Caring as a Pedagogical Approach by: Mary Rockwood Lane
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Mary Rockwood Lane, PhD. R.N., FAAN.
Michael Samuels, M.D.


Introduction to Caring as a Pedagogical Approach to Nursing Education

This chapter will describe courses that are currently taught at the College of Nursing at the University of Florida (UF) and at San Francisco State University, Holistic Studies. The two courses were developed by the authors together and have similar syllabuses. Both courses are unique interdisciplinary courses, Creativity and Spirituality in Healthcare. The Center for Spirituality and Health, which funds the University of Florida course, has also supported several similar courses at UF in a variety of colleges. The San Francisco State University course is supported by the University and is part of their holistic health major for nurses, psychologist and heath majors. These courses offer students an opportunity to experience their own personal spiritual journey and to explore ways in which spirituality might be integrated with their academic and career paths. In Creativity and Spirituality in Healthcare, nursing students are provided with hands-on experiences with music, dance, writing, journaling, and guided imagery. They are then encouraged to contemplate and reflect on what these experiences mean to them and what they might mean to different patient populations for whom they will care. The theory of human caring provides the philosophical and theoretical framework upon which this course was developed. This chapter will describe how the core caritas practices are foundational for the teaching and learning experience.

Overview of Program: Philosophical-theoretical Influences

Jean Watson’s theory of human caring is based upon the belief that the learning and teaching experience is a caring encounter. Watson’s 10 core caritas—Latin word meaning “to cherish, to appreciate, to give special attention, if not loving, attention to” (http://www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resources/Jean_Watson.ppt.) embrace the belief that trust and faith in human expression and self actualization is the focus of the educational process. The approach of this course calls for the encouragement of contemplation and self-reflection as well as the encouragement of illumination of the human spirit. The teaching and caring process results in caring encounters (Watson, 1979), which are congruent with facilitation of students’ engagement and emancipation.

Creativity and Spirituality in Healthcare has a scholarly component which includes: a project proposal, reading integrations, personal creative journals, and a final paper. The most significant part of the students’ grades (besides attendance and participating in class) is their semester long project and presentation that has both a personal and professional component. This project gives the students an opportunity to experience art as way of healing as something in their own life, as well as integrating creative interventions into their chosen profession. The graduate student’s final 10-page APA formatted paper must be researched, and include at least seven scholarly articles relevant to the course project. Students are required to be specific in how they will weave this course material into their future jobs, clinical, etc. The project is the opportunity for the student to create a transpersonal caring experience. There are two text books required, as well as a third required text of their choice. Having this choice allows students leeway to address their own unique needs, styles and preferences. At the beginning of the course, students are given an opportunity to meet with the faculty member for a one-on-one appointment that is geared toward student exploration of the course project and processes/activities. This is an opportunity for the faculty to bond with students and ask questions to facilitate reflection and contemplation. The following questions are indicative of this encounter:
If you could do anything you want with your life, and there were no obstacles, what is it that you would do?


    Growing human consciousness that all human experience is constantly unfolding, infinitely creative, and profoundly healing, is the foundational premise of this course.
    The authors highlight in their book, Spirit-body Healing (2000), the healing power intrinsic in the process of exploring the spirit mind-body connection. Based on the author’s phenomenological hermeneutic study of creating art as a way of healing, the author proposes there is a transpersonal shift possible in the engagement of the creative process, which results in a deepening of spiritual expression and connection. This course uses creative, visionary, and spiritual practices to deepen students’ journey of self exploration and self discovery. The entire course is an ongoing invitation for students to get in touch with their own spiritual essence and a higher power that has meaning for them. The students’ journeys, themselves, create a place of healing, beauty and grace within the ordinary setting of academia. The authors, a nurse and physician, believe it is essential for nurses to explore the authentic human experience of what it means to be a nurse.

    Course Development and Content

    Creativity and Spirituality in Healthcare at University of Florida was developed by the authors and submitted to the general College of Nursing (CON) faculty for approval to be added to the curriculum. The curriculum is reviewed by the entire faculty in the process of shared government. The course’s content was perceived by the general faculty as meaningful and significant, yet the high demand of the required curriculum makes it difficult for nursing students to take electives. Since this course is not standardized in content, nor is it tested on the nursing licensure board, the content is not required. Despite this, many students have taken the course, and their feedback and evaluations have been excellent in the five years the course has been offered. Nursing students have also requested that this material and experience be integrated with their regular curriculum. Currently, the course remains an elective. At San Francisco State University, the course was approved by the chairman of Holistic Health as part the major and is a elective that fulfills all major requirements.
    Caritas in Practice for Creation of Classroom Culture and Structure
    The 10 caritas processes proposed by Watson (1979) are the foundation for creating the classroom culture and structure. In the semester sequence, the intention is to facilitate creative emergence and embracing infinite possibility, a foundational of caritas science. The classroom is a dynamic flow encompassing the appreciation of each student’s individual contribution and honoring each student’s subjective life journey. The caritas processes are introduced in the initial orientation to facilitate a caring and safe classroom culture.

    1. Practice Loving Kindness
    The practice of loving kindness and the process involved in authentic presence is fully subscribed to in the communication dynamics of each class. For example, in the initial faculty-student meeting, each student is encouraged to experience being nurtured and to express and incorporate his or her own spiritual beliefs and practices as part of the project. The faculty demonstrates tolerance and acceptance, allowing freedom of expression, and honoring where each student is right now in their life. In the class atmosphere, there is an embracement of joy, laughter and tears. There is an acknowledgement of the inner critic that so many of us have inside, and there is an invitation for the inner critic to wait outside the classroom doors. The students are asked to be kind and noncritical of themselves and their art. It’s about process not about the outcome. The students are honored and create the flow of the manifestation of the class, which allows the students to have space. There is a fluidity and tolerance and acceptance of what is actually happening. There is an appreciation of the humanness, and a tenderness in the interaction between students. The class is defined for the students as a caring community where each student is to be honored and cared for in a loving way intentionally in each encounter.
    2. Instill Faith and Hope
    Our classroom has the qualities of freedom, safety, trust, and collaborative expression. Students are encouraged to personally express themselves, with the witness and collaboration of others. When we create sacred space, we are intentionally shifting the environment from a traditional classroom environment into a community of harmony and balance. This is done with intention. Sacred space allows for deep listening, trusting and faith, and for the spiritual expression of each student to be honored and visible. When we create sacred space in the room, in essence we are creating sacred space both within the body and outside of the body. One technique we use to facilitate this is experiential centering and focusing activities. Faith and hope are instilled and reinforced by telling stories of how art heals and encouraging students to realize that art will heal them and their patients.
    3. Nurture Individual Spiritual Beliefs and Practices
    We create the sacred space that allows for a visionary and non-ordinary reality to manifest. The space is pregnant with power and personal meaning. We create rituals that allow students to become connected to their own experience and what they bring to the class. Each student is invited to bring a sacred object into the physical space and share how this object is meaningful to them. In that way, each individual in the community creates an art piece in the center of the room that is a circle, places their object into a sacred circle, and integrates and interweaves diversity. They are actually placing themselves into the circle, and weaving their stories together with their sacred objects. Each sacred object represents and symbolizes something deeply meaningful to each person. This may be expressed in words or just in the gift of the object. Each object is the student’s own, and is deeply tied to personal meaning. The sacred space creates an altar, a place to place an object of beauty. The objects may vary from a pinecone, to a cross, to a picture of a beloved, a feather, a rock, a piece of jewelry. It depends what that person wants to contribute in the that moment. The sacred space is nondenominational, does not exclude any religion, and invites everyone to participate.
    Each student signs up to facilitate either an “opening” or a “closing” activity. This gives the student an opportunity to experience their own leadership of a creative/healing process. The opening shifts the space, bringing in the collaborative, collective spirit, and the closing gives a sense of completeness to the time we had been experiencing together, making a smooth transition. Some examples of these various activities are: guided imagery, meditation, writing letters to loved ones, writing poetry, hand massages, yoga, stretching, sharing a significant prayer, tai chi, singing a song, playing music, leading a dance with everyone blindfolded, etc.

    4. Developing Trusting – Helping Relationships
    In each successive classroom meeting, the entire class contributes to developing a safe environment that supports helpful and trusting relationships between faculty and students and students and students. The checking in at the beginning of class, allows each student to share what is going on in their life and in their work. Confidentiality is important. We ask students to create a commitment that honors every student’s story. The sharing is confined to the classroom, which allows students to know they are safe in their vulnerabilities if and when they choose to share. During the course, sometimes emotional stories come up. If someone cries and shares a painful story, one of the ways we handle profound emotional sharing is to honor it with a moment of pause and silence, allowing students to hold the emotional expression. Nurses need this type of experience to overcome fear or discomfort with patients needing to express this type of emotional pain. We allow it to be expressed, pause, and experience the silence in holding their story. In the beginning of the course, students are given free counseling resources in case students want to pursue counseling. This course is not a substitute for group or individual counseling but students are encouraged to realize that they will be loved and helped when they express emotion.
    5. Promote and Accept Expressions of Positive and Negative Feelings There is integrity and wholeness in the creative expression. A painting can hold the despair of a painful experience. In the painting itself, the despair is held, acknowledged, and honored. There is a witness, and in the witnessing, that expression can be complete.
    Inherent in exploring different and various creative activities, we promote and accept the expression of both positive and negative feelings. For example, students are invited to share their joys as well as their struggles as part of the class. As part of the creative process these expressions and feelings, are expressed in poetry, art, music, songwriting, even dance. In students’ journals, their truth is encouraged, and there are oftentimes dark and painful expressions and processing. In their reading integrations, we encourage them to critically examine and integrate the readings, and to share their personal opinions of anything they agree or disagree with or would change about how the readings apply to their understanding. One of the things this class does by integrating creative modalities, is that it really opens up deep expressions of both negative and positive feelings. What manifests are incredibly exquisite art forms. These art forms contain profound and deeply felt expressions of sadness, pain, anger, hurt, grief, anxiety, fear, love, joy, appreciation, acceptance, self awareness, etc. The images demonstrate the emotions almost more explicitly than words. What is so powerful about the manifestation of art with human expression, is that it creates something tangible emerging from the intangible depths of their humanness. The power of creative expression is the ability for the artist to reach into the dark depths of themselves, into the darkness and pain, and allow the expression of these very intense, and palpable feelings. They come from the darkness within, and you bring them forth into the light. When we create art with this depth of expression, we have the ability to witness ourselves. There becomes an ability to be detached from ourselves, enough to embrace ourselves with compassion. The art gives us an opportunity to accept, embrace, and forgive ourselves, and fall in love with the beauty that we are capable of creating, Even in our sadness and fear….there is beauty in the ugliness when the ugliness is the truth. The truth reflects what is in each and every one of us. Its simply a reflection of the truth of our own humanity. The course is unusual in there are moments of deep emotional expression and revelation. Students often cry, hug each other, and become deeply connected in community with new friendships created.
    6. Creative Use of Self in All Ways of Knowing/Being/Doing
    We encourage students to get connected to remembering when they were young and loved making art, when there was no inner critic. The following are examples of prompts we use to help students get in touch with their inner artist, free from self-consciousness and criticism, to experience patients in a new way and make creative connections between what they imagine (or have witnessed) and their nursing role(s).
    See Beauty. How do we look at our practice as nurse-artists? It is simple: we can begin to cultivate a way of seeing from the eyes of an artist. We can learn to see beauty in the faces of people for whom we care. To see the beauty of lips, eyes—to cultivate a way of seeing that always sensitive to the human in front of us—the tear that flows down a cheek, the hand that trembling, reaches out as we walk around the bed. Notice and experience these encounters of incredible beauty. Pause and reflect. Cultivate a way of being in the moment with the patient more deeply, more fully.
    Use Voice. We can cultivate the artist’s use of vibration and learn to recognize the power of our own voices. Voice used as sentiment, voice as music, a soothing tone, a soft whisper of reassurance. We can use our nursing voices as instruments for healing. We can project our compassion, our comfort, through our voices—filling our chests with the deep vibration that connects to the center of ours and our patients’ souls. When we use voice, we come from a powerful place, we speak from our center and are grounded. Voice becomes a powerful healing tool.
    Move with Grace. The nurse-artist can use the body to flow in the graceful movements of the dancer. Move in and out of rooms with gestures of grace, rhythm, and beauty, creating symmetry and balance within the routine rhythms of daily unit activity. Moving patients, helping them get out of bed, can be like a dance. See yourself and your patients as dance partners—leading and following, practicing the moves, until the patterns are smooth and graceful. Remember, the operative word is practice—and this applies to graceful communication as well.
    Healing Touch. As nurses, we cannot overestimate the power of touch, the gift of being able to touch another human in moments of pain and suffering. We can touch with softness, healing energy, and can be connected through the textures, smells, and needs of another in sacred intimacy. We can embody intimacy as a sacred connection. Touch as you yearn to comfort, care, protect. Touch to help ease pain and transmit confidence and hope. Touch is an intuitive healing intervention we all know deep inside our bodies. For some it comes naturally; for others, awareness of sacred touch can be cultivated. For starters, remember how essential it is to be hugged once in awhile or how much joy the weight of a squiggling puppy can bring to young and old alike. In particular, remember that your hands have the power to convey caring and gentleness, just as they can convey impersonal “busy-ness.” Know, too, that your eyes can “touch” others. Truly, they are windows to your soul.
    8. The Classroom As a Healing Environment for the Physical and Spiritual Self That Respects Human Dignity.
    The classroom climate is liberating, open, and energetic. This is a humanistic value system, in which the learning experience is inherently customized to each students’ needs and desires. What they need from this class is what they are going to get. There is emphasis is placed on the value of innovativeness, being creative, and embodying the experience of self exploration. The experience in each student’s project is really being able to tap into their own inner resources, and each student is honored as a healer and an artist by self discovery and inner contemplation, this experience honors the wisdom of intuition, and encouraging the student to see into their own beingness and discovery of who they are.
    The classroom is housed in a very traditional academic university setting. However, when the student walks into the room, there is soothing music playing, there is an art cart and art supplies on the table, art is hung on the walls, beautiful fabrics cover the tables, and are accented with arrangements of flowers and food. Thus, the student experiences an immediate and significant transition, entering a sort of portal to a different time and space. The environment is non-critical, non- judgmental. The novelty sometimes creates awkwardness and fear about trying unfamiliar, activities that may not have been engaged in since childhood, or possibly never tried before. There is much gentle encouragement to experiment, to do something they may have always wanted to do but never gave themselves permission. The environment is all about embracing newness and the moment. Students typically support each other right away and are patient with each other’s reluctance or hesitance. The shared experience of discomfort or self-consciousness bonds students and encourages a level of tolerance from the start. The classroom environment is created in each class session intentionally to make a new sacred space that invites healing and protects the students from what in not healing for them.
    9. Basic Needs
    Since this class is typically conducted in the evening during dinner time, students sign up to share food, snacks and drinks. This is the caritas practice where students’ basic physical needs (thirst and hunger) are met. We serve hot tea with lemon – this is cleansing, healthy, and provides unique sharing. The invitation to share food is another opportunity to be creative. Food can actually be part of the art-making process or it can simply serve to quench hunger. For some students, food can serve to help decrease stressful feelings. This class also meets the basic need of stress relief. Many students have shared that this student is something they really look forward to each week. There is a lightness and opening that really is nourishing for them. Students can step out of a stressful, rigorous, high pressured, information heavy, high tech, overbusy lifestyle, and rejuvenate their energy.

    10. Allow Space for Miracles to Take Place

    The most wonderful caritas process is allowing the space for miracles to take place. Many of the students’ projects are deeply healing and transformative, and in the presentation and sharing, there are moments that are so heart-opening and that produce so much awe and revelation, they are truly miraculous. Students are prepared for this by constantly hearing and sharing stories of miracles in art and healing. Websites and stories of patients and artists are shared that are exemplars for miracles in healing. The openness of the class allows a natural flow where an energetic field is created where a miracle reveals itself. It can’t be planned, but gives permission for a magical deeply spiritual energy to appear and be illuminated and the miracles are witnessed and seen as they are experienced. As students share they are even astonished by their own experience of themselves. The mystery of who they are is revealed to themselves. There is such exquisite beauty in that that it is a miracle and give you goose bumps.

    There is rarely repetition, there is not formula, which manifests a much more interesting experience. The classroom time in the time allowed for the classroom there is a natural flow that evolves. Sharing and expressing of what would have never been able to be anticipated. Inside this creative freedom the student can evolve within themselves, as themselves within a caring community that honors and witnesses their illumination and their growth.. What is truly remarkable is the unfolding of the mystery as each student’s humanness is revealed in the moment. These moments are indescribable and exquisitely beautiful. They are miraculous moments.



    Pedagogical Practices: Examples of Transformative Liberating Approaches to Teaching Learning
    The class is organized like a seminar. Teachers and guest speakers (artists, poets, dancers, actresses, yoga teachers, clowns, etc.) are guides and facilitators rather than lecturers. Students are gathered in a circle seated in chairs with a desk in the center. There is no hierarchal presentation of faculty.

    Creative teaching/learning activities examples:

    Journal Writing

    . We invite students in the class to allow themselves to connect with their inner artist with daily journal writing. The journal is brought to class and students continue to journal as the class takes place. The journal is a portable studio, accessible for self expression and self reflection.

    The Journals are a place where people can find their place of their own compassionate, wise, inner truth. The students can shamelessly discover what they are sometimes afraid to say out loud. They paint, draw, write, color, collage, decorate their journals with meaningful quotes, poems, etc. Diverse mediums are set out to allow the students to explore which art materials resonate with them. The journals are a place for students to externalize their internal confusion, clarity, pain, joy, anger, gratitude, etc. Students are amazed at what their journal pages reveal to them about their inner workings. One journal writing exercise is called Vigali’s Questions. The students do a guided imagery about what is their essence, what is blocking them from connecting to their essence and what can they do to see their essence manifest .

    Music as Healing

    Music engenders a sense of community throughout the semester. We invite students to bring in CDs to play as background music for each weekly class while they are amidst the creative processes. Class members are exposed to new musical possibilities as students share their musical interests with one another. One of our classes each semester has music in the foreground, where we concentrate on the therapeutic value of music.
    You tube videos can be very transformative, evocative, relaxing, empowering, etc. Songs and lyrics can bring up very relevant and deep seeded emotional resonances. This is relevant to nurses because with modern technology, with an ipod or computer,
    Patients can be guided from a lonely and isolated place, to feeling connected, and having their situation normalized through even just one 3 minute music video. Various artists have taken traumatic, painful situations, diseases, loss, suffering, death awareness, etc. and shown how beauty can be created from the ugliest of circumstances.

    We demonstrate this in a classroom setting by playing one you tube video at a time, in the dark, and then having a five minute pause after each one, where we turn the lights back on and the students respond in their journals. A packet of lyrics is distributed to the students so they can process and personalize what the messages mean to them.
    There is often very strong reactions. For example, a very significant lesson happened when one of the facilitators showed a song that addressed child abuse. Showing music videos about child abuse can ignite powerful and enlightening dialogue, healing opportunities, heightened awareness and compassion. Child abuse is one of the many harsh realities of life that nursing students may be exposed to in their hospital settings.

    After presenting the prepared you tube videos, the students get an opportunity to share their own examples of music that is healing, therapeutic, and transformative in their lives.


    Dancing – create an atmosphere of comfort, safety… lowering the lights… candles (electric if not allowed), light lamps. The students are encouraged to dance, in class exercises, breaks and with each other. Dance facilitated movement, freeing healing energy, and group bonding. It is social for young people, they know it well and enjoy it, but they may never have used it intentionally for healing. Dance activities are taught such as one person leading another blindfolded person in a dance, to encourage trust, partnering and dancing a story of an illness and healing and dancing as healers around a person who asks to be healed. We move the tables and chairs so there is room to dance freely. Dance is present in the class and flows over to the students lives. Students often remained after class drumming and dancing when class was long over.

    Visual Art Projects

    Students do visual art after each guided imagery. They draw what they image to see more deeply. They draw for more than an half hour after each guided imagery and become used to using visual arts to heal and see deeper. It is an integral part of the class, students sit and draw in their journals as class takes place, it becomes natural, healing and powerful and is often the beginning of their projects.

    The story of my body: This class we paired the students up. We layed out a long roll of paper, and one student laid down at a time, to trace their partners and that student traced the other student’s outline. The next person laid on the table and they were traced. Then they used markers crayons, collage, magazine articles,

    Collage

    Students do a self portrait collage. This is an opportunity for students to go through magazines, intuitively collect images that are a reflection of themselves. Something they resonate with, without thinking much, spontaneously, and the students share the collage, and discuss what the collage means to them, and the metaphors within the words and images, and that relates to a deep meaningful part of who they are.,

    Art cart
    There are a variety of art supplies (pastels, water color kits, stickers, ribbons, magazines, multiple colors and designed papers, glue sticks, colored markers, pencils, etc)

    Drama

    In our drama/theater in healthcare class, our class members participate in theater games that entail playful improvisational interactions. These games give opportunities for students to outside their comfort zone and play. The movement and self expression
    allows the nervousness to dissipate, and creates an atmosphere of fun and playfulness. We intentionally have the theater class in the beginning of the semester, because the laughter and liberated energy that is created from the theater games and play back can take down walls and dissolves the awkwardness that students sometimes come in with. Openness and comfort is fostered. In the theater games, students are invited to take on various emotions and roles. They can take on different emotions and characters, and go beyond their persona. This class has a guest facilitator who is an artist in resident who works with patients in the hospital with her playback troupe. This focuses on listening intently to someone’s personal story, and then reflecting back to that person an enactment of that story. This can be profoundly validating and healing to witness the externalization of such an internal and emotional experience. In our class, one way this was demonstrated was by a student who volunteered to share her story of being depressed and overwhelmed with her life, feeling pulled in so many different directions, wearing so many different hats in her life, and not knowing how to juggle all these seemingly competing roles. A group of her classmates was assigned the role of representing the various aspects of her life that were pulling on her and competing for her attention, (her own personal health, her family, her husband, graduate school, work, etc.) Each person acting out each valid part of her was talking over one another, demanding that their needs be met. In the process of this being acted out and demonstrated in such a realistic way, many students in the class related to this overwhelmed feeling, and a few students shed tears, feeling so validated and having their struggle being shown in this way. A very genuine empathy was created because so many students (and obviously patients) can relate to feeling stressed out in their own lives.

    Guest Artists

    There is a spontaneousness and openness to what they bring to each class. Every semester the course is taught it is never the same as it was before. The guest speakers are available for information and to be a resource to the students inside and outside the classroom. The guest speakers enjoy sharing their artistic talents, in essence give the student opportunity to explore new and innovative ways to be creative. Guest artists in art and healing also allow the students to see art and healing professionals, know other ways of teaching and realize the art and healing field is large and has different points of view.



    Structure of Curriculum Framework:
    The curriculum in which this course is offered is a traditional undergraduate/graduate nursing program. At UF, there is a strong focus on research, quantitative and measurement of evidence based. This course is in the college of nursing which is one of 6 health science colleges in a major academic state public system. At the San Francisco State University the curriculum matches the 12 weekly model of a usual 3 credit course.

    Course description example
    NUR 4930/6930: Spirituality and Creativity in Healthcare This course gives undergraduate and graduate students in nursing, art, and other disciplines an overview of the field of Spirituality, Creativity and Healthcare. It will describe the history and physiology of Spirituality, Creativity in Healthcare, explain the use of art, writing, music and dance to heal, provide exemplars of programs that use creativity and spirituality to heal, and demonstrate the praxis of artists healing themselves, others, and the earth. The course utilizes stories of patients and artists, and guided imagery as a way of teaching. Creative art projects provide exciting opportunities for personal growth and healing. The final art project can be any art process that heals. Students have built meditation sanctuaries in their homes for peace, written poetry for a brother who was ill, painted their inner critic and inner artist, created portfolios of healing photographs, sculptures, or painting, and created art programs in healthcare settings. This course shows how art, spirituality and healing are one. It shows how creativity and spirituality resonate the body, mind and spirit and talks about how art is transformational to us, others, and the earth. The course discusses the future of art, spirituality and healing and talks about how spirituality and healthcare departments in universities are now helping people pray and use spiritual disciplines to heal. This course is about healing your own spirit.
    Course Sequence

    Initially, we go over the syllabus, provide a question and answer period, and immediately begin to establish the structure of free forum of ideas between all participants.


    Example of syllabus:

    UNIVERSITY OF FLORIDA
    COLLEGE OF NURSING
    COURSE SYLLABUS
    Fall 2009



    COURSE NUMBER NUR 4930 – section #2861
    NGR 6930 – section # 2853

    COURSE TITLE Spirituality and Creativity in Health Care
    CREDITS 3
    PLACEMENT Elective
    PREREQUISITES None
    COREQUISITES None
    FACULTY

    Mary Rockwood Lane, RN, PhD HPNP 3210 273-6371 By appointment
    Clinical Associate Professor
    mlane@health.ufl.edu

    Emi Lenes, Med/EdS, NCC HPNP 3210 682-9594 By appointment
    Em00017@ufl.edu

    DEPARTMENT CHAIR

    Maxine M. Hinze, RN, PhD HPNP 3230 273-6394 Mon. 1-2; Tues. 1-2
    hinzemm@nursing.ufl.edu or by appointment

    COURSE SCHEDULE

    Days Time Room
    Thursday 5:10 -8:10 HPNP 3203/3203A

    COURSE DESCRIPTION: This course provides an overview of spirituality and creativity in healthcare and extends the student’s knowledge of the creative arts in human caring. It will provide an understanding of the use of visual arts, writing, music and creative movement. Emphasis will be placed on the artistry of caring and spiritual praxis in holistic care. The focus will be self-utilization of the creative arts, guided imagery, and meditative practices.


    COURSE OBJECTIVES: Upon completion of the course the student will be able to:


        ATTENDANCE
        Students are expected to be present for all classes, other learning experiences and examinations. Students who have extraordinary circumstances preventing attendance should explain these circumstances to the course instructor prior to the scheduled class as soon as possible. Instructors will make an effort to accommodate
        reasonable requests. A grade penalty may be assigned for late assignments or make-up exams. Make-up exams may not be available in all courses.

        ACCOMMODATIONS DUE TO DISABILITY
        Each semester, students are responsible for requesting a memorandum from the Office for Students with Disabilities to notify faculty of their requested individual accommodations. This should be done at the start of the semester.

        STUDENT HANDBOOK
        Students are to refer to the College of Nursing Student Handbook for information
        about College of Nursing policies, honor code, and professional behavior.
        TOPICAL OUTLINE

          TEACHING METHODS
          Lecture, discussion, group work, guest lectures, art projects, audiovisual materials, demonstrations and exercises.

          LEARNING ACTIVITIES
          Active participation, journaling, experiential creative processing, written papers, group processing, reading integration, project proposal, final project, presentations

          EVALUATION METHOD/COURSE GRADE CALCULATION
          Class participation, written and artist journals, scholarly paper and healing art project.
          (Note: specific guidelines will be included in the course materials. Student enrolled for graduate credit will have higher-level requirements specified).

          COURSE REQUIREMENTS:
          Each student will:
          • Attend each class/Participate in class discussion and projects.
          • Create plan for a significant project you will be implementing
          • Work throughout the semester on this project that explores the spiritual dimension of healing yourself and others.
          • Read assignments prior to class. Write a paper integrating the readings
          • Create a personal journal – bring to class each week.
          • Prepare a written paper on your selected project. Students taking the course for graduate credit will require a more in depth scholarly paper.

          Your grades are based on:
                GRADING SCALE
                A 94-100 C 74-81*
                B+ 92- 93 D+ 72-73
                B 84-91 D 64-71
                C+ 82-83 E 63 or below
                * 74 is the minimal passing grade


                COURSE GRADE CALCULATIONS
                Attendance/Participation 30% of total grade
                Creative Healing Project/Presentation 25% of total grade
                Student Journal 20% of total grade
                Reading Integration 10% of total grade
                Student Paper 10% of total grade
                Project Proposal 5% of total grade


                REQUIRED TEXTS

                1. Samuels, M. & Lane, M. (2000). Spirit body healing. New York: Wiley and Sons.
                2. Samuels, M. & Lane, M. (2003) Shaman Wisdom. New York: Wiley and Sons.
                3. See List of Choices for 3
                rd required Book


                RECOMMENDED TEXTS
                Fox, M, Creativity, (2002), New York, Tarcher.
                Watson, J. (1999) Postmodern nursing and beyond. Edinburgh, NY: Churchill Livingstone.

                WEEKLY CLASS SCHEDULE

                Ch. 1-3
                Journal Entry – spiritual history

                Ch. 4-6
                Journal Entry

                Ch. 7-9
                Journal Entry

                Ch. 10-11
                Journal Entry

                Ch. 12-epilogue
                Project Proposal Due
                Journal Entry

                Ch. 1-3
                Journal Entry

                Handout
                Journal Entry

                Ch. 7-9
                Journal Entry

                Ch. 10-12
                Journal Entry

                Ch. 13-14
                Journal Entry

                Journal Entry







                DATE
                TOPIC/EVALUATION
                ASSIGNMENTS/READINGS
                FACULTY
                August 27Introduction/Names
                Color My World
                Project Examples
                Spirit Body HealingM. Lane
                Emi Lenes
                September 3Guided Imagery, Create Sacred Space, Sharing Spiritual Experiences
                Spirit Body Healing M. Lane
                Emi Lenes

                September 10Slideshow
                Healing Collage

                Spirit Body HealingM. Lane
                Emi Lenes

                September 17Playback Theater/ Drama & Healing/Self Reflective Storytelling
                Spirit Body Healing M. Lane
                Emi Lenes Paula Paterson
                September 24Feedback on Projects
                Intuitive Painting
                Spirit Body Healing
                M. Lane
                Emi Lenes

                October 1Music and Healing

                Shaman Wisdom M. Lane
                Emi Lenes
                October 8 Creativity and Counseling
                Grace and Grit Emi Lenes
                Ana Puig
                Lyn Goodwin
                October 15 The Story of my Body

                Shaman Wisdom M. Lane
                Emi Lenes
                October 22 Mosaic
                Shaman WisdomM. Lane
                Gina Zeitlin Emi Lenes
                October 29 Visual Art and Healing
                Shaman WisdomMary Lisa
                November 5Death and Dying
                Reading Integrations Due
                Mary Lane
                November 12 Alex Grey

                Journal Entry
                Alex Grey
                November 19 Student Presentations
                Journals Due
                You!!!
                November 26 Happy ThanksgivingNo class
                December 3Student Presentations
                Final Papers Due
                You!!!
                December 10 Creating Sacred Space,
                Ceremony
                Dinner Celebration Gathering at Mary’s Home
                M. Lane
                Emi Lenes
                Approved: Academic Affairs Committee: 6/02
                Faculty: 6/02

                UF Curriculum:


                Guided imagery

                Guided imagery is foundational for allowing students to access their inner world. It is a basic tool used in cancer centers for relaxation and is useful for all nurses to be able to understand and practice. We use guided imagery extensively in the class, with guided imagery exercises for experiencing the inner artist, the inner critic, the inner healer, and experience darkness, light and healing energy.
                 A living example of guided imagery  
                Make yourself comfortable. You can be sitting down or lying down.  Loosen tight clothing, uncross your legs and arms. Close your eyes. Let your breathing slow down. Take several deep breaths. Let your abdomen rise as you breathe in, and fall as you let your deep breath out.  As you breathe in and out you will become more and more relaxed. You may feel feelings of tingling, buzzing, or relaxation, if you do, let those feelings increase. You may feel heaviness or lightness, you may feel your boundaries loosening and your edges softening. 
                  Now let yourself relax.  Let your feet relax, let your legs relax.  Let the feelings of relaxation spread upwards to your thighs and pelvis.  Let your pelvis open and relax.  Now let your abdomen relax, let your belly expand, do not hold it in anymore.  Now let your chest relax, let your heartbeat and breathing take place by themselves.   Let your arms relax, your hands relax.  Now let your neck relax, your head, your face.  Let your eyes relax, see a horizon and blackness for a moment.,  let these feelings of relaxation spread throughout your body.  Let your relaxation deepen.  If you wish you can count your breaths and let your relaxation deepen with each breath.
                In your mind's eye picture yourself healing. Let the love you feel come to you and surround you. Be in the love and compassion you are given from the universe.  Now imagine you are the most compassionate person you have known, heard of, read about or imagined.   Be in your heart.  Let the love you are, merge with the love within your heart.   Now look at yourself with pure compassion. Look through the eyes of the compassionate one. Look  through your own eyes seeing yourself in the deepest love and compassion. 
                 Now remember your own story of great suffering or pain.  Listen to your own story as you are the healer.  The healer is the artist within. As you hear your own story, let your love and compassion surround like a blanket from a mother to her baby. Let the love flow into your heart as you are the compassionate one. Let the suffering emerge into a sea of pure love.
                Take this image and imagine yourself as an artist in total freedom creating art. a dance, a song or a poem. You are beautiful and spontaneous. Imagine yourself being an artist. Allow yourself to play and explore, Allow whatever images emerge.....
                           When you are ready, return to the room where you are doing the exercise. First move your feet and then move your hands.  Move them around and experience the feeling of the movement.  Press your feet down onto the floor, feel the grounding, feel the pressure on the bottom of your feet, feel the solidity of the earth.  Feel your backside on the chair; feel your weight pressing downwards.  Now open your eyes. Look around you.  Stand up and stretch, move your body, feel it move.  You are back, you can carry the experience of the exercise outward to your life.  You will feel stronger and be able to see deeper.  You will be in a healing state.  Each time you do the exercise you will be more relaxed and be able to go deeper and be more deeply healed. 
                This class is a personal journey where the student is honored as their own healer and artist. The class provides an opportunity for the student to go deeper into their own quest of their spiritual journey.

                Pedagogical Practices – examples of transformative liberating approaches to teaching

                The key role of the faculty is to facilitate and empower the student. This course is a place to capture ideas and create a plan for implementation. As time goes on, the classroom becomes an increasingly sharing, caring, and cohesive community, that embraces the energies and aspirations of each student. The teaching approach is active and collaborative. The classroom is a structure for open and expansive learning. The course is about tapping into the infinite potentiality for each student. Its remarkable for the class members to witness each other in the deep depths of wandering within themselves.

                Just as our external physical space can be sacred, creating sacred space within the body is ultimately what is happening as well. The class provides an opportunity to slow down, leave the rest of their concerns behind, and step into another experience.
                The faculty focuses the student on settling down into their sitting posture, becoming aware of their breathing, taking slow deep breaths, allowing the body to relax and go into a mediation centering experience…


                Our Students come from diverse departments, such as: Nursing, Counselor Education, Religion, Premed, Anthropology, Fine Arts, Ceramics, Photography, etc. Being all together in the classroom, students realize that no matter what their profession is, they are part of an interdisciplinary, multifaceted community of people who are also professional in many diverse and different ways. This course deepens the experience of self awareness also allowing the students to understand the experience of other students in a powerful way.

                Each class has an outline and agenda, but this class has a fluidity and its not rigidly planned. The last half of the class is always an experiential process – engage in making art together


                Use of arts, humanities, healing models for learning environment –examples;

                The project is the most important part of the class. Each student does a project to actually use art- visual arts, music, dance, word or ceremony, to heal themselves others, neighborhood, or the earth. The project is presented to the class in a fifteen minute presentation, with any visuals the student wants, e.g. PowerPoint, music, dance. The presentation is an intentional healing act, the student is healed by revealing their truth. In addition, a written paper is due. Below is the an excerpt of the paper turned in after the presentation. In the course at San Francisco State University, the process is emphasized, not the language of the paper or writing style. The paper below was by a student with Spanish as the first language.

                This is an example of a project done by a nursing student in neonatal care unit in the class at San Francisco State University .

                Art as Healing for Mommy and Baby      "I am passionately committed to helping people discover their healing power, the one that lives and breathes within each of us. My mission and focus for the project was to volunteer one day out a month to dedicate to healing the mothers body, mind and spirit through the creative and therapeutic process of writing and listening to poetry. My vision is to awaken this creative and healing voice in the human sprit.  I am collectively dedicated to nurturing and strengthening the mothers’ capacity to connect with themselves, others, and most importantly with their babies. I brought together mothers whose babies are in the Neonatal Intensive Care Unit. They wrote a letter or a poem to their baby and furthermore, I took a picture of the mother, father and their baby and I framed the picture with the poem and gave it to them as a gift. For the project, I focused on Spanish native speakers; however anyone was welcome to participate. I am committed to helping Spanish speaking parents through the stressful experience of hospitalization.       One of the main reasons why I thought about doing this project is because I was a preemie baby my self and my mother wrote me a letter when I was in the Neonatal Intensive Care Unit. In the letter, she explained her painful and difficult experience in the NICU.  In addition I was only 1 pound 13 ounces when I was born, and for that reason the doctors explained to my mother that I had a very slight chance to survive, and if I did survive I might have some health problem in the future. My mother always had hope- she explained to me that she believed in God and she knew in her heart that I was going to survive. She always told me “think positive- never think negative”. Thanks to God, I am still here on this earth and I truly believe that this class was a sign for me. The class reopened my eyes in a good way. Thanks to the class, I am dedicated to helping others through the creative and therapeutic process of art.   Hospitals all over the world are including art into patient care. For that reason, I am glad I did this project, because now I am going to volunteer in the Neonate Intensive Care Unit once a month to help the parents heal their body, mind and spirit through the creative and therapeutic process of writing and listening to poetry. In addition hospitalization can be stressful- problems or concerns may arise during anyone’s stay, and not being able to communicate with others can make it difficult. For that reason, I created the Art as Healing for Mommy and Baby class for the Spanish speaking parents.  I have enhanced the NICU by making it a more transnational place. In addition, helping the parents capacity to connect with themselves, others, and most importantly with their babies, puts a smile on my face. Many times, non-English speakers feel unwelcome in the health care system, and one of the reasons can be because of their lack of communication. Studies show that the number one factor in receiving competent care, building effective communication with Latinos in the U.S., is having a Spanish speaking health professional. But, since relatively few providers speak Spanish, the interpersonal communication between the physicians and patients can be ineffective. Communications need to be effective because many times they are dealing with people’s health.

                The Art as Healing for Mommy and Baby class, can be a solution to the parent’s current needs. When the parents are able to communicate with me as a Latina and when they can be able to express their feeling through the process of writing or poetry, a huge difference occurs. I want to take the extra step and help parents heal their body, mind and spirit though the process of art. I want to become a hero in my mothers' eyes and a role model for everyone in my community. What makes me strong is my Latina roots and my mother. Because of her, I am where I am now. I’m glad I am using my mother’s experience as a way to help other people. My determination to succeed is fueled by my passion to break down barriers that keep many Latinos from excelling. I want to prove that I have persevered against all odds and I have changed my community by making it a more transnational, and non stressful Place. Thanks to the Art as Healing course, I learned so many things that will help me in my future. This class enabled me to understand many particular ways to be able to heal my body mind and spirit. It made me open my eyes a little more so I can become extra curious about life. I appreciate the faculty for giving me the opportunity to expand my education about healing. The class has made me a stronger Latina, and I’m exited to continue helping others heal their bodies, mind, and spirit because I am also healing my self." The class could not believe how beautiful this simple elegant project was. One woman, a student in a University class, changed healthcare in a neonatal unit in a one semester project for a course. How incredible is that?



                Lessons from Art as Healing for Mommy Baby
                In class, we talk about what we learn from the presentations. This is an example of lessons students learned from the lived experience projects:

                From Art as Healing for Mommy Baby the students learned: Passionate commitment
                Cross cultural awareness Mission focus dedication. Vision process emerged simple and clear Past history informed her deeply inside Based in research she became a hero and model for all Determination to succeed fueled by passion Change community heal community Found who she was healed herself

                Conclusion

                We want to enable the nursing students to reconnect to their own humanness, exploring their own inner sense of being and their own inner world at the same time honoring their academic and scholarly pursuits in their variety of disciplines This course is an opportunity for students to return to themselves and remember why they went into nursing in the first place. This course is an opportunity for students to return to lost parts of themselves. Many students have dreams that have been buried, disowned, or let go of, because of the academic rigor they are immersed in. When the student has gone into an academic program, they experience intense professional socialization. This course gives the student a personal opportunity to attend to obstacles that prevent them from being able to be fully present in their career decisions. One of our intentions is tapping into the students ability to be in love with what they do academically and professionally. We ask the student provocative questions about what it is that they are going to dedicate the rest of their life to. We allow the student to have a glimpse of looking inside themselves and see deeper into the mystery of who they are. The students can go to a place where they discover and reconnecting to what they are most passionate about relating to their lives work. This opportunity allows the student to experience a shift in their reality and become more conscious of what they are going to contribute to the role of their professional life. The students then begin to remember who they are and what they bring to their profession.
                This course is an opportunity for the student to contemplate who they are, what does it mean to be in this professional role and who they are as a human being doing it. The most important thing that people bring to their career is how they authentically and uniquely are. This course calls them to go back inside and explore why they made the choices they made, recommit to the choices they made, and remember what they are most passionate about.