I received a mailing earlier this week and it contained a small bookmark card with a quote from Thomas Merton (1915-1968) which read:
"And the deepest level of communication is not communication, but communion. It is wordless. It is beyond words, and it is beyond speech, and it is beyond concept. Not that we discover a new unity. We discover an older unity. My dear brothers, we are already one. But we imagine that we are not. And what we have to recover is our original unity. What we have to be is what we are."
This seems to be a part of the essence of what it is to be a psychiatric mental health (PMH) professional nurse. We strive to a very deep level of communication where we no longer just listen to the words of what our patients/clients are saying but rather we listen beyond the speech, beyond the concept and from a sense of shared unity we can be in communion with those we serve and from whom we often learn life lessons. We can develop an understanding of what the individual is experiencing, fearing, dreading or grieving if we move beyond words, concepts and busy work and move into the space of "original unity". I dare say that this movement is often disconcerting or frightening to the novice nurse (or the rigid, experienced nurse). It is going to a place that opens us to our own vulnerabilities and in the realization that we are "one" frequently leaves us with more questions than answers. Experience teaches us that when we act from "what we are", authentic, real persons--not just employees, technicians or medication passers, we are able to reach even the most difficult for whom we care. This "work of nursing" is not easily explained to the non-nurse. It may also be a reason that nurses still are practically "invisible" to those outside of our profession. What is often seen and what is valued in our society are the "tasks" and the "duties" we perform, yet mental health nursing is that part of practice that goes beyond the bandage or the wound care to the core of the human spirit. So, I cringe when I am called to a psychiatric code and find young nurses trying to rationalize with a psychotic patient or hear "experienced nurses" say 'let's get him/her into the seclusion room and some meds on board' as a first response. As a clinician and as an adjunct faculty member I am saddened by the reduction of attention to psychiatric mental health nursing that has occurred in our nursing programs. Rather than seeing PMH nursing as a part of the supportive frame for nursing practice, it seems that our concepts have been reduced to "communication" threads in many curricula. The result being novice nurses who are inadequately prepared to deal with human events and suffering across the lifespan from our "older unity". So, as Merton told his monastic brothers: "And what we have to recover is our original unity. What we have to be is what we are", perhaps we as nurses need to "recover our original unity".
By the way, Merton was a Cistercian monk who opened dialogue between western and eastern religions. He was a profound spiritual guide and author and toward the end of his life a wise, ecumenical man who met an untimely death by accidental electrocution in Thailand in 1968. He was known in his monastery (Gethsemani Abbey, Trappist KY) as Fr. Louis and he is buried there with a simple grave marker designating only his name. This is just 20 miles south of Louisville where APNA will be meeting for our annual Conference next fall.