Academic journal article Creative Nursing

The Making and Meaning of Presence: A Conversation with Jayne Felgen, MPA, RN

Academic journal article Creative Nursing

The Making and Meaning of Presence: A Conversation with Jayne Felgen, MPA, RN

Article excerpt

Jayne Felgen discusses the characteristics of presence, its relationship to caring, creating presence in challenging situations, creating structures that support therapeutic relationships, and the necessity for clarity-of self, of role, and of systems-in supporting people's ability to provide care that is based on relationships instead of tasks.

Marty Lewis-Hunstiger: Thank you Jayne, for joining me in a discussion of the theme of this issue of our journal: Creating Presence. I'd like to begin by asking you for your definition of presence. What does presence look, feel, and sound like?

Jayne Felgen: This is a challenging topic to get our arms around succinctly, so bear with me. To me, presence is a "showing up,"in the deepest way, as in a deep commitment. It is being in a relationship with one or several people in this "showing up" state, which is fully attentive in the moment not only to what is happening, but also to what might unfold. Underlying this state is a conscious intention to serve the moment and those with whom you are sharing that moment. There is an opening, if you will, that begins with what is known but has a willingness-a total commitment-to go into the unknown. Underlying it as well is the awareness of finding meaning. There is a sense of purposefulness in presence-the purposeful use of self in service to another.

So, attention, intention, comfort with the unknown, and an unfolding. What does it look like? A person who is calm, confident, and joyful in being in service. It feels as if there is safety-an emotional safety because there's a connection and a commitment that are palpable.

Lewis-Hunstiger: Is there an opposite image? An image that would lead you to say, "This is someone who is not present"?

Felgen: In contrast to someone who is present, there is a nervous, quick manner, not making eye contact, with full attention on the task instead of on the person with whom I am. An impatience to move a conversation along instead of really, deeply listening and allowing for the conversation to unfold based on the cues of the speaker. It is attention on task instead of the person.

Lewis-Hunstiger: We are told that sometimes one can behave in a certain way and his or her attitudes will follow. In other words, if I don't want to be truly present in a situation but know I should be, if I exhibit the behaviors of presence, then the attention, intention, and unfolding will follow. Do you think that's true of presence, or is it something that has to come from the inside out?

Jayne: That's a tough one. I believe it's both. I believe that the greater influence is self-awareness, and therefore the capacity to use one's self in service to another. And I think that there are supportive behaviors that help one to stay focused in a busy work environment. An example suggested in Jean Watson's Caritas work is staff nurses consciously committing, at the moment before they cross the threshold of a patient's room, to stop at the door, take a deep breath, and focus on the patient as a person, as opposed to the task. Or, as they are washing their hands, coming into a conscious state of presence on behalf of this particular person they are about to serve.

So I think it's really both. I think a work environment can really negatively influence the ability to be present, or at least make it more challenging. But I do believe the intrinsic factor matters more.

Lewis-Hunstiger: Thank you for that. We have rich information in this issue about how to create presence in adverse circumstances. That brings me to my next question, about the relationship between presence and caring. Is it possible to have one without the other, or do they always coexist?

Felgen: I believe it's possible to care without being present, but in those instances the caring is at an unconscious level-it's been suppressed or submerged. I have been stating for many years, in organizations around the world, my belief that everyone who chooses to work in health care does so (consciously or unconsciously) because they want to make a difference for patients. …

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