Assignment: Multiple Intelligences
Regulatory structures and systems
How do pain management policies and procedures influence my connection with my clients?
What is my group role in meeting or changing pain management regulatory guidelines?
How do I use systems and structures to improve pain management practice?
Do I allow technology to help me deliver better pain relief care or does it interfere?
Adapted from Dossey, B., & Keegan, L. (2009). Holistic nursing: A handbook for practice (5th ed.). Sudbury, MA: Jones & Bartlett.
30 International Journal for Human Caring
of quadrants are terms used in everyday
language to convey the direction of our
communication and the direction of one’s
experiences in the world. Each quadrant
helps provide a framework for interpreting
the theory and is guided by four main
principles: (a) Nursing requires the
development of the “I,” (b) the discipline of
nursing is built upon the “We,” (c) “It” is
about behavior and skill development, and
(d) systems and structures are embedded in
and frame the understanding of “Its.” Each
principle continues to remind us that being
an integral nurse is first, more than being a
holistic nurse, and, secondly, an evolving
process that becomes clearer and more
meaningful over time through ongoing
practice and reflection.
All Quadrants, All Levels (AQUAL)
The final concept in the theory of
integral nursing is all quadrants, all levels
(AQUAL). Wilber (2000) recognized that
the quadrants of reality are connected to
levels, lines, states, and types that help
the individual create a comprehensive map
of reality. Levels refer to aspects of the
self that change over time and become
permanent as one moves through stages
of growth and development. Lines refer
to the complex aspects of self that enrich
and enhance one’s development, such
things as multiple intelligences, cognitive
awareness, etc. States refer to temporary
and changing forms of awareness, such as
consciousness, unconsciousness, dreaming,
waking, meditative states, recollection
of peak experiences, etc. Types refer to
differences in personality and expression
that may mediate one’s experiences of
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