The Art of Nursing Becomes a Celebration of Nurses

Tracey Motter, DNP, MSN, RN; David Hassler, MFA; Mary K. Anthony, PhD, RN

Disclosures

Online J Issues Nurs. 2021;26(2) 

In This Article

The Art and Science of Nursing

Throughout history, leaders in the profession of nursing have grappled with the separation, integration, and synergy of the art and science of the discipline. Writings of nurse scholars such as Peplau (1988) explain the beauty of both the art and the science to provide a holistic lens to describe the complexity of nursing care. Carper's (1978) description of the values and beliefs for professional practice expanded our understanding of empirical and aesthetic ways of knowing. Empirical knowing allows scientific evidence to guide practice, while the aesthetic way of knowing embraces the art of nursing.

Science, as a way of knowing, serves as a basis to advance nursing practice necessary to continue the service of human health needs (Grace & Zumstein-Shaha, 2019). This perspective is encompassed in the four nursing metaparadigm concepts of health, person, environment, and nurse. Empirical knowledge informs professional practice not only from the common understanding of scientific systematic assessments and observations, but also the subjective experiences of persons and the meaning they attach to these events (Carper, 1978).

Collectively, nursing science informs the evidence base necessary for the practice arm of the profession and is vital to improve healthcare and patient outcomes (Titler, 2011). Evidence-based practice includes evidence from scientific studies, as well as patient preferences and nurse expertise. It is nurse expertise that may often be unobserved and only known through a deeper understanding of the art of nursing.

The art of nursing, in its earliest history, was rooted in vocational norms related to motherhood and homemaking (Peplau, 1988; White, 2002). Evolving over time, the art of nursing has been defined as the nurse's ability to be compassionate, caring, and communicative (Palos, 2014). These behaviors enable nurses to interpersonally connect with patients, a skill which is critical to quality patient-centered care and deeply valued by patients and families. Holistic care by nurses explores a patient's illness or cause for seeking healthcare. It offers to nurses a framework to learn about patients' physical, mental, and psychosocial needs to optimize care for them and their families.

Nurses are the most present of healthcare professionals and thus best able to read the emotional cues of patients and establish human connections and relationships. Intrinsic to the art of nursing, compassion aligns with nurses' highest professional ideals. Compassion is an emotional response to reduce another's pain or suffering (Goetz, Dacher, & Simon-Thomas, 2010). It involves taking action, and is distinguished from empathy, a necessary precursor of compassion defined as feeling and understanding one's suffering (Trzeciak & Mazzarelli, 2019). Compassion elevates care through actions, voice, and touch, motivating other forms of relational connectedness demonstrated through caring practices and communication (Goetz et al., 2010). When relational connectedness is established, individualized opportunities for tailored, patient-centered care exist, giving nurses needed insight to know and do things differently. The value of this work is in the resulting physical actions and intellectual and emotionally invested decisions at the core of nurses' work. Sadly, these often remain invisible.

Caring is a multi-dimensional concept interpreted within one's experiences. Watson (1979) summarized the work of caring as holding humanistic values of trust, developing relationships, maintaining hope, and recognizing the importance of spiritual, physical, and mental support. She also associated the work of caring with systematic creative problem solving and teaching patients to improve their quality of life. The unique role of nurses to be present around the clock, both physically and mentally, provides the opportunity to engage in meaningful patient relationships that demonstrate caring.

Communication, as an art form, encompasses both verbal and non-verbal interaction and active listening. Nurses use both instrumental and affective communication skills to provide optimal care to patients. Instrumental communication fulfills the patient need to gain knowledge about diagnosis, treatments, and the healthcare journey. Affective communication, sometimes considered a soft skill, is the ability of nurses to provide an empathetic, compassionate, and caring approach toward patients and families (Van Vliet & Epstein, 2014). Clear, concise, and relational communication is essential to quality, safe nursing practice and patient-centered care. When the art and science aspects of nursing practice become synergistic, they shape a holistic and powerful approach to improve patient and family care.

Nurses use the science of knowing and art of nursing in their daily practice across a breadth of situations. For example, nurses learn the best approach to provide comfort for patients and families, especially for those who struggle to cope with a diagnosis and experience frustration and anger. Nurses advocate for patients and families using compassionate and empathetic communication to help them understand and navigate the healthcare environment and health outcomes. Nurses bring calm to an often chaotic experience by being present with patients.

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