NURSING IS AN ART

Through the analysis, a definition emerged suggesting that the art of nursing is the intentional
creative use of oneself, based upon skill and expertise, to transmit emotion and meaning to
another. It is a process that is subjective and requires interpretation, sensitivity, imagination, and
active participation.

By Erica Bettencourt

Everybody knows that the nursing profession has two different sides—it is both science and art.
That said, nursing as a science is more apparent.

For example, if you are a nurse, you must know the patient-based nursing care plan (NCP). You
must also know the disease mechanisms of all diseases, medications, and management from all
sides. Nurses also need to be up to date on new policies, practices, and procedures. Moreover,
they need to know how to manipulate new diagnostic equipment and machines.

The science of nursing is easily noticeable and it is very critical for each one to know.

What Is the Art?

Meanwhile, the art of nursing is more than a great deal of science. It is more than just knowing;
it is doing. It bridges information from nurses to patients in a skillful way. It is the application of
all the science known to nursing to give the utmost care the patient needs.

During your first year in the nursing profession, you are in the heat of the moment. You now
belong to that bunch of young professionals who are enthusiastic and motivated in practicing
their craft. Maybe many could attest that when you first become a nurse you see the art more
than the science of it.

But it is sad to note that as time passes by the semblance of the nursing being an art bleeds out.
At the drop of a hat, you get suffocated from the career you once loved.

The Human Touch

In the past 7 years that I have been a clinical instructor, I have seen so many changes in the
healthcare arena and how nursing should be. But one thing remains: human nature.

Our patients’ needs have remained constant and relentless. As Maslow’s hierarchy of needs
suggests, these include food, sense of belonging, warmth, compassion, self-actualization. These
basic needs have been addressed in the same way since the dawn of science. However, the ways
to meet them may have changed from time to time.
The art of nursing may have been in each person even before entering the profession. That innate
capacity to respond to the needs of individual is already the art of nursing. In nursing school, this
vivacity is awakened through constant interaction with the patients in various settings.

Nurses are called to perform relational work. Therefore, the motivation to keep that art in us
should be continuously burning. We have the power to heal the sick. An effective nurse is one
who gives nursing care independently and collaboratively with other healthcare teams.

The art of nursing comes in as a nurse independently does his or her job. The options s/he
considers in taking a certain action and ultimately the action s/he does to respond to patient
needs are the art of nursing.

It is in the nurses’ hands to promote positive changes in patients. Everyday we are faced with
patients who are in different conditions. In this case, individualized nursing care is noteworthy.
Knowledge is not enough. Compassionate care is paramount.

Where Is the Art?

In my experience, I have witnessed things in which nursing as an art is not manifested. I squirmed
while hearing a nurse teaching pre-operative patients without compassion. Instead of comfort,
fear is built within the patients. I have observed nurses, who are not well informed about a
disease process, explain things to patients without using therapeutic communication. I have
noted procedures done outside the context of the protocols and sterile technique.

Sadly, many of these incidents are from those who have been in the profession for so long.
Science is applied, but where is the art in this perspective?

Clearly, nurses must be equipped with the science of nursing. But until the art of nursing is
recognized as a necessary principle for patient care, nurses will likely to continue to demonstrate
behaviors that make them good technicians. However, they will not necessarily be good nurses.

As a field grounded in compassion and direct patient care, the art of the nursing profession is
more important than the science. And this is where the so-called calling comes into play.
Self-awareness

A Johari window is a psychological tool created by Joseph Luft and Harry Ingham in 1955.
It’s a simple and useful tool for understanding and training:
 self-awareness
 personal development
 improving communications
 interpersonal relationships
 group dynamics
 team development; and

It is one of the few tools out there that has an emphasis on “soft skills” such as behaviour,
empathy, co-operation, inter group development and interpersonal development. It’s a great
model to use because of its simplicity and also because it can be applied in a variety of situations
and environments.
In this example we are going to talk about how the Johari window works with an individual within
a team. In this instance there are two factors at work within the Johari window. The first factor
is what you know about yourself. The second factor relates to what other people know about
you.

The model works using four area quadrants. Anything you know about yourself and are willing to
share is part of your open area. Individuals can build trust between themselves by disclosing
information to others and learning about others from the information they in turn disclose about
themselves.

Any aspect that you do not know about yourself, but others within the group have become aware
of, is in your blind area. With the help of feedback from others you can become aware of some
of your positive and negative traits as perceived by others and overcome some of the personal
issues that may be inhibiting your personal or group dynamics within the team.

There are also aspects about yourself that you are aware of but might not want others to know,
this quadrant is known as your hidden area. This leaves just one area and is the area that is
unknown to you or anyone else – the unknown area.

The balance between the four quadrants can change. You might want to tell someone an aspect
of your life that you had previously kept hidden. For example, maybe you are not comfortable
contributing ideas in large groups. This would increase your open area and decrease your hidden
area.

It is also possible to increase your open area by asking for feedback from people. When feedback
is given honestly to you it can reduce the size of your blind area. Maybe you interrupt people
before they have finished making their point which can cause frustration. Alternatively people
may always want to talk to you because you are a good listener. Sometimes you don’t realise
these aspects of your character until it is pointed out.

By working with others it is possible for you to discover aspects that neither of you may never
have appreciated before.

Some examples of unknown factors can be as follows:

 an ability that is under-estimated or un-tried through lack of opportunity, encouragement,
confidence or training
 a natural ability or aptitude that a person doesn't realise they possess
 a fear or aversion that a person does not know they have
 an unknown illness
 repressed or subconscious feeling
 conditioned behaviour or attitudes from childhood
Self-enhancement

Self-enhancement is a type of motivation that works to make people feel good about
themselves and to maintain self-esteem. This motive becomes especially prominent in
situations of threat, failure or blows to one's self-esteem. Self-enhancement involves a
preference for positive over negative self-views.

Why you need to do self-enhancement?

That is, the self-enhancement motive is believed to guide people toward situations in which
they believe they will excel or situations in which they can promote their positive qualities,
which will help them increase their self-esteem.

Caring

 Is central to all helping profession and enables people to create meaning in their lives.
 Means the people, relationships and things matter.

Other definitions of caring:

• Caring as a moral imperative
• Caring as an affect
• Caring as a human trait
• Caring as an interpersonal relationship
• Caring as a therapeutic intervention

Nursing Theories in caring

Culture Care Diversity and Universality (Leininger)

 Noted that caring, as nurturing behavior.
 Most critical factors in helping people maintain or regain health.
 Leininger, proposed that caring is the essence of nursing and the distinct, dominant,
central and unifying focus of nursing.
 Defines caring as assisting, supporting, or enabling another individual or group with
evident or anticipated needs to ameliorate, improve a human condition or lifeway, or to
face death.

Theory of Bureaucratic caring (Ray)

 Focuses on caring in organizations (e.g. hospitals) as cultures.

 Suggests that caring in nursing is contextual and is influenced by the organizational
structure.
 Rays meaning of caring is varied in departments.
Caring, the Human Mode of Being (Roach)

 Focuses on caring as a philosophical concept and proposes that caring is the human mode
of being, or the most common, authentic criterion of humanness.
 Roach visualizes caring as center to nursing
 Roach 6 C’s attributes of caring
1. compassion
2. competence
3. confidence
4. conscience
5. commitment
6. comportment

Nursing as Caring (Boykin & Schoenhofer)

 Emphasizes the importance of the nurse knowing self as a caring person.

 This awareness of self allows the nurse to authentically care for others in nursing practice.
 Caring in nursing is an altruistic, active expression of love and is the intentional and
embodied recognition of value and connectedness.

Theory of Human Care (Watson)

 Views caring as the essence and the moral ideal of nursing.

 Watson state that caring science encompasses a humanitarian, human science
orientation to human caring process, phenomena and experiences.
 Carative factors

Theory of caring (Swanson)

 Defines caring as a nurturing way of relating to a valued other, towards whom one feels
a personal sense of commitment and responsibility.
 Client’s well-being should be enhanced through the caring of the nurse who understands
the common human responses to a specific health problem.

The primary of caring (Benner & Wrubel)

 Caring emerged as the essence of excellence in nursing.

 Nursing is describe as a relationship in which caring is primary because it sets up the
possibility of giving and receiving help.