Mystery and Miracle in Nursing: A Preliminary Unitary... : Advances in Nursing Science (2024)

IN A POIGNANT STORY, titled “Black Hopes Matter,” a Black couple facing an end-of-life decision horribly mismanaged by the staff ends in a wife's grief so complicated that she almost lost her “will to live.”¹ This story points to the significance of beliefs about miracles in nursing care and how these play out for clients' and families' beliefs, making life-altering decisions about future health care in the most challenging of situations. Nurses are at the forefront of these decisional processes.

The study reported here evolved from the researcher's participation in an online course grounded in Watson's theory of caring.² The focal point of the study was participants' responses about the embodiment of caring expressed in the 10th Caritas Process calling for openness to mystery and allowing miracles to enter. The online course presented content on caring science and mindful practice³ and was open to anyone in health care across the globe. The course involved weekly general and reflective posting assignments. In the fourth week of the course, the assignment was to provide an example of someone you know in a professional setting who embodies the 9th or 10th Caritas Process. The science of unitary human beings⁴ was the orienting conceptual framework to study the phenomena of mysteries and miracles. The study was launched as a preliminary unitary appreciative inquiry⁵ to explore mystery and miracle occurrences from the vantage point of nurses who had experienced them.

Before presenting this study, it is important to acknowledge my positionality as a White gay male nurse 74 years of age who is married and well-educated and subscribes to a spiritual worldview open to the existence of miracles. There are events that

BACKGROUND AND SIGNIFICANCE

The predominant health care literature on mystery and miracles is about beliefs of patients and families regarding miracles and the impacts of those beliefs on decision-making that can have a bearing on the clinical course of treating a life-threatening condition. Some literature addresses the conundrum health care workers face regarding giving false hope while supporting individual spiritual and religious attitudes and beliefs. There is relatively minor attention given to sensitivity to racial and ethnic factors, differences, and preferences. There is little emphasis on the perspective of the nurse regarding mystery and miracles in relation to patient care.

Some researchers have suggested that typologies of beliefs in hope for miracles are the best way to negotiate decisions related to care for the terminally ill.^6,7 Ellington and colleagues⁸ suggest a need for protocol to support patients' and families' hope for a miracle as part of spiritual care. They acknowledge the challenges nurses face regarding the potential for false hope, yet see hope in a miracle as a form of energy that results in perseverance useful to patients and families. Norman et al⁹ note that nurses practice in a system whose points of reference about science are mainly empirical and realist in nature. Coincidentally, many health care professionals acknowledge that they have witnessed miracles, albeit it is unlikely that they will discuss these experiences widely.

Several studies discuss miracles in the context of spiritual and religious belief systems. Tenenbaum and Blatt¹⁰ note that more aggressive treatments are often avoided, believing religion overrides any other prognostic information. Leal et al¹¹ consider praying for a miracle, its positive and negative impacts on health care, in terms of the concept of spiritual/religious coping. Oftentimes, religion and spirituality help patients cope facing “dismal prognoses, and harrowing treatments that lead to permanent sequela or even death.”^11(p2)

Blackler¹² defines miracle as “an extraordinary event that surpasses known human or natural powers and is attributed to a divine intervention.”^12(p116) She draws attention to the interplay between hope and despair and calls upon health care workers to give attention to belief or hope by exploring the meaning of a miracle for the patient and caregivers to get an understanding of their perspective. However, in a compelling essay, a 21-year-old nursing student undergoing chemotherapy from infancy to adulthood calls on nurses to see simple things, embedded with the extraordinary, as small miracles.¹³

Research findings from 3 studies, each with a culturally distinct group with potentially terminal conditions, suggest the significance of religious beliefs and practices in advanced care planning cuts across cultures.^14-16 In one case, researchers interpreted the focus on religious beliefs by Latino patients as promoting an overly optimistic picture.¹⁴ In a study of African American adolescents dealing with HIV positivity, it was concluded that adolescents who believe in miracles may benefit from chaplaincy referrals.¹⁵ Suárez and Fidanza¹⁶ found that religion plays a significant role in fostering agency and capability expansion in their study of poor Latin American women based on daily spiritual practices and “miracles storytelling.” The researchers conceptualize miracle receptiveness as a way to a holistic and cosmological matrix with sacredness beyond the everyday and spheres connected and signifying wholeness.¹⁶

Two studies reviewed focused on the role of miracle belief in decision-making associated with medical prognosis.^17,18 In one study of cancer progression, it was concluded that belief in miracles impedes an accurate prognostic understanding of the course of one's cancer and should be mediated by oncologist training. In the second, it was found that treatment decisions by surrogates in end-of-life care tended to minimize prognostic and other clinical information.¹⁸

Two studies reported on nurses' perspectives of hope in miracles.^19,20 A study of neonatal nurses caring for compromised infants suggested that for the most part nurses had a negative view of parents hoping for miracles. Nurses had not witnessed miracles and believed relying on false hope would exacerbate already futile situations. In a second study²⁰ regarding spiritual care of young people with life-threatening and life-limiting conditions, miracles were described as supporting “false hopes” that were unrealistic and difficult to manage, thus interfering with appropriate clinical decision-making.

Chuang and colleagues²¹ conducted a phenomenological study to explore the lived experiences of persons with spinal cord injury living in Taiwan. The core experience delineated was “finding a way to cope,” which was described by the researchers as a process of moving through despair to self-acceptance. The people were not willing to remain in helplessness and contemplated or sought alternative treatments or reached for help from God.

Three studies^22-24 used the 10th Caritas Principle as an orienting framework for the research.² The 10th Caritas Principle of the theory of human caring articulates the value of being open to mystery and miracles² that surround life itself.³ The setting for each of these studies were ones in which Watson's theory of caring was used. In the first study,²² professionals in a children's hospital described the dominant perception that life is believed to consist of mysteries waiting to be discovered, a sense of infinity expressed in being open to miracles. In a study²³ of nurses providing palliative care for patients, nurses reported knowing the importance of spiritual care but being unable to deal with the mysteries of life and spirituality in many cases. The final study occurred in a neonatal intensive care where Watson's theory of human caring was practiced by nurses.²⁴ Ten parents and 7 grandmothers of infants in the unit were interviewed about care. One of the themes that emerged from analysis was “envisioning a positive future” in which caring practices allowed for hope and miracles. This was embodied in nursing practice that included “creating opportunities to express our feelings and concerns, asking us what we were going to name our baby, having us bring in new clothes or blankets, encouraging us to take pictures, letting me know when she opened her eyes for the first time, giving us updates and information, praying with us, reassuring us that our infant would be going home.”^24(p84)

SENSITIZING FRAMEWORK

The sensitizing conceptual framework for this study was the science of unitary human beings,⁴ providing the ontological perspective. Unitary appreciative inquiry^5,25 provided epistemological alignment and guided the research process. Conceptualizations guiding this study were the significant postulates fundamental to the science of unitary human beings, which include energy fields, openness, pattern, and pandimensionality expressed as follows: (1) patterning represents the wholeness and mutuality of human-environmental fields manifesting in the experience of miracles and mysteries; (2) wholeness is the inherent nature of human existence expressing itself in miracles and mysteries; (3) pandimensionality is a way of perceiving reality aligning with the infinite possibilities of a unitary world; (4) appreciating is a way of being aware of the participatory nature of a unitary world that allows for a deep and profound way of knowing transcending fragmentation in the service of wholeness.

The science of unitary human beings⁴ emphasizes the pandimensional. “It best expresses the idea of a unitary whole, and it is defined as a nonlinear domain without spatial or temporal attributes.^4(pp31-32) Pandimensionality is an ontological postulate that supports the notion of mystery and miracles in human life. “The uniqueness of nursing, like that of any other science, lies in phenomenon central to its purpose; people and their worlds in a pandimensional universe are nursing's phenomena of concern.”^4(p29) It also grounds the epistemology underlying unitary appreciative inquiry that seeks to know the wholeness of human existence through patterning manifestations inclusive of mysterious and miraculous phenomena. The ontological and epistemological foundation for the preliminary study uses a form of unitary appreciative inquiry^5,25 as the method that aligns with the theory.

PURPOSE

The study aimed to derive meaningful unitary understandings and insights into the nature of mystery and miracles through storylines and imageries offered by nurses. It was hoped that this approach, grounded in the science of unitary human beings, might inform theoretically based practice for nurses. The research method chosen for this preliminary study was a form of unitary appreciative inquiry,^5,25 unitary appreciative rendering, tailored to capture phenomena from a unitary nursing perspective. The themes and unitary appreciative renderings that grew from engagement with texts and images of the postings of nurses telling stories of mystery and miracles represent a form of appreciative and participatory unitary knowledge.

PROTECTION OF HUMAN SUBJECTS

The researcher was brought onto a larger project as a co-principal investigator. That project is titled “Student Attributes, Needs, and Experiences in a Caring Science Open Online Course” and was approved as exempt by East Carolina University's institutional review board. Participants were not required to include any identifying information to participate in the project. For the study reported here, any personal names, identifying information, or names of institutions or settings were removed from postings used for analysis and synopsis. The documents were stored in an encrypted file. There were no apparent risks to participants. While the benefits of this study did not impact the participants directly, it was the intention that findings, discussions, and conclusions would broaden and deepen an understanding of the phenomena. Coincidental with the descriptions of mysteries and miracles was an elaboration of meaning made by these occurrences.

DATA COLLECTION PROCEDURES

The research method used for the study is unitary appreciative rendering, a creative approach customized to the purpose predicated on the tenets of unitary appreciative inquiry.^5,25 It was created because it aligned with the sensitizing framework, the science of unitary human beings, and was congruent with the purpose of the research. Unitary appreciative inquiry encompasses unitary appreciativeness that is fulfilled by acknowledging the wholeness inherent in human experience, which is descriptively represented in patterning manifestations. Unitary appreciative inquiry is a qualitative research methodology that relies on narratives in the form of text and images to describe the patterning associated with phenomena of human experience. In the case of this research, the narratives are the texts and images from postings about mystery and miracles. Themes were generated from analysis and the rendering from synopsis.

The research process consisted of a systematic review of preexisting postings generated by nurses taking an online course in mindful caring practices. Each student was asked on a weekly basis to do a discussion board posting and a reflective journal posting and “thoughtfully respond” to at least 2 classmate postings. The postings could take the form of a narrative of at least 250 words or a pointillism, mandala, or photographic image with brief explanation of at least 150 words. Prompts for postings typically consisted of examples or instances of mindful practice with the integration of caritas principles² covered in the module for that week.

SAMPLING

The sample consisted of discussion postings from week 4 that referred to mystery and/or miracles in response to the prompting questions that referenced the 10th Caritas Principle.² All fourth-week postings for the courses that ran from 2017 to 2022 involving 2331 course participants and all the postings that contained any of those terms formed the database for the appreciative analysis and synopsis. The postings sampled were from the individuals who intentionally chose to address what they perceived to be mysteries and miracles. This resulted in 119 postings that mentioned the word “miracle,” “miracles,” or “miraculous” and 54 postings that mentioned mystery or mysteries. Postings selected included original postings and all responses to those postings.

ANALYSIS AND SYNOPSIS

To achieve the purpose of the study, a synoptic rendering was generated to provide a unitary appreciative depiction of mystery and miracles. Unitary synoptic rendering is a process of appreciatively exploring phenomena through a pandimensional, appreciative lens. Unitary synoptic rendering implies the deliberate viewing together of aspects of phenomena to create a representation that seeks the inherent wholeness that transcends parts or elements. The intention of unitary synoptic rendering is to expand and deepen understandings of phenomena in novel ways that support human healing and well-being.

Although the trigger assignment focused on what embodied being open to mystery and allowing for miracles to emerge, the intent of this research was to learn about and appreciate the nature of the phenomena through the eyes of nurses. In other words, the question is what is the nature of an experience deemed to be mysterious and miraculous? To be able to speak to the embodiment of the 10th Caritas Principle, an assumption was that the participant making the post would describe a mystery or a miracle and provide some perspective. This was the substantive focus of the synopsis process.

RESULTS

Three major themes emerged that are discussed in the following text, and a unitary appreciative synoptic rendering was created to illustrate miraculous, mysterious pandimensional life patterning.

Death and dying are laden with the mysterious and miraculous providing opportunities for transcendence for the nurse and those dying and their loved ones. Nurses described both subtle and profound experiences associated with the death and dying process. The nurses worked in intensive care, critical care, and hospice situations. Those who had a history of working with people undergoing death and dying described mysteries associated with the timing of death. These included waiting until loved ones arrived or in some cases waiting until all the family members had left after a long period of being in attendance. They discussed the phenomenon of the loss of a loved partner, followed by deterioration and sometimes death of the surviving partner. Many described the close connection that occurred among the dying person and family members that they associated with a peaceful death. Others described the potential for healing within the dying process both for the person who was dying and for family members and other close loved ones. Profound near-death experiences characterized as mystery and miracles were observed. Many nurses called out the unique connection they felt with the person dying and the family members during the transition to death as exemplified in this quote by a participant. “The sacredness, honor, and privilege of being present at the moment of death is unlike any other caring moment I have experienced.” One nurse described a situation in which she was helping with an organ harvest of a young 18-year-old girl who was killed in an automobile accident. The recipient was waiting in a room nearby. She saw the miracle of the death of one bringing life to another. Many nurses saw the dying experience itself as filled with mystery and miracles. While there were a variety of diverse experiences described, a common perception of death and dying was that it was imbued with mystery and miracles often characterized in enhanced connections with loved ones and with the nurse, potentials for healing, and unexplainable events.

Nursing itself is imbued with the mysterious and miraculous in connections with others and in the willingness to see possibilities for healing. The postings commonly described the ways in which nursing itself is mystery and miracles and providing detailed stories that identified specific mysteries and miracles. Nursing was portrayed as providing an opportunity to shift perceptions and find new meanings in the practice of it with persons and families. One viewed this as allowing and readying her to open their heart. Having access to people's lives at their most vulnerable and fragile points of their existence was viewed as an honor, often moving into unknown territory. The necessity of nursing using touch, providing comfort, and offering soothing care was cited as an element of nursing that held mystery and miracles by the nature in which they created a connection of the nurse to the patient and helped the patient to experience peace. One nurse expressed this as, “Sometimes we are the miracles that bless our patients with a smile or kind word.” In addition, the features of nursing of witnessing and being present were viewed as filled with mystery and miracles.

Miracles are mysteriously ever-present, unanticipated, and unexplained, unacknowledged by science, yet realized as deeply meaningful. Nurses described both the sense of life itself being a miracle and that the presence of miracles are oftentimes missed in the ordinary or the mundane. There was a perception that each human being and human beings as a collective are miraculous, implying individually and together we exist as miracles. This was articulated as: “…we are all miracles, and our life is a miracle. It is so powerful to realize that miracles exist all around us in the people we love.” Miracles might take many different forms, some profound and some subtle. One nurse pointed out that sometimes healing can mean easing into a situation and finding appreciation without resolution of the condition; in a sense, letting go and allowing a trajectory of illness-health that resonates with a person's choices. “In the health care field, we often see events we can't explain with science or facts. Let us look at those occurrences with wonder. Doing so allows us to bring some beauty, magic, and joy into the experience.” Consistent with this perspective, nurses saw miracles as essentially the territory of the unexpected and unexplained. The theme demonstrated the complexity of mystery and miracles and the many dimensions and conundrums that exist.

SYNOPSIS: A RENDERING

The findings and results of the study are presented in the style of a unitary appreciative rendering. Render implies interpreting, depicting, and portraying, especially from an artistic perspective; to put forward for consideration and scrutiny; and translating a body or piece of work.²⁶

I am a nurse and I work with people, patients, and their families. I work in many different settings and with so many different people of different ages. Some of my patients are newborns, some are infants, some are teenagers, and some are older. Most of my patients and their families are facing very challenging events and conditions in their lives and feel overwhelmed with making decisions they believe will alter the events and future of their lives. I feel closely connected to them and feel responsible for helping them through these situations. I know they are not really “my” patients; they do not belong to me. But I do not know any other way to express the closeness and connection, the intimacy, I feel when I am with them and oftentimes when I am just thinking about them. My patients are dying or told they will die. My patients are frightened of going into surgery and not coming through it alive. My patients are unconscious and unable to tell me what they want. My patients are babies so vulnerable and at the mercy of adults. My patients have been critically hurt in accidents. My patients are waiting for organ transplants, or they will not survive. My patients may never walk again or do simple tasks in their lives. My patients are often not expected to survive much less get better. I feel close to their families as well. Most of them love these people and want them to get better or at least be comfortable and at ease if they are going to die.

I believe in mysteries and miracles—mystery is the enigma of life, and miracles are the unexplained and unexpected events that flow from this mystery. I have professional and personal experiences that I would most definitely consider to be mysterious and miraculous. A baby shot in the head survives beyond all odds, and so many others die. A newborn found in a trash can thrives regardless of what we thought would happen. A young teenager who was so severely injured in an automobile crash not only recovers but also after months comes out on the other side, returning to a relatively normal life. A young woman dies in an automobile crash; her organs help the woman in the next room survive. A beautiful young woman walks into the clinic where I work, striding in her high heels. She had been left with severe spasms throughout her body due to a mistaken medical procedure. Her husband was told to expect her to be quadriplegic for the rest of her life, and here she was, not only walking but also in those lovely high heels!

I have been at the beside with dying men and women who are struggling to keep going, surrounded by their families, and yet finding peace and comfort as they drift away. Dying is really a mystery to me. Some people die after waiting for a loved one to come to their side, others when everyone finally leaves the room. Some people have told me stories of dying, experiencing the afterlife in strange and remarkable ways, and returning blissful. I have seen people suddenly or gradually fall ill and die after losing someone they love; I really do believe people can die from a broken heart. I feel a sacredness and honor to be there when someone dies. I want to walk with them through the end, prepare their bodies, knowing I am touching their souls, and sometimes escort them to the morgue. Being there for their loved ones gives me a deep sense of purpose. All of this is filled with mystery and miracles that I cannot fully explain.

Sometimes there are things that happen out of the blue that simply amaze me—I am sure these are signs of the mysteries of life and the miracles that await us, which may even happen when we are not noticing. These profound ones, which are totally unexpected, help confirm for me that miracles do exist, although I cannot explain them. An older doctor who had been working in the war in Ukraine came to me as a patient. Earlier, after several diagnostic studies and assessments, he was told he had a form of uncurable cancer. Yet, suddenly when he came for an office visit, the physicians could find no evidence of cancer. One of the patients was in a coma for more than a month. The physicians told the family that he would not likely survive and, if so, he would require total care and perhaps an artificial ventilator just to breathe. A month later he walked out of the hospital independent of any assistance. This was just like a woman I took care of who had a bilateral lung transplant. We had no expectation she would live; several times during the course of her treatment, we had to trach her. Then things started to fall into place, and she was finally discharged home.

I am told not to give false hope to patients or their families. I am told to be objective. I am told to believe in science and use evidence-based practice. I am expected to believe that mystery and miracles do not exist. I still believe. I guess that is the strength of the “mystery-miracle” occurrences. I am thoroughly convinced that mysteries and miracles are a part of life. They dwell in the simple and the profound. I feel them when I wake up and when I drift off to sleep. When I am in nature, I am connected to something I cannot explain, but I know is real. Then there are the totally unbelievable and mystifying things I have experienced. The family of a young child I was caring for was hospitalized in a corner room. The family desperately begged me to move their child, saying they felt afraid of being in that room and were worried about their son. I finally was able to secure a room. Later, I learned that a young child had died in that room, the night before the admission of their child. In a nursing home, I cared for a man for many weeks who was critically ill and slowly dying. His loving family stayed with him throughout this time. I felt a deep satisfaction in gently caring for and comforting him, doing my best to soothe him through this transition. When he died, I cleansed him and cared for his body before the funeral home came; I felt a deep sense of connection with him. I think that is what I mean by sacred—it is beyond the body, something else, maybe the soul. After he was taken away and I was working at the nurses' station, his room kept calling me, like 3 times. And when I went to look, no one was there. There is no way I can make sense of this without thinking there are events that transcend the physical world. It means considering the possibility of the universe and human beingness, existence, as something perhaps very different from what I have been taught. I have infinite appreciation for the limitless ways in which some sort of sacred mystery touches my life and leads me to wonder. Perhaps, this is cosmological and divine—perhaps, that is a stretch. I am not sure. Sometimes I imagine it is like the mandala, which I think is like the complexity of this pattern of mystery and miracles. I close my eyes and think I am holding the gift of a shining light in my hands, and other times I see a butterfly in my hands that I am joyful to free.

I do not tell anyone about these things. I know that it is likely that I will face ridicule. Occasionally, a colleague will confide in me about similar experiences. I have some family members who feel perfectly comfortable about sharing experiences like mine. On my own, I contemplate all of this and think what nursing would be like if more nurses shared mysteries and miracles with one another. I think my world is different from those of my colleagues—I do not know. Perhaps, if we could acknowledge and appreciate the mysteries and miracles that surround us, we might discover some things that could help us care for people in a more meaningful way.

DISCUSSION

The findings from this study provide a rich description of the life patterning of the group of participants reflected in the intimacy of connections with people and their families during the health-illness experience. Life patterning is conceptualized as integrating the human-environmental mutual process. Rogers⁴ noted that from a field pattern perspective, aging of a unitary human field is manifested in greater diversity and a wider range of varied forms of experiences in the aging and dying process. Phillips²⁷ has labeled this “living-dying.” Although Phillips²⁷ does not refer to miracles, his theory of pandimensional awareness-integral presence is a unitary niche for understanding of death as transcendence. Miracles in dying can be considered as a pandimensional experience of reality defined as “a non-linear domain without spatial or temporal attributes.”^4(p29) Rogers pointed out, “The nature and continuity of field patterning subsequent to dying, while admittedly a difficult area to study, nonetheless is open to theoretical investigation.”^28(p8)

Malinski^29,30 explored the dying process from a unitary science perspective. Building on the ongoing transformational capacity of energy fields, Malinski notes that the energy field transforms in the dying process. “The energy patterning persists, manifesting in new ways.”^29(p296) This view is consistent with the principle of helicy, which posits that human and environmental fields evolve innovatively, unpredictably, and with increasing diversity. Malinski²⁹ described the unitary perspective espoused by Rogers that death is a static term that is not appropriate to a dynamic universe preferring the term dying. Malinski noted that Rogers also identified the living-dying process as one of the natural rhythmicities. “Rogers described dying as a transforming of energy, a moving beyond the visible spectrum in higher frequency, increasingly diverse patterning.”³¹ Rogers²⁸ suggests that the viewing of living-dying as characterized by rhythmical pattern has the potential for a new approach to studying dying.

Rogers⁴ postulated the capacity of human beings to participate knowingly in change. Barrett³² developed a theory of power as knowing participation in change, noting that while human beings are always participating in change, they are not always participating from a knowing perspective. Nurses' descriptions of the mystery and miracle aspects of the dying process indicate knowing as a way of being with these people by giving them opportunities to explore and make choices about how to die as dying unfolded. Specifically, the theory of power as knowing participation in change could be used to extend the knowledge and advance the science of dying from a unitary nursing perspective. Likewise, the reports of nurses regarding their own sense of transformation arising from the human-environmental field mutual process comprise an area worth further exploration.

Participants oftentimes remarked that nursing itself was a mystery and filled with the possibility of miracles. They described experiences of a deep sense of connection that allowed them to absorb the notion of miracles even if they were not fully understood. They described feeling a sense of being in nursing and experiencing nursing as mysterious and miraculous. Nursing allowed them to be exposed to situations that no other professional was likely to experience, and this was an aspect that differentiated nursing from other fields. While feeling perplexed by some of what they encountered, many recognized the need for attuning to the possibility of mystery and miracles in their practices. Many suggested a different view of healing not necessarily in the form of full recovery and not always dramatic and profound. They accepted the idea that what they believed about miracles was not as important as what patients and families believed, never shutting the door to such beliefs.

The deep connection felt with others is signified in the close intimacy that nurses share with patients and families through a variety of health-illness trajectories expressing the human-environmental mutual process. Weaving unitary science themes and complexity theory, Davidson explored the environment as a sacred healing space, noting that “human beings in mutual process with the environment reveal manifestations of the whole, a continuously changing phenomenon.”^33(p101) She suggested an interesting analogy to copper as it ages oxidizing to reveal different colors and hues, at different rates across various areas, showing the fingerprints of those working with it. “Similarly, human beings in mutual process with the environment become more beautiful. In the course of the journey, manifestations of health or disease may involve the nurse, who leaves fingerprints on the process.”^33(p101)

From a unitary nursing science perspective, the revelations of the mysterious and miraculous events reported by the nurse in the postings are consistent with the principles of homeodynamics that explicate the continuous changes in human-environmental field patterning.^4(p31) This continuous change is characterized by higher frequency; innovativeness, unpredictability, and increasing diversity; and the mutual human field and environmental field process. Furthermore, the universe is conceptualized as pandimensional characterized by infiniteness and continuous motion. Within the context of the principles of homeodynamics and a pandimensional universe, the presence of mysteries and miracles is emblematic of unitary life patterning. In addition, the relative nature of change varying across humans becomes explicit. “In fact, as evolutionary diversity continues to accelerate, the range and variety of differences between individuals also increase.”^4(p32)

The unitary appreciative perspective is guided by the understanding that life is a mystery and miracle and not a problem to be solved, and mystery is something to be caught up in, often unclear yet amenable to discovery.³⁴ Patients who experience miracles may have a profound or subtle sense of pandimensional awareness beyond the normal scientific way of perceiving reality. It was not clear from the reports that persons experiencing what was considered miraculous shared a worldview from which they made sense of these miracles. Nurses certainly were unclear in how they perceived them in the context of a worldview except for leaning toward a spiritual one. Finally, Rogers⁴ described the purpose of nursing as promoting human betterment. The mysteries and miracles that were reported may require a greater degree of imagination in ways to provide support, as well as the emphasis on individualization of nursing practices, given relative diversity in patient and family experiences.

The unitary appreciative rendering created a synopsis of the shared as well as differing experiences, perceptions, and expressions of the nurses' postings about mysteries and miracles. The purpose of the unitary appreciative rendering was to uncover the inherent wholeness that reflected the patterning through its manifestations. There is appreciative knowledge that arises from this unitary rendering that distinguishes it from other forms of knowledge.³⁵ This knowledge describes and explains the uniqueness of the patterning contextualized within the occurrences of mystery and miracles with this group of nurses. Thus, the unitary appreciative patterning of mystery and miracles is expressed in manifestations reflected in these key phrases: Mystery and miracles are a complex enigma stretching beyond commonly held expectations and explanations. Miracles arise from the mystery of life itself and reflect the hidden possibilities residing in the being of all people. Mystery and miracles appear in many diverse forms, subtle and profound. Miracles may appear as an answer to a wish, desire, or prayer. Mystery with its accompanying miracles is noticeable in people dealing with health and illness challenges. Mystery and miracles are uniquely manifested with each person situated within the conditions they encounter. Mystery and miracles are most profound in the midst of struggle and crisis, with overwhelming odds against you. Mystery and miracles open the door to greater wonder and passion to know more. Death and dying are infused with mystery and miracles. Mystery and miracles reside in our connection to other human beings and nature. Mystery and miracles give clues to the nature of the universe and the positionality of human beings within it. Mystery and miracles can be imagined as a complex living mandala visited with the potential for release and enlightenment. Mystery and miracles create opportunities for suspension of former ideas, beliefs, and judgments. Mystery and miracles are infused with wonder and awe and when recognized and appreciated can accompany shifts in consciousness and transform awareness.

LIMITATIONS

This study represented a preliminary exploration of the phenomena of mystery and miracles. The findings are limited to a group of nurses taking an online course who were asked to describe the embodiment of being open to mystery and allowing for the possibility that is described in the theory of human caring.³ Therefore, the findings are limited to their experiences and is an indirect way of using the voices of nurses to capture the phenomena of the inquiry. The study employed unitary appreciative inquiry that has been previously used in research and praxis with people and until now focused on unitary patterning appreciation of adult women survivors of abuse as children and other challenging contexts. Thus, for the first time the method was tailored to focus on phenomena with the creation of a synoptic representation operationalized as a unitary appreciative rendering. It is both preliminary in findings and use of the tailored method.

CONCLUSION

This study of mystery and miracles is an opportunity to explore them using the orienting conceptual framework of the science of unitary human beings.⁴ The findings from this study exemplify the major concepts articulated in the principles of homeodynamics. The principles of resonancy, helicy, and integrality describe the nature of change for individuals and groups. It is a continuous mutual and environmental change process reflecting patterning of lower and higher frequency and is characterized by innovativeness, unpredictability, and increasing diversity. Mystery demonstrates unpredictability and openness, and miracles characterize a pandimensional universe as well as a human-environmental field process. A nonlinear universe without spatial or temporal attributes as in pandimensionality provides a context for appreciating mystery and miracles. In summary, mystery and miracles can thus be understood and appreciated in the context of the continuous change process that human and environmental fields undergo mutually in evolving. Since change is relative to each individual and groups in unitary evolution, varying degrees of diversity can account for variations in how humans experience and manifest patterning contiguous with mystery and miracles. The study findings coupled with the background literature are highly reflective of the tendency to minimize or dismiss mystery and miracles. Perhaps, with further inquiry, the science of unitary human beings might provide a framework for research and practice that would guide nurses through this territory in order to promote human betterment.

REFERENCES