Nursing, Caring, and Complexity Science: For Human ... - Axon

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prologue
social, ethical, religious/spiritual, political, economic, technological, and legal
caring. By researching and understanding the meaning of caring, nurses and
other professionals showed the uniqueness of caring as an expression of the
complex human-environment mutual process. To capture this uniqueness of
caring within contemporary nursing practice in complex organizations, the
nursing process has been reconceptualized with a new mnemonic: recognizing,
connecting, partnering, and reflecting (RCPR) (Turkel & Ray, in press).
Complexity Sciences and Nursing
Complexity sciences, called the science of quality, look to networks of relationship
as the underpinning for choices in the continual and emerging
mutual human–environment process (Bar-Yam, 2004; Briggs & Peat, 1989;
Peat, 2002). Complexity sciences also fit the ontology (what we know about
being) and epistemology (the way we know) of nursing science (Anderson
et al., 2005; Davidson & Ray, 1991; Davidson et al., 1997; Lindberg, Nash, &
Lindberg, 2008; Ray, 1994, 1998). The mutual human–environment process
for both complexity sciences and nursing science involves phenomena that
are complex, dynamic, relational, nonlinear, structurally similar, integral,
pandimensional, holonomic, difficult to study, qualitative, self-organizing,
and open to emergence. The human–environment mutual process recognizes
the unitary nature of the human and the environment—everything in
the universe is interdependent; is sensitive to initial conditions (hysteresis);
is patterned; evolves over space and time, is similar through constant change
(homeodynamic) but never again exactly the same (irreversible); has “properties”
that arise in the act of observation itself; has phenomena that are
capable of filtration (choice) by involved agents-in-relationship; and has phenomena
that self-organize (change or transform). Thus, there is continuous
emergence (Bar-Yam, 2004; Briggs & Peat, 1989; Davidson & Ray, 1991; Peat,
2002; Ray, 1994, 1998). In nursing science, the mutual process of humans
and the environment evolves toward health, healing, or well-being through
the caring relationship. This transformation is relational self-organization
(Ray, 1994).
Complexity sciences and nursing science have the power to promote a
deeper understanding of human beings as they evolve with the environment.
It is a symphony of mutual continuous change or transformation: “The complexity
and the interdependency of agents who interact in a self-organizing
manner make it impossible for any single agent to control the processes and
outcomes of care for any patient” (Wiggins, 2008, p. 11). However, relational
caring self-organization in nursing exposes the power and energy of the caring
relationship and the caring moment (Watson, 2008). Choice within networks
of relationship or honoring the patient and family through caring cocreates a