What does it mean to "be in the moment, to be fully present?" These phrases are increasingly used as we attempt to further humanize the health care system and address issues of safety and quality, comfort, and care. For me, "being present" implies a relaxed control of myself and an acceptance of the fact that the past is gone and the future is not yet here, so best to lose myself in the present tasks at hand, like, preparing for a class, bathing a patient, comforting a family, conducting a staff meeting, or just walking down the hall. To be in the moment, to have lost the self in the act at hand is the highest form of self-composure and radiates to others. How often have you heard a patient describe the nurse who "is there for me; who looks at me, who focuses only on me when I am trying to tell my story?" Concomitantly, how often have you gotten complaints about the health care provider who is impersonal and hurried and who appears to care more about the technology to which patients are attached than about the patients themselves? I have a nurse educator colleague who conducts clinical simulations with the simple goal of getting new nurses to "look" at patients and to "sense" what they are experiencing. One of her test questions postsimulation is, "What color are your patient's eyes?" Many students cannot answer the question, but they get a perspective on how limited their focus might be during interactions with patients. There is so much to learn and so much to do in nursing practice that we need to find ways of thinking and being that will enhance our practice and the experiences of those for whom we care.
The Zen perspective can be of enormous value in the stressful world of health care. Zen, an ancient Eastern philosophical system or "way of life," may be considered a religion by its followers. However, Zen has no deity, no sacred scripture, and no fixed rules or dogma. It is, for those who attempt to live by its precepts, a way of life that includes the pursuit of the highest degree of self-knowledge leading, hopefully, to peace of mind and comfort with the self. Zen modalities are congruent with many holistic self-care practices such as meditation and the use of paradox and puzzles, sometimes called "koans" designed to free the mind from preoccupations with the past or the future and engendering a deep appreciation of the present moment. "What is the sound of one hand clapping?" is a familiar Zen puzzle intended to stop the mind and focus on the here and now. And although not a puzzle, per se, we can add the question of my nurse educator colleague (Robin Yeager, MSN, RN, staff development educator, Kennedy Hospital, Cherry Hill, New Jersey, oral communication, May 12, 2011) to every nurse's efforts to be more present: "What color are your patient's eyes?" Knowing the answer means that you are living in the moment and on your own path to satori!
-Gloria F. Donnelly, PhD, RN, FAAN
Editor-in-Chief