by Kristen Lombard
October 2009

This post has been moved from its original location at PeerSpirit.com and archived here, so you can continue to access it.

This month’s Circle Tale comes from Kristen Lombard, a founding member of True North Health Center in Falmouth, Maine, which has governed itself with The Circle Way since its inception. Kristen has also helped train other clinics and nursing staff in circle practice.

She tells her story in this tale and invited registered nurses from any specialty or educational level who have experienced sitting in circle with other nurses to participate in her doctoral research.

Two years ago, I sat in circle with nursing leader Jean Watson and twelve other amazing nurses as we studied and dialogued together during the Human Caring and Healing Certificate Program. One day, during check-in, I shared the grief of my recent departure from my healthcare practice community, True North in Maine, with whom I spent nine formative years working in circle as a form of governance and community. I had chosen to refocus my energy on a PhD, researching the use of circle process among nurses. As I described to the group my passion for circle, I became overwhelmed with tears, sadness, and loss. I didn’t know where or if I would ever find such a community again. I felt bereft and alone. “Where is my community?!” I wept. Later, I expressed my embarrassment to a colleague about my earlier outburst. “It couldn’t have happened without love” she replied. Indeed. circle, for me, is about learning how to love.       

In 1998, I was one of three nurses who got together in a small community hospital to initiate a broader program of holistic care. A group formed, and through tremendous dedication we created a holistic council, which manifested an array of educational sessions and complementary therapies for staff and patients, a Division of Integrative Care and an outpatient integrative healthcare practice. Serendipity brought Calling the Circle and Christina Baldwin into our midst, and we concluded that our collaborative actions needed to intentionally demonstrate congruence with our holistic values, in contrast to the unhealthy status quo in healthcare at that time. We created the term “reverent participatory relationship” to describe our intentional approach to everything we did. We had no inkling how this form of collaboration would change our personal and professional lives. In circle, we practiced how to be in “right relationship” with each other, so that we could then go out and do it with others. We learned how right relationship — with ourselves, our colleagues, systems and communities we worked in, the world, and beyond — transformed our experience of healthcare and the care we provided.        

In 2005, I had a serious health crisis and felt compelled to look at my life and determine what to let go of and which activities and relationships brought me joy and would, as Van Manen (1990) suggests, “commit” me to this world. What did I really believe in? Where would I put my precious life force energy? From a career perspective, I knew. Nursing and circle. Because of my own experience of being a nurse working in circle for years, and the grace that ensued, my intention has been to cultivate a culture of mindfulness and caring within nursing and healthcare through presence,  research, and the use of circle.

So, for the last four years, I have been incubating in rural Maine and preparing to do my qualitative research study about the experiences of nurses who have sat together in circle using the guidelines of The Circle Way. I have learned that the scientific literature reveals one ethnographic dissertation and other studies on aspects of being in circle, but no actual defined models. Other aspects researched include: participative management models, mindfulness, empowerment, healing environments, learning communities of practice, educational pedagogies, transformation, dialogue, and caring behaviors. Ultimately, the evidence supports that mindful presence of the individual and attention to relationships are making the significant changes in optimal patient care and safety outcomes, compassionate collaboration, job satisfaction, recruitment and retention, translation of research into practice and the professional development of the practitioner. Yahoo!

Now that I have done all the “head” work, I am eager to get back to the heart aspect of my work and am ready to start my research and see where it takes me. My aim is to contribute to the knowledge base of circle and articulate its value within the profession of nursing.

The gift of circle for me has been learning how to love, through presence, congruence, intention, respect and caring with myself and others. It has definitely not been an easy path, but I and my True North community are much stronger for having taken the risks. Where is my community now? I think I am about to find out and it will be bigger than I ever imagined!