key: cord-0022041-jyr4x0do
authors: Perkins, Ignatius; Alexander, Groundie Rumay
title: An open letter: Will you listen to me?
date: 2021-06-03
journal: Nurs Outlook
DOI: 10.1016/j.outlook.2021.04.001
sha: 7af43f851b119ab48e3dde07736bef4a53b37275
doc_id: 22041
cord_uid: jyr4x0do

nan

Our world today is suffering from many complex causes, some the result of the coronavirus and other infectious diseases, others due to chronic illnesses, still others caused by a society and culture infected with an ethic of discrimination, indifference and racial injustice where human dignity, freedom, and human flourishing through mercy and charity for every person who has ever been born remains elusive. Captured in this culture of suffering are most notably the lost, the last, the least valued among us especially victims of injustice, persons of color, discrimination, the unwanted, immigrants, the unloved and our brothers and sisters who are forced to live on the peripheries of our communities in deafening anonymity. Psychological homelessness and moral injury are running rampant.

Throughout our global world, the pandemic and trauma of a suffering community is starkly evident and screams out for reconciliation and peace. The issues and concerns about the violation of the civil rights of persons of color, racial and cultural inequities, discriminatory legislative mandates, incivility and systemic prejudices, and intolerance of alternative views infects and disables our abilities to reclaim human dignity, freedom and secure an enduring peace. Where should we begin to bring healing and hope to one another, to our families, colleagues, communities, and our world?

Only when we are free and willing to listen to others, allow them to articulate their anger and frustrations, their fears and experiences of abuse and experience something of their pain, can we gain their respect as we enter into an authentic healing relationship. Only then can we as a human caring community accompany one another to a lasting peace sustained through human dignity and freedom. Implicit bias is a form of buried prejudice and stereotypes, identity theft on display. Both should be starved, never nourished or fed.

The capability to be inclusive largely defines us but like all of humanity none of us are perfect or have all the answers. While the notion of a listening presence first seems rather straight forward, it is perhaps the most difficult of the caregiving behaviors. However, we as nurses know first-hand this is the best path to being with each other rather than simply doing to each other. It is the best and enduring path to healing. Exactly what is happening in a healing relationship when listening at its utmost is occurring? a Listening presence is the conscious willingness to risk knowing the one who is suffering, as a person, to be with her, in joy and pain, and to risk becoming vulnerable in the person's suffering (Pettigrew, 1990, 503-508) . b Presence takes place only at the invitation of the one suffering. It is always a privilege never a right. It can only be requested, never assumed or demanded. Nothing apart from the permission or invitation of the one who is seeking to be healed ever gives the healer the right to enter another's pain, or intimate life experiences, whether it be physical, emotional, relational, or spiritual (Pettigrew, 1990) . c The invitation of presence, to be allowed to see, to share, to touch, and to hear the brokenness, the vulnerability, the suffering of another, and the celebration of joy and hope is at the heart of nursing. It provides us, as healers, with the privileged opportunity to stand on holy ground, and that ground is the life of person who is suffering and in pain in all of the person's particularities, beliefs, values, fears, hopes, and joys. d Presence means making room internally for the other person, being willing to be involved, to be there wholeheartedly; e By the belief that we hold the person who is suffering in the same regard as we hold ourselves, two persons of incalculable dignity and worth who have joined in solidarity with each other in search of healing and hope; f By naming our own limitations, powerlessness, vulnerability, impotence, and woundedness; and g By acknowledging that at times our hands will be empty and yet we have the courage to weep as we listen to them, their fears, their hopes, and their dreams unfulfilled.

The late Edmund D. Pellegrino, MD, MACP (1985) distinguished physician and ethicist, offered this very Available online at www.sciencedirect.com N u r s O u t l o o k 6 9 ( 2 0 2 1 ) 7 1 2 À7 1 3 www.nursingoutlook.org helpful reflection in caring for the sick and suffering. It is especially applicable to our current experiences of human suffering today (p. 97-103).

Listen to me -hear what I mean by being ill; listen to what illness is doing to me, of my conception of life, to the kind of person I am and want to be, a person of this age, this family, this set of hopes, these frustrations, this history. I am not the universal patient. I am this patient. My experience of illness is unique for me; you can't heal me unless you understand my illness and only I can tell you about my unique experience of it.

Please understand that I am impaired and wounded in my person and therefore vulnerable before your knowledge and skill which I need to make me whole. To heal me you must also help me repair my personhood; regain those freedoms of self-determination I have lost through illness. Don't take advantage of my vulnerability to humiliate me or advance your own interests, to treat me as an object, a disease, a case; don't diminish my already diminished person even further. Please try to understand the uniqueness of the assault this suffering makes on this person, on me. Have compassion; feel something of my distress as you undertake to diagnose, treat, and prognosticate. Your general rules, your techniques, must be operative in my unique personal experiences of life and illness.

When we are free and willing to be present and open to listening to our suffering brothers and sisters and acknowledge our vulnerabilities. . .when we listen to each other this is indeed holy ground where human dignity, freedom and human flourishing will lead to an enduring peace and the best of conditions to teach and to heal. Miller and Cutshall (2012) state:

It is the condition of being consciously and compassionately in the present moment with another or others, believing in and affirming their potential for wholeness, wherever they are in life (p. 12).

This original manuscript was prepared jointly by Bro. Ignatius Perkins, OP and Dr. Rumay Alexander solely from our own professional experiences as nurse educators.

Philosophical groundings for treating the patient as person: A commentary on Alasdair MacIntyre

Intensive nursing care: The ministry of presence

The art of being a healing presence: A guide for those in caring relationships