Pathic Inquiry – van Manen

1. Pathic Inquiry – van Manen • Pathic Touch IS Personal Touch = supportive, caring, comforting, healing, therapeutic: these justify the body through touch. Distance is removed, the touched is invited to be one with their own body, to inhabit their own body = Professional Touch • Is NOT Private Touch which may be loving, erotic, intimate, familar, a caress = Unprofessional Touch

2. Gnostic Inquiry: Hand • Finger Pads – for detecting moisture, contour, consistency, mobility • Fingertips – suited to explore lesions • Dorsal surface and ulnar edge of hand & fingers to detect temperature • Palmar surface (ball) – to assess vibratory impulses • Grasping Fingers – information on position and consistency

3. Pathic Inquiry: Hand • This is a healing hand, a caring hand which does not only touch the physical body, it also touches the self, the whole embodied person = the core meaning of the healing act of nursing care • This hand, if trusted, has the power to reunite the client pathically with their body, making room for them to heal, strengthen, to become whole • Is used in many nursing tasks from bathing, to dressings, to assessing vital signs

4. Gnostic Aspect • Analyzes, anatomizes, dissects, makes diagnoses and prognoses that tend to separate clients from their bodies = the knowing intellectual hand • Is the Science of Nursing and Medicine • Includes tasks that look for causal, symptomatic, developmental patterns, psychological, physical, genetic abnormalities, various tests, devices used to measure and quantify: focuses on pathology – but tends to fragment the body.

5. Pathic Aspect • Lies at the Heart of Nursing • Aims to console and comfort, to ease suffering, to be there in moments of need, to support healing in convalescence, and to assist clients to feel whole and making life liveable again • Pathic refers to the general mood, sensibility, and felt sense of being in the world = feeling the world in an emotive modality of being • Touch is the primordial medium to overcome separation and relational distance

6. Pathic Meaning in Nursing • Consists in reuniting the patient with his or her body, and thus make life liveable again in whatever way this has to be learned by the patient

7. Professional Touch • Firm not light • Confident • Directed with Purpose, Goal, Intent • Both Pathic and Gnostic • Gnostic (Dia)gnostic Touch – to know well • The person being palpated feels the nurse's hand but also their own body = the probing hand turns anatomical – may draw them in = xray eyes or gnostic eyes

8. Gnostic-Pathic Touch • An expert nurse's hands are both at once – as instrumental and as caring • Is something deeply personal or itnersubjective in the pathic relaitonship – person is seen as a whole not as a case, category, type, set of factors, etc. • Honors the uniqueness of each client, despite thier “diagnostic portrait” • Need to address and reflect on the experience of the client and their illness = phenomenology

9. Ways of Knowing - Walker • Speaks of the Unnaming just as van Manen did at the beginning of his article – this changes our perceptions of the “object” in question • Perceived Nature as Teacher, Guide, Being • Learned about Self in the process • Taught about Interconnectedness of All • Experienced a Revealing by Being with Plants, Geographic Places, other Humans, Animals • Stories, Dreams, Silences, Poetry from the Land

10. Terms • Ontology – What is the nature of Nursing? • Epistemology – What is the nature of Nursing knowledge? • Legitimate Knowledge – associated with Power, what is accepted as reliable, as expert, as worthy of attention, respect, adherence, $$$$ • Multiple Realities – a phenomenological view – each person has their own Personal Meaning of their world, and their own Personal Worldview