Nursing Philosophy: The Art of Science
Amy Lichtfuss
Rush University College of Nursing
Nursing Philosophy: The Art of Science
Nursing is the art of science. While medicine is based on science and scientific concepts and nursing interventions are guided by evidence-based practice and best practice techniques, nursing itself requires creativity, intuition, critical thinking, and the application of science in an artful way. Turning science into art is how nurses provide high quality care and better patient outcomes. The theorist Jean Watson’s definition of nursing is, a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human transactions (Watson, 2012). Applying scientific concepts in a personalized, unique manner that is also creative, intuitive, flexible, empathetic, and compassionate is what makes nursing the art of science.
This philosophy is evident in a
hypothetical situation in how two different nurses care for a patient. A middle-aged man was recently admitted to
the orthopedic floor at a major hospital after undergoing an extremely invasive
and body altering surgery to remove a pelvic tumor, a hemipelvectomy. Five days post operatively the patient is
alert and oriented, although he does not talk much or smile at all, has not
been eating well, has no interest in watching TV, reading, or listening to
music, and refuses visitors. The first
nurse assigned to this man does a great job of implementing the science of nursing. She properly cares for the surgical incision,
repositions him every 2 hours, gives his pain medication on time, provides nourishments,
and teaches him strengthening exercises to do in bed. But the patient has put little effort into
his recovery, his condition is deteriorating, and he feels hopeless. The second nurse takes a different
approach. She physically cares for the man just as the first nurse did, but at one point she reaches out to him on a
personal level with one hand on his shoulder and asks, “How are you feeling about this?” The man starts crying, shares all of his fears and sorrows, and begins to perk up. Through more interactions like this, the nurse got to know the patient as a person, understood his greatest fears, learned his goals, anticipated his needs, and they began to build a mutual trust and respect. They set mutual goals and developed a personalized care plan, the patient
interacted with staff, his appetite improved, he went to PT, and he began to feel hopeful. This second nurse
clearly provided a higher quality of care to the patient by turning science into art.
Throughout my life experiences, the influence of my
family, and nursing school I have learned to value knowledge, therapeutic relationships, integrity, and most importantly caring. I believe
these values are fundamental in nursing and involve both science and art. Knowing how science affects the body and how
treatment affects disease impacts nursing interventions. Nursing interventions can then be implemented
in a straightforward, objective manner, or artfully through therapeutic relationships, personalized care plans, and compassion.
Barbara Carper’s Four Patterns of Knowing In Nursing
encompass all aspects of art and science.
Empirical ways of knowing involve the science of nursing. It is objective, quantifiable, verifiable
observations that formulate the laws and theories upon which nurses and doctors
practice. Esthetic knowing is the art of
nursing. It is subjective, experimental,
and descriptive; it involves sensing, perceiving, and intuition, etc. Personal knowing involves relating to the
patient through personal experiences; it is reflecting, empathizing, acknowledging
spirit/religion, etc. The fourth and
final approach is the ethical way of knowing.
It involves what is right and what is wrong, advocating for patients,
and assisting in conflict when there are difficult moral decisions to make (Arnold
& Boggs, 2011, McEwen & Wills, 2011).
An artful nurse will implement all four ways of knowing while caring for
a patient.
Jean Watson says, “the practice of caring is central to
nursing,” and she says caring is more “ healthogenic” than curing (2012). I support the author Susan Gordon’s viewpoint
in the book, “Life Support,” that doctors cure and nurses care. One of the most
effective ways a nurse can begin caring is through a therapeutic
relationship. Establishing a trustful,
respectful, mutual, patient-centered relationship while fostering autonomy and independence
is an art in itself. In general,
patients are often in uncomfortable, sometimes uncertain, painful situations
that can make building effective relationships a challenge. A nurse who really cares will be able to create
a therapeutic relationship and get to know the patient despite these
circumstances, just like the second nurse did in the hypothetical situation
above. In addition, not every patient
will react the same way to treatment and not every patient manifests disease as
expected. The nurse who understands the
disease and really knows the patient will be able to customize interventions to
improve the quality of care.
And finally, a home health nurse, Ellen Kitchen,
referenced in the book, “Life Support”, is the epitome of a nurse who follows
this philosophy. One of her patients
that she had known for many years, Mac, required diuretics for heart problems
that he was scheduled to take every morning.
Ellen also encouraged Mac to take daily walks for energy and strength
and to promote mental health. She soon
found out that he was not getting out and taking walks because the diuretics caused
urinary frequency and he was afraid to have an accident outside. Ellen worked with the patient to adjust his
medicine schedule so he could still take walks and not be affected by the side
effects of his medications. Ellen put
the art into science. She genuinely
cared for Mac and their solid nurse-patient relationship allowed her to
personalize her interventions, which greatly impacted Mac’s quality of life.
I plan to use this philosophy to guide my
nursing career. My education in science
and classes in therapeutic relationships will be the foundation for the care I
give to patients. I will practice caring
versus curing, I will implement the four ways of knowing, and I will remember
the second nurse in the hypothetical situation and Ellen Kitchen and use these experiences to guide my practice.
References
Arnold, E. C.,
& Boggs, K. U. (2011). Interpersonal relationships, professional
communication
skills for nurses. (Sixth ed.). United States of America: W B
Saunders Co.
McEwen, M., &
Wills, E. M. (2011). Theoretical basis for nursing. (3 ed.).
Philadelphia, PA:
Lippincott Williams & Wilkins.
Watson,
J. (2012). Caring science ten caritas processes. Retrieved from
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