Strengthening a Praxis of Suffering

Abstract

Suffering involves the loss of acceptable meaning and nourishing connection. How nurses are present to those who suffer makes a significant difference. In a context where sustained engagement with the sufferer is crucial but often neglected, important questions for educators arise. These include how to cultivate moral courage and compassion among our students and how to select philosophical and pedagogical approaches that can guide teaching and learning. This article presents the challenges raised in a graduate-level nursing course aimed at advancing a praxis of suffering as well as our experience integrating interpretive phenomenological and narrative-based approaches.

The dark corner of the heart – understanding and embracing suffering as portrayed by adults

“…Anxiety is more commonly used to describe a generalised sense of discomfort, whereas suffering, as stated earlier, has more to do with the human being's own unique experience of being in the world. In suffering, when the human being's central purpose is questioned, temporarily influenced identity issues arise . Suffering implies that the human being lacks strength and that he or she is self‐centred and passive .…”

“…Suffering implies that the human being lacks strength and that he or she is self‐centred and passive . If there is no sense of central meaning or purpose in life, the person comes into conflict with him‐ or herself, and feelings of aimlessness or bewilderment ensue . All suffering involves a kind of conflict with self since the integrity of the person is threatened .…”

“…These conceptions of suffering, such as an absolute difficult experience, constitute the leading understanding of suffering. However, an alternative understanding that focuses on the potential of suffering has also been presented, since suffering has the potential to provide the individual with enlarged ways of being in the world, with an expanded sense of self . Frankl also states that even in the most hopeless situations, meaning may be found and that suffering ceases to be suffering the moment it encounters a meaning.…”

“…When given support and offered caring connections, persons who, for example, have been victims of violence may go on to develop a greater understanding of others' suffering and a desire to help others with their health and well‐being . Therefore, understanding the potential of suffering has a moral meaning; people who suffer need not be condemned to isolation, passive resignation and inhumanity . The individual's sense of central purpose is strengthened when he or she intentionally reaches out to help others .…”

Using Poetry Writing and Sharing to Promote Student Empathy and Caring

“…Methods include writing reflections about perceived patient experiences 16 ; using the arts and humanities to promote caring 17 ; interpreting poetry 18 ; incorporating drawing, song composition, and poetry into problem-based learning 19 ; using imagery, film clips, and stories about personal, patient, or family experiences of positive or negative empathetic nursing behaviors 20 ; and reading assignments, followed by written narratives on suffering. 21 In Watson's Theory of Human Caring, Caritas 7 promotes interpersonal teaching-learning through the use of "learning experiences that attend to unity of being and meaning, attempting to stay within another's frame of reference." 11(pp5-6) Aesthetic knowledge has long been recognized as one of the fundamental patterns of nursing knowledge that results from improved empathetic skill development and leads to increased choice of therapeutic interventions in providing nursing care.…”