Relationship Experience in India

2020 SUMMER SMRM NEWSLETTER Volume 29, Issue 2 
Society News:Website Announcement
President’s Message
Reflections from Helen Erickson
Focus on Students:
Holistic Education in Undergraduate Nursing Curriculum
Modeling and Role-Modeling in Practice:
‘Enhancing Relationships with Modeling and Role-Modeling Theory’
by Joyce Bredesen, DNP, RN, PHN
Enhancing Relationships with Modeling and Role-Modeling Theory
By Dr. Joyce Bredesen
Most of us were introduced to Modeling and Role-Modeling (MRM) theory as a foundation for nursing practice. However, once immersed in the theory, it becomes evident that MRM guides interactions in our lives beyond caring for clients. The following story provides an example of how a personal encounter was enhanced through using MRM.
As I was doing research in the northern part of India on women’s health care during pregnancy and childbirth, I had the honor of interacting with many women. MRM theory was utilized throughout my research on women’s healthcare. Many of the interactions were memorable, but the following story impacted me the most. In this interaction, the concepts of nurturance and unconditional acceptance were demonstrated. While we look at these concepts related to our clients; there is a reciprocity that occurs that impacts the relationship and ultimately our own health. The story also demonstrates connecting heart-to-heart and spirit-to-spirit. Developing a trusting relationship and connecting at a spiritual level enhances the ability to see the human spirit.
Nuturance is described as seeking an understanding and appreciation for the client’s personal world or perspective and role-modeling of the client’s world through interactions to assist in growth to become healthier. Cognitive, physiological, and affective processes are integrated (Erickson, Tomlin & Swain, 1983). “Nurturing is what we do because of our belief about people, our professional goals, and ourselves” (Erickson, 2006, p. 336).
Unconditional acceptance is defined as accepting the person as a “unique, worthwhile, important individual” in order to facilitate the client to develop his or her potential (Erickson, Tomlin & Swain, 1983, p. 49). 
Rishikesh, India
In some of the rural areas of India, women do not work outside the homes; only men are seen in the workplace. The hotel in which I was staying was staffed only by men, cleaning the rooms, cooking and serving the meals, and working the desk. The shops in the area were all staffed with men.During my two months stay at the hotel, I got to know several of the people working there, including a waiter in the restaurant. His English was very broken, and I did not know any Hindi, but over the course of a month we had some time to talk and share a few stories. He was always pleasant and very curious about me and my life. He talked about his wife and new baby. One day, he invited me to have lunch at his home with his wife and son.
Their home was a small two room house made of cement with curtains hanging as the door to the outside. There was a common courtyard area with many multiple small cement houses that were all attached sharing an outside toilet and water supply. The home consisted of the outer room containing 2 twin beds, with a space of approximately 2 feet between the two beds. There was a small table but no room for any chairs. The other room was much smaller. It was considered the kitchen. It had a small place on the floor for a fire with a hole in the ceiling for venting. There were no shelves, the small number of pots and pans were stacked in a corner. The room was approximately four by six feet. This also had a curtain that separated it from the other room of the house.
When I arrived, Mai was squatting in the kitchen next to her fire stove making food for me; her 9-month-old son strapped to her back. She rose to greet me and as she smiled shyly, her beauty struck me. She was short, as most Indian women I had met, with long dark hair braided neatly. She wore a bright blue sari that accented her dark skin and features. Her eyes are what struck me the most. They were soft and curious, inviting me into her home. She had prepared more food than one could possibly eat. She laid out newspaper on one of the beds and invited me to sit down by it. She then proceeded to bring out the food, setting it on the newspaper. The Indian custom is to serve all the food in individual dishes. I was humbled by the amount of food she presented to me. The main dish was rice and a bean dish, with many sides. Her husband had to go back to work, so it was Mai, her 9-month-old son, and me. Her husband had informed me that their son had been running a temperature for a few days and Mai had taken him to the doctor that morning. He was strapped to his mothers back as she was preparing the food, sleepy, yet curiously watching me.
The custom that I had experienced while visiting families in India was that the women did not eat with the men, or their guests. They fed you, and then I guess they ate when you left, as I never did see them eat when I was visiting homes. This situation was no different. As I ate, Mai watched me, and kept offering me more and more food. There was enough there to feed at least 6 people. I felt badly knowing that they had limited food supplies, and they were sharing what they had with me so graciously. I ate as much as I could, smiling and making small talk, which of course she couldn’t understand. Neither of us spoke each other’s language, but we were able to communicate by gestures, nods and smiles. 
After I finished eating, I pointed to a picture that was pinned on the wall and asked about it. Mai then proceeded to bring out a small photo album that she had under one of the beds and showed it to me.  They were pictures of her wedding, beautiful pictures. She became very animated as she pointed to picture after picture, describing who they were and where they were taken in Hindi. This was one of those momen s I wished I could speak her language yet was amazed by how we interacted without verbally being able to communicate. As I watched her face as she tried to describe her family members to me, her pride and joy was etched in every facial expression. I had also brought family pictures with me. I showed her my home and my family. She pointed to things in my pictures and asked questions, which of course I had no idea what she was asking, yet she seemed satisfied with my answers and continued to ask questions as if she understood every word I was saying. She made it so easy to talk.
I spent 3 hours with her that day. We watched her son play in the courtyard with the children; I sat by her side on her tiny bed as she nursed him to sleep and softly cooed and sang to him. I felt I had received a rare gift of a glimpse into the life of this beautiful young mother. 
As I was getting ready to leave, hugging her and tenderly kissing her son on the forehead, she took my hand and gently led me to the bed, insisting I sit down. While I was sitting down, she pulled out a shoe box from under her bed. She gently opened the lid of the box. As I peered into the box, I could see that there were various small items and keepsakes. She reached into the box and pulled out a small bag, opening it with tenderness and an expression of reminiscence. Inside the small bag was a pair of very decorative toe rings, with beautiful red stones. They were the toe rings that she had worn for her wedding; I recognized them from a wedding picture that she showed me and had pointed them out. At this point she was squatting on the floor next to where I was sitting on her bed. She reached over to my foot, attempting to take off my sandal. I was taken aback, not sure how to respond. As I pulled back, she looked up into my face with eyes that showed a tenderness and determination that is hard to explain. I then realized she wanted to put her toe rings on my feet. She again lifted my foot, took off my sandal, and gently put the toe ring on my foot. She then took my other foot, removed my sandal and placed the other toe ring on my foot. 
I was so moved by the experience; I didn’t know how to react. I admired them, smiling, then reached down to take them off and give them back to her. She shook her head vehemently and put the toe ring I had taken off back on my toe. She took her hand and covered my toes gently, as if saying ‘this is my final decision, they are for you.’ I was moved to tears at that moment as this young mother, with her son strapped on her back, was squatting on the floor, holding my dirty foot in her hand with her wedding toe ring on my toe. She had just given me a very precious gift, sharing a part of her life with me that was beyond words. In that moment, I experienced a spirit-to-spirit and heart-to-heart connection.
I will forever remember that moment, one of the most humbling experiences of my life. Modeling and Role Modeling takes on a new perspective for me regarding nurturance, unconditional acceptance, and connecting at a deep level with another. “The more conscious we are in our intent to create heart-to-heart relationships, the more effectively we connect spirit-to-spirit with our clients, facilitate their ability to connect with their Soul and experience holistic growth and healing” (Kinney, 2006, p. 278). MRM theory offers insight into the human spirit if we allow ourselves to develop those relationships. This young mother, who had little, shared one of her most prized possessions with me. She gave me insight into her world; even though we did not speak the same language. As we said our goodbyes, we hugged, holding each other for a moment longer, stepping back, and looking at each other, with tears in both of our eyes. We live a world apart physically, but at that moment, our hearts were connected.

Erickson, H. (2006). Nurturing growth. In H. L. Erickson, (Ed.) Modeling and  role-modeling: A view from the client’s world (pp. 324-345). Cedar Park, TX: Unicorns Unlimited.
Erickson, H., Tomlin, E., & Swain, M. (1983). Modeling and role-modeling a theory and paradigm for nursing. Englewood Cliffs, NJ: Prentice-Hall, Inc.
Kinney, C. (2006). Heart-to-heart: Nurse-client relationships. In H. Erickson (Ed.), Modeling and role-modeling: A view from the client’s world (pp. 227-299). Cedar Park, TX: Unicorns Unlimited.

Joyce Bredesen,DNP, RN, PHNCollege of Nursing and Health Sciences, Metropolitan State University, St. Paul MN