Why The Art of Nursing is in Decline
The Art of Nursing is in Decline.

There I said it. And how do I know this? What does this mean for the profession of nursing?

Nurses Speak Up

A couple of years ago, I set out on a mission to talk to nurses and understand some of their biggest challenges. While there were many, I discovered several common themes. One of them related to the art of nursing practice.

As healthcare moved more and more into the future and technological advancements are a daily occurrence, nurses shared with me that they felt a disconnect between them and the patients they set out to take care of. The science of nursing advanced full speed ahead, while the art of nursing seemed left behind.

Electronic charting requires that nurses are on computers and mobile devices all day long. Advanced alarms and communication systems add bells, whistles, and beeps to nursing’s workflow. As we continue to seek quality care improvements that will make things safer and faster for patients, the science of nursing speeds right along.

Where Did the Art Go?

But what about the art? What I heard from a large amount of the nurses I spoke to was that the art of nursing is in decline.

There is less time to connect with the patient. To teach them about their illness or medications. The nurse feels rushed and as though he or she never has a chance to sit down. Patient teaching becomes hurried. Holistic care gets lost. Nurses told me that they felt helpless as they need to do more with less.

Art of Nursing Defined

While some nurses may already have an idea of what the art of nursing is, it would be unfair to assume that everyone understands this concept.

The science of nursing is the skills. It is what we are required to study, know, and do as a nurse. Science could mean that you are able to correctly calculate a medication dosage. Or it is that you are following a procedural policy in an operating room. The science of nursing is safely practicing in your role as a nurse.

OK, so what is the art? 

The art of nursing is the human connection with the person. It is providing holistic care across the continuum. The art requires the nurse to be present, fully engaged with the patient in front of them. It is the subtle knowing, the nursing instinct, or the trusting of one’s own nursing judgement based on experience. When a nurse is able to build rapport and truly connect with the patient on a deeper level, this is the art of caring.

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Reasons above related to science and technology are the first reasons I found in my conversations with nurses several years ago. And there are more.

Nurse-to-patient ratios. Safe staffing. Having the people in the jobs to do the work. This is a great issue for nurses across the country.

When a nurse is asked to do more with less and feels hurried by his or her job itself, how can the nurse connect with the patient? How can the nurse be fully present with the person in front of them? How is that rapport ever established?

Art and Science in Nursing Combined

The point of this post is not to bash the science of nursing. Gosh, the science is a must-have. It is necessary to base practice on evidence. To follow clinical practice guidelines to provide safe care. To study hard, learn more, advance our knowledge, and embrace life-long learning. Science rocks, readers!

What we need is a balanced blend of art and science together? We need strategies that can help the nursing profession continue to advance the science while keeping the art of nursing in mind.

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Why The Art of Nursing is in Decline1) Teach Mindfulness Practices

Just breathe. Really. One way to blend the art with the science of nursing is to use a tool that you have at your disposal. All day long. Any day of the week. Every day of the year.

Your breath.

When I started The Art of Nursing program in 2014, the entire line up of guest interviews was all about how to bring the art into nursing practice. I interviewed each guest in a different way, but all 12 interviews gave one technique for allowing the art of nursing into a very scientific world.

As a nurse, what do you do several times (hundreds of times) a day? That is right! Wash your hands. Instead of standing at the sink, thinking about where you are headed off to next, breathe. Feel your feet to the floor. Take one breath in through the nose. Pause at the top of the breath. And then slowly exhale it out through the nose.

You can do this while washing your hands, when gathering your medications, while waiting for the person you are calling to pick up the phone, or even as you chart. There are so many opportunities to breathe. Pick one and invite more art into your work day.

2) Role Model and Buddy Up

As a nurse leader who wants to see this behavior in the nurses he or she employs, you yourself must value the art of nursing practice. And when this is a value of yours, you can weave it into your work day. This will show your nursing staff that this is important to you.

Here is a great example. Maybe you lead a weekly staff meeting. Instead of jumping right into the extremely full agenda, pause. Lead your nursing staff in a group breath. You do not have to sit there with hands in some pose for 5 full minutes of silence. No, one breath. Two breaths. Three, that is all that you need.

Another suggestion is to encourage each other. Find a nurse on your unit who is already championing the art of nursing. Trust me, there is at least one. Sit down and talk to them. Ask them how they do it, why they do it, and what benefit it brings to their scientific practice of nursing.

Have this nurse talk to other nurses. Allow him or her to buddy up with other nurses who are excited about the art of nursing. Make sure the champion speaks to the benefits and how it impacts their practice. If a nurse sees another nurse doing something that makes the work more enjoyable, you and I both know that others will want to jump on board.

3) Take Responsibility, Action, and Work Together

There is a delicate balance between individual and organization. Sure, the individual nurse is responsible for their own resilience. And the organization must provide a supportive environment to allow the art of nursing to grow and thrive.

As an individual, take a look at yourself. Do you whine? Complain? Vent? Have you gone into your manager or supervisor’s office, dumping the problems of the day? Guess what! Nursing leadership does not like this. In fact, it keeps them up at night!

An individual nurse can certainly assess and point out the problems on hand. And then do something really radical. Become part of the solution! Go into your boss’s office with data, a solution, or an innovative idea. And be persistent. Maybe the first time you hear, “We don’t have the budget for that activity.” Keep trying. “No” just means find another way.

Organizations, if you have nurses like this who are coming to you with solutions for making the work a better place, you need to partner with the nurse to start the action. Organizations need to value their employees and allow the nurse to practice the art of this profession- or they will be likely to lose some very good people!

Either way, strategies are needed. Individual nurses must do what they can to invite the art of nursing practice, while nurse leaders and organizations who employ them need to partner to make nursing workplaces fun, healthy, and balanced in art and science of nursing.

Let’s hear from you! What do you think about the art of nursing? Have you ever thought that it was in decline? What did you do to balance or blend the art with nursing science? Leave a comment and thank you for reading.

Elizabeth Scala, MSN/MBA, RNAbout the Author: Keynote speaker and virtual conference host, Elizabeth Scala MSN/MBA, RN, partners with hospitals, nursing schools, and nurse associations to transform the field of nursing from the inside out. As the bestselling author of ‘Nursing from Within’, Elizabeth guides nurses and nursing students to a change in perspective, helping them make the inner shift needed to better maneuver the sometimes challenging realities of being a caregiver. Elizabeth received her dual master’s degree from Johns Hopkins University. She is also a certified coach and Reiki Master Teacher. Elizabeth lives in Maryland with her supportive husband and playful pit bull.