Recovering the Lost Art of Nursing


Recovering the Lost Art of Nursing



A cunning group of masterminds known as the “the evil-doers,” a notorious bunch consisting of the “thieves of time,” “organizational skulduggeries,” and the villainous “them” (aka the “fiscal restrainers”) are turning the nursing profession upside down! They are systematically stealing one of nursing’s most precious gifts to the world of health care—the art of professional caring. Absence of the art renders nurses technicians of care, efficiently moving from one task to another. Left in the wake of staff with little to no time for building therapeutic relationships, patient care becomes an item on a to-do list that receives a check mark at the end of shift.

Nurse managers, this chapter is your urgent call to action to muster your personal and professional leadership resources, on behalf of patients, and join together with staff to remove system barriers and recover the art of nursing. Warning: Apparently, “evil-doers” are specifically targeting therapeutic relationships, compassion, absence of “presence,” professionalism, and identity confusion. Time is of the essence!


In this chapter you will learn:

1.    The need for urgency behind the call to action

2.    The clues of a covert art theft presence

3.    Strategies for reclaiming the art of professional practice


Despite all the decades of circuitous discourse, mountains of scholarly articles, nursing theories, and educational preparation, the term art of nursing leaves many nurses struggling to describe its meaning within the context of their professional identity. Nursing practice is a symbiotic relationship between the art and science of professional care. One cannot exist in isolation from the other. Nurses are inclined to connect the art of nursing with terms such as compassion, caring attitudes, the therapeutic relationship, presence, professionalism, advocacy, and competence, otherwise known as the “soft or caring side of nursing.” The science seems more linked to the procedural, technical skills and competencies associated with the physical tasks of care. In today’s frequently chaotic and frenzied practice settings, nurses face challenges that force many of them to choose between these tasks or the relational aspects of care. Feeling overwhelmed and backed into a corner by time constraints and the physical demands of care, they make a judgment call, defaulting to Maslow’s hierarchy in attending to physical safety needs first, and fueling patients’ and families’ perceptions that “the nurses here are too busy to spend time with me” (also expressed as, “I don’t want to bother the nurses”). At the end of shift, staff members feel exhausted, guilty, disheartened, and inadequate. The “evil-doers” have scored another hit!


The greatest threat to the disappearance of the art of nursing lies with the perceived “big three”: (1) time, (2) fiscal restraint, and (3) failure of the system to support a full staff of nurses, so those employed are working at full capacity.


When you hear staff say, “We don’t have enough time” or “We don’t have enough staff” (despite being at full complement), and your desk is piled high with “inadequate staff” notices, be mindful of your response. While the tendency is to fix this problem with a knee-jerk response, step back for a moment and ask what is not being said. The comments and requests may be a call for help to deal with a significant practice issue larger than nurses believe they have the power to influence or control. Underlying this behavior is a deeper emotion left unexpressed: Fear. Their practice is threatened and they need a champion—and you’re it! Consider the following utterances, and what each implies:

    “The system is failing me. I can’t do what is required.”

    “I’m not meeting my standards.”

    “Why can’t my manager do something?”

    “I’m frustrated and angry and feel bad about my practice.”

    “The patients are suffering because my hands are tied.”

    “I could do so much more but time won’t allow it.”

    “Why did I become a nurse? All those years of education and expense and I can’t practice what I learned to do.”

    “The theories we learned can’t influence care delivery in a system like this.”

    “How long will it take for the system to figure out they are paying nurses a lot of money to do a lot less than their scope requires?”

    “I’m outta here!”

This is a red flag moment and cause for deep concern. When the art of professional nursing practice is MIA (missing in action), it is your job to draw attention to the fact and lead the recovery initiative. Action is not an option because you are accountable (according to the standards) for the overall quality of care and care delivery model. You have the evidence of research to support interventions to support nurses working to full scope.

A second red flag presents itself during budget season when senior leadership becomes preoccupied with the bottom line, requiring you to analyze care requirements, staffing mix, and hours of care. It is fair to say that at this time management is caught between a clinical rock and a hard place, with everyone scrambling to fight for every dollar and defend why their department, practice setting, or staff deserves to be saved from the chopping block. With the focus inclined toward viewing the costs of nursing staff as opposed to their value added in quality care outcomes, fiscal decision making defaults to cutbacks of nurses (expensive) rather than equating nursing excellence to organizational success. Few senior leaders have witnessed firsthand what nurses working to full scope actually do. Communities are now beginning to “see the light,” recognizing the health benefits to individuals and communities as a whole in having nurses work in independent and collaborative practice. Acute and long-term facilities appear to be slower off the mark.


    Without the art of nursing, nursing practice becomes a mechanistic series of tasks. The evidence of a scientific, humanistic, and compassionate approach to professional care can quickly evaporate, increasing the possibility of negative care outcomes and, in some cases, replacement of nurses with less-expensive personnel.

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Dec 16, 2017 | Posted by in NURSING | Comments Off on Recovering the Lost Art of Nursing
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