Caregiver Well-Being Scale. One-way ANOVA, chi-square, Kruskal-Wallis, and independent t-test were used to determine the homogeneity at baseline. In the post-test, multiple between-groups and pairwise comparisons were assessed by One-way ANOVA and Tukey's post-hoc. Within-group comparisons were evaluated using paired t-tests. All tests were two-tailed, and the statistical level was considered 0.05. RESULTS: Data analysis showed that the mean scores of caregiver sense of coherence and well-being from pre-intervention to post-intervention were significantly increased in the intervention groups (p < 0.001). At the same time, there were no significant differences in the control groups. CONCLUSION: The health promotion program based on Watson's human caring theory facilitated ongoing intrapersonal, and holistic caring and improved the sense of coherence and well-being in caregivers of persons with schizophrenia. Hence, this intervention is recommended for developing healing care programs. TRIAL REGISTRATION: https://www.irct.ir/trial/55040 : IRCT20111105008011N2 (11/04/2021).

Del cuidado humano al cuidado del ambiente / From human care to environment care

El objetivo principal de esta teorización es reflexionar sobre el cuidado humano, a partir de la identificación de la crisis paradigmática y los cambios requeridos del paso de un modelo biomédico a uno transformador basado en la ciencia del cuidado humano. La metodología fue un estudio teórico de reflexión amparado en la teoría del cuidado humano y la teoría ecológica cosmocena. Los principales resultados dan cuenta de que los modelos de compresión ontológica amplían la visión del cuidado humano de la salud a una visión que involucra una comprensión del cuidado del ambiente, son una importante contribución al campo de las ciencias humanas y de la salud que puede servir para orientar nuevas formas de ser y actuar. Se concluye que es en el concepto de alfabetización ontológica unitaria donde las enfermeras y enfermeros poseen competencias que implican conciencia, formas de ser reflexivas e intencionales que conducen a la curación y plenitud de pacientes, familiar, colegas y el ambiente. En el área de salud, comprender la necesidad de un cambio hacia filosofías de cuidado, permite ir hacia paradigma generadores de salud. (AU)

The main objective of this theorization is to reflect on human care, starting from the identification of the paradigmatic crisis and the changes required to move from a biomedical model to a transforming model based on human care science. The methodology was a theoretical study of reflection based on the theory of human care and the cosmocene ecological theory. The main results show that the ontological understanding models expand the vision of human health care to a vision that involves an understanding of the care of the environment, they are an important contribution to the field of human and health sciences that can serve to guide new ways of being and acting. It is concluded that it is in the concept of unitary ontological literacy where nurses have skills that imply awareness, reflexive and intentional ways of being that lead to the healing and fulfillment of patients, family members, colleagues, and the environment. In the health area, understanding the need for a change towards care philosophies allows us to move towards health-generating paradigms. (AU)

The effect of nursing care based on human caring theory on posttraumatic growth in parentally bereaved adolescents: Action research.

PROBLEM: The death of a parent is a traumatic experience for adolescents. Studies to ensure post-traumatic growth in adolescents are limited. The aim of this study to evaluate the effect of nursing care based on Watson's Theory of Human Caring on posttraumatic growth in parentally bereaved adolescents. METHODS: This study was participatory action research. The study was carried out with four participants through online interviews. In the study, pre- and post-action data were obtained through individual interviews and scales. During the action process, nursing care based on the Theory of Human Caring was provided to the participants individually tracked through the Omaha System. Pre and post-action qualitative data were analyzed using the descriptive analysis method. In quantitative data, scale total and sub-scores were documented. FINDINGS: During the action, it was determined via Omaha System coding that the participants mostly experienced grief and mental health problems. In the pre-action, the participants stated that they experienced various difficulties regarding grief. In the post-action, the participants stated that the meaning of parental loss,its effects on life, and their ability to cope with loss changed and they experienced positive changes. In addition, when the scale scores of the participants' pre- and post-action were compared, it was found that the Mourning Scale scores decreased, and the Post-traumatic Growth Inventory scores increased. CONCLUSIONS: The result of this study demonstrate that nursing care based on Theory of Human Caring reduces the grief symptoms and contributes to post-traumatic growth in parentally bereaved adolescents.

Frontline nurses experiences about human caring during pandemic of COVID-19: A directed content analysis study.

AIM: This study aims to investigate experiences of frontline nurses about human caring during COVID-19 pandemic based on the Ten Caritas Processes® of Watson's Human Caring Theory. DESIGN: A directed content analysis was performed. METHODS: A total of 15 frontline nurses were recruited by purposive sampling from Razi hospital (north of Iran), in 2020 and semi-structured interviews were conducted. RESULTS: Extracted categories based on Ten Caritas Processes® included feeling satisfied in providing care to patients, effective presence with patients, moving towards self-actualization (moving towards transcendence), care with trust and compassion, experience positive and negative emotions, creativity in providing care, self-directing learning experience in the field of care, unfavourable environment for providing care, feeling acceptance and worth, uncertainty (facing the unknown). This study showed that communication skills, self-sensitivity, patient dignity, teaching-learning and problem-solving skills, holistic attention to the patient, and the provision of a healing environment are necessary for patient care.

Watson's Authentic Presence: Philosophical and Theoretical Approaches.

Presence remains a fundamental aspect of nursing practice and theory and yet remains poorly defined. The author describes Watson's phenomenon of authentic presence in both the nursing and interdisciplinary literature. The emerging themes are applied to Watson's theoretical and philosophical perspectives of human caring science.

Scope review of human caring for patients by head nurses / 中华医院管理杂志

Objective:To explore the current practice of head nurses′ human caring for patients at home and abroad, and integrate those effective measures and effect evaluation methods, so as to provide reference for nursing administrators.Methods:A framework was built on the scope review method proposed by Arksey and O′Malley, and such search terms as head nurse/nursing administrator, human caring/care/human-based, sick person/patient, nursing supervisory/charge nurse/head nurse/nurse administrator/nurse manager/nurse executive, empathy/care/compassion, patient/client were used. CNKI, Wanfang database, VIP, Chinese Medical Association Journal Full-text Database, Medical Knowledge Network (PubMed, Elsevier, Springer, Wiley, OVID, EBSCO) and the Cochrane Library were searched from their initiation to November 29, 2022. Two researchers independently screened and extracted basic characteristics of the literature, as well as the measures used by the head nurses to implement human caring for patients and the effect evaluation tools.Results:A total of 57 articles were included. This paper reviewed the measures of human caring for patients at both levels of head nurses as direct caregivers and as organizers.The measures at the level of direct caregivers included implementing human caring in their ward rounds, creating a caring atmosphere, setting up a head nurse reception day, interviewing the care needs of patients and their families, innovating working methods based on the perspective of human caring, and caring communication with patients and their families; measures at the level of organizers included building a nursing human caring mode with specialist characteristics, building a human caring mode for different patient groups, strengthening the training of nurses′ human caring ability and literacy, building a caring environment and atmosphere, simplifying the nursing work process, and establishing a continuous and diversified nurse-patient communication mode, continuing human caring for discharged patients, organizing participation of nurses in social practices of human caring, setting up caring posts, and conducting care supervision and quality control. Patient satisfaction survey was used to evaluate the practical effects of human caring, but the evaluation objects were nurses or nursing services.Conclusions:Head nurses play an important role in the implementation of human caring, and a variety of measures can be taken to directly or indirectly implement human caring for patients. It is suggested to build more human caring modes to cover more specialties and patient groups, and improve the patient satisfaction evaluation tools with head nurses as the evaluation object.

Human Caring: A Concept Analysis.

Introduction: Human caring combines science, art, and humanity. Humanity is the heart of care and interpersonal interactions. Despite the critical emphasis on human caring and concern for nursing care without humanity, there is no clear definition for human caring in nursing. This study aimed to analyze the concept of human caring. Methods: Walker and Avant's strategy for concept analysis was used. Electronic databases such as PubMed, Scopus, Ovid, Google Scholar, Magiran, Iran Doc, SID, and a number of dictionaries were searched without any limitation in date. Search keywords were "care", "caring", "human caring", "humanization", "patient care", "comprehensive care" and "nursing care". We searched all documents published before September 2020. In the initial search, 1637 articles were found but finally, 39 relevant articles remained in the study. Results: The nine defining attributes of human caring were establishing therapeutic communication, presence at the patient bedside, empathy, providing scientific care, subjectivity, dynamicity, respecting the patient's rights and ethics of care, helping the patient achieve a feeling of well-being, and art and creativity. Antecedents of human caring were categorized into three categories namely, human, personal, and organizational factors. The consequences were also categorized into consequences related to nurse, profession, patient, and organization. Conclusion: A theoretical definition and a conceptual model of human caring were developed. This concept should be included in the nursing curricula at all undergraduate and graduate levels and even in nurses' in-service training programs.

Experiences of nurses diagnosed with COVID-19 and recovered: A qualitative research.

AIM: This study aimed to explain the feelings and experiences of nurses who survived COVID-19 in their care and recovery processes, based on Watson's theory of human caring. BACKGROUND: The COVID-19 pandemic was an extraordinary time when nurses both took care of their patients and dealt with their illness by catching the disease themselves. In this process, nurses who contracted the disease experienced the fear of transmitting the disease to their relatives. METHOD: A qualitative descriptive research design was used in this study. The sample consists of 15 nurses selected by the convenience sampling method and diagnosed with COVID-19 and recovered. The data were collected in face-to-face interviews using the individual in-depth interview method through a semi-structured interview form. A thematic analysis was performed on the data according to the 10 carative factors of Watson's theory of human caring. RESULTS: It was determined that the spiritual and professional difficulties experienced by nurses who recovered from COVID-19 during the disease and symptom management process were the fear of death, infecting their family members and losing them, and the importance of life. CONCLUSION: It is considered that care practices based on Watson's theory of human caring will be beneficial in the management of these processes. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses diagnosed with COVID-19 should be supported by the nursing management during their illness so that their negative experiences will not be repeated. Watson's theory of human caring can help eliminate this sense of fear and loss.

Experiences of COVID-19 survivors: A qualitative study based on Watson's Theory of Human Caring.

This study aims to investigate the experiences of survivors of COVID-19 in Turkey. The research questions and results are structured according to Watson's Theory of Human Caring. The study was conducted using a descriptive qualitative research design. The phenomenological method was used to explore the experiences of survivors of COVID-19. A total of 34 survivors of COVID-19 were included in the study. Data were collected using semistructured and open-ended questions online and via telephone interviews between February and March 2020. Data were evaluated using thematic analysis and descriptive analysis. Six main themes and 25 subthemes were defined that describe the experiences of survivors of COVID-19 regarding the illness: (a) denial and adaptation, (b) fear, (c) feeling of hopelessness, (d) preventions, (e) meaning attribution, and (f) metaphors about COVID-19. Information from this research may be used by healthcare professionals to develop new strategies for the care of survivors of COVID-19. Moreover, it can be said that Watson's Theory of Human Caring is suitable for monitoring the psychosocial development of patients with COVID-19.

A caring leadership model in nursing: A grounded theory approach.

AIM: This study aimed to develop a theoretical model of caring leadership in nursing. BACKGROUND: Nurse leader's role plays an integral part in complex health care institutions. As a common feature of leaders, leaders' caring leadership can positively influence the stakeholders in health care institutions. Still, little is known about caring leadership in nursing, especially in the Chinese cultural background. METHODS: Grounded theory was used to develop the theoretical model of caring leadership. Both semi-structured interviews and open-ended questionnaire surveys were used to collect data for constructing the theory model. Ten nurse leaders and 11 nurse staff were recruited for an interview, and 168 nurse leaders and 286 nurses were recruited for an open-ended questionnaire survey. RESULTS: A theoretical model of caring leadership was developed using five core attributions: benevolent to others, appreciate the uniqueness, facilitate self-actualization, maintain mutual benefit and motivate with charisma. Caring leadership in nurse leaders works through the caring and leading process, resulting in nurses' well-being, patients' healing and organisational excellence. CONCLUSION: A caring leadership model was developed through grounded theory, revealing Chinese nurses' perspectives on caring leadership in Chinese cultural background. According to the model, the concept of caring leadership has been further explained, and it makes contributions to the measurement and leaders' practice in health care institutions. IMPLICATIONS FOR NURSING MANAGEMENT: This caring leadership model developed in our study provides a new perspective and understanding of caring and leadership for nurse leaders. Nurse leaders need to strengthen their responsibilities and personal qualities while caring for nurse staff to improve leadership efficacy based on the theoretical model. And caring leadership can help nurse leaders to balance the interests of stakeholders, leading to positive consequences for nurse staff, patients and health care organisations.

Spirituality as a core concept in the theoretical literature of nursing: A comparative overview between Watson & Lovering's perspectives.

Nurse theorists have addressed the primacy of the phenomenon of caring, aiming at providing a framework that captures the complex nature of caring. Several theorists emphasized the mechanical facet of care while others emphasized the holistic aspect of care. Spirituality as a central concept in caring theories was targeted in this manuscript; as it a fundamental aspect of holistic care. Watson's Human Caring Science Theory and Lovering's Crescent of Care Nursing Model represent two distinctive approaches to caring in the dimension of spirituality. A compare/contrast approach is used to depict the similarities and differences between both works, focusing on spirituality as a common concept. The outcome of the comparison showed that spirituality is a multidimensional metaphysical concept that both theorists had identified as an indispensable core aspect of holistic nursing and is context-bound in terms of its dimensions, applications, and meaningfulness.

Transformation of Clinical Nursing Practice Following a Caring-based Educational Intervention: A Qualitative Perspective.

Introduction: Hemodialysis (HD) patients experience numerous physical and psychological symptoms on a daily basis. These symptoms have a heavy impact on their quality of life, which is a key indicator of their survival in the short term. Numerous empirical studies have shown that the quality of the nurse-patient relationship (NPR) is essential in promoting positive outcomes for patients. When patients receive caring, their autonomy and independence grows, their sense of hope increases, their quality of life improves, and their sense of satisfaction with nursing care received rises. Inversely, the presence of dehumanizing practices in hemodialysis settings can contribute to delay healing for patients. In light of the importance of the quality of the relationship between nurses and HD patients and of the benefits to be had from a quality relationship, an educational intervention based on Watson's Theory of Human Caring was delivered to HD nurses. Objective: The purpose of this study was to explore qualitatively the perceptions of nurses working with HD patients in French-speaking Switzerland regarding changes to their clinical practice after receiving an educational intervention intended to reinforce caring attitudes and behaviors towards patients. Methods: The method used was that of consensual qualitative research (CQR). Sixteen semi-structured interviews were conducted with hemodialysis nurses post-intervention. Results: The results evidence a transformation of clinical nursing practice illustrated by three core ideas: (1) caring practice was reinforced; (2) new practices emerged; and (3) some limitations appeared. Conclusion: In these times of global pandemic where the issue of the humanization of nursing care is front and center, this professional development activity helped reinforce caring-based practice. This practice needs to be developed within the various care units in order to guarantee and promote quality of care and patient safety.

Effects of a nursing care program based on the theory of human caring on women diagnosed with gynecologic cancer: a pilot study from Turkey.

PURPOSE/OBJECTIVES: This pilot study aimed to determine the effects of a nursing care program based on the Theory of Human Caring (THC) on chemotherapy symptoms, hope, and meaning in life in women diagnosed with gynecologic cancer. DESIGN/METHODS: This pilot study was conducted in a single-blinded, randomized controlled trial on 52 women diagnosed with gynecologic cancer in Turkey. In the present study, the experimental group was given a nursing care program based on the THC alongside routine nursing care for five sessions, while the control group received solely routine nursing care. Data were collected using the Chemotherapy Symptom Assessment Scale, the Herth Hope Scale, and the Life Attitude Profile. FINDINGS: There was a statistically significant decrease in the frequency, severity, and degree of discomfort of some chemotherapy symptoms in the experimental group. In addition, the mean scores of hope and meaning in life were significantly higher in the study group compared to the control group. CONCLUSIONS/IMPLICATIONS: This study revealed that a nursing care program based on the Theory of Human Caring might be of benefit for decreasing the frequency, intensity, and discomfort level of some chemotherapy symptoms, and also for improving the level of hope and meaning in life in women diagnosed with gynecologic cancer.

Women's experiences about the psychoeducational group programme with caring-healing modalities and peer support on fear of childbirth: A phenomenological study.

AIM: To explore women's experiences on the psychoeducation programme based on Human Caring Theory in decreasing fear of childbirth. DESIGN AND METHODS: This Husserlian phenomenological qualitative study was conducted with 11 women. RESULTS: Four themes were identified; "self-motivators for participate in psychoeducation programme", "psychoeducation: a bridge to deal with fears", "ability to manage the fear of childbirth," and "change in birth type preference", with 10 subthemes. PRACTICE IMPLICATIONS: Clarifying the experiences of women on educational interventions gives an idea about the applicability, sustainability and developability of these interventions.

Human Trafficking: Empowering Healthcare Providers and Community Partners as Advocates for Victims.

Human trafficking, also known as modern-day slavery, is a public health crisis and a growing worldwide crime exploiting approximately 40.3 million victims. A decade ago approximately 79% of human trafficking crimes were related to sexual exploitation and 18% were related to forced labor, but more recent reports show approximately 50% and 38%, respectively. Although sexual exploitation continues to make up the majority of human trafficking crimes, forced labor continues to grow at an alarming rate. The purpose of this paper is 2-fold. First, to empower healthcare providers and community volunteers serving potential victims of human trafficking in traditional and nontraditional settings with human trafficking identification training. This education should include the use of a validated human trafficking screening tool and the timely provision of resources. Second, to guide professional nurses in the holistic approach to caring for potential victims of human trafficking. The core values of holistic nursing practice and Watson's Theory of Human Caring are the pillars guiding mindful and authentic nursing care. Merging evidence-based practice with holistic care will boost victim identification and rescue.

Effects of an educational intervention to strengthen humanistic practice on haemodialysis nurses' caring attitudes and behaviours and quality of working life: a cluster randomised controlled trial.

BACKGROUND: Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients' quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson's Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design. METHODS: One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study. RESULTS: The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention. CONCLUSIONS: Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices. TRIAL REGISTRATION: NCT03283891 .

Watson's Ten Caritas Processes with the Lens of Unitary Human Caring Science.

The author in this paper articulates how Watson's caritas processes evolved to caritas-veritas light on virtues, facilitating unitary transformative experience. This shift builds harmonic coherence between major streams of consciousness that focus on (a) the physical and conceptually concrete (objective/quantitative/particulate/determinate); (b) the mental, emotional, meaningful/belief systems (subjective/qualitative/interactive/integrative); and (c) the gestalt of spirit and the natural environment (virtual/quantum/unitary/transformative). The lived experience of harmonically braided streams of consciousness melds human-environment, potentiating health, healing, love, and compassion. Unitary transformative pandimensional awareness unfolds in the consciousness and everyday life of the practicing nurse, facilitating a direct experience of sacred praxis.