Nursing: Art vs Science
I was asked interesting questions, and my answers I thought would make an interesting article. It makes one take pause and look at why we become nurses. Is it the art--which means the physical and compassionate part of nursing, or the science which is the data and evidence based practice part of nursing. Can the 2 intertwine? Are they in direct opposition to each other? What is the definition of nursing as an art and a science? How would you explain them? Give some examples--do you practice artfully, scientifically or a nice blend of both? Which is more important? Is their one more important than the other?
If I were to explain the difference between the art and science of nursing, I would say that it is having a patient trust that you are going to take all of the aspects of their process seriously. That you are compassionate, fulfill their emotional needs and wishes, and explain their plan of care in a way that they are going to understand. It is about being responsive, putting one's self in the background and focus solely on how you are going to put a plan of care into action. That if you don't know, you know who to ask or where to find the answer. The expectation is that as a nurse, I wouldn't tell them anything that I did not know, that was not true, or substandard. The art of nursing is the qualities that you set for your patient that you enact, it is your nursing character, your nursing reputation. People come to us from every walk of life. You could have 1 patient who is a VIP, and one who is dying of AIDS(<---been there done that). A true art is balancing the two.
The science of nursing is the number sand the results. What is wrong with your patient? Why are they ]here? What information do you have to support your plan of care? What are subtle changes in condition that are important? When do you need to respond with help, an extra set of eyes, when does the doctor need to come? Can you anticipate needs based on the numbers and the results? Evidence based practice.
I have been a nurse for a long time. I have seen hospice patients who were life long friends die under my watch. My friend's parents, my parent's friends. A jokester or two that would be laughingall the way to the light. I find that I am drawn to and have a giftfor what some could consider "undesirables". The mentally ill, the addicts, the alcoholics. Patients who are actively dying. The HIV/Hep C patients. I have held hand, listened to secrets and dreams and always say I hold them in my heart and in my head. I have shed a tear or two. But how I can sleep at night is knowing that patients know I have their backs. That their plan of care I think over carefully, and explain mindfully. It is the knowledge that I have my patient's trust. They may not like it, but they know that I am working for them, not the other way around. I am a nurse because it is my calling. And that mindset is what makes me a strong advocate for the art of nursing.
The science of nursing is a bit more of data based observations. I always say I have a bunch of "useless information" in my head. Such is the life of a small town nurse in a tiny hospital. I know that Mrs. So and So can't breathe, it is Passover and she had brisket. We need to get a BNP. That Mr. So and So has been traveling and hasn't had his lasix probably, as it is far too much work to have to urinate that much. That Mrs. X needs VNA to do her pills,as she is taking FAR too much coumadin. But with all that being said, I am learned in making a general impression based on the results of lab work, x-rays. I have honed my craft so that I have learned how to start that hard stick,how to put in a crudet catheter, and how to get that NG tube in. I know what requires and immediate call to the doctor. I know my medications, and what each one does, what it can do, and to make sure I explain all of it correctly. It is putting the objective information with the subjective to make a plan.
Which is more important is a difficult question to answer, as one is nothing without the other. A well rounded nurse is one who can weigh both equally. Often, you need the art to even get to the science. We have a very unique patient population, we see a number of the same patient soften. Critical thinking on your feet is a must, and that is both art and science. Science is not worth the paper it is printed on if your patient doesn't trust in your instincts, your actions or your words which is an art. But you need the science to back it up to obtain the patient goal you are seeking.Last edit by Joe V on Apr 29, '13
Apr 27, '13Something that is a combination of art and science is sometimes called a craft. Nursing fits this idea, but is hardly unique. From nursing to medicine to photography to counterintelligence, there are many fields and disciplines that are both an art and a science.
Some might argue that different nursing specialties have more art or more science. I definitely see some specialties like their Jean Watson bell-ringing while others have no use for such things.Apr 27, '13My managers have had a similar discussion with me. I guess they'd say that I'm good at the science...need to work on the art. Thanks for the article. That's good deductive thinking, by the way - those examples of figuring out the link between a Pt's life and their symptoms. I'm not sure of the correct way to say this without offending anyone, but it sounds as though you're thinking like an MD (I mean that as a compliment!)Apr 27, '13This has been a recurring theme for me lately. I just went to a STEM symposium where by happenstance the opening speaker, the closing speaker, and every one of my breakout sessions revolved around the marriage of art and science.
Traditional thinking has art as interpretation, and science as facts, but the truth is that science is an act of art interpreting reality, and art is an interpretation of science. Dance is physics for example.
I am glad to see your article putting it into a nursing perspective.Apr 29, '13I was reaidng an old thread and found this lengthy comment quite relevant...
Quote from nursemikeOK, so in another life, I was a physics major, so I have to quibble, but not only for the sake of quibbling. In the seventeenth century, before there was a theory of gravity, Galileo demonstrated that objects do not fall to the ground with a speed proportional to their mass. A bowling ball and a baseball fall at the same rate. So does a feather, in the absence of air resistance. That's picky, I know, but it does tend to reinforce the argument that people often dismiss theories without full understanding them. (I don't fully understand Watson, either, but I am impressed at how much her theory of caring, stripped of jargon, is good, common sense.)
So, I've had an interest in science as long as I can remember, and I did, briefly, major in physics, until it proved incompatible with my minors in girls and beer. At around that time, I was forced to take some psych courses, and in those days behaviorism was all the rage. I HATED behaviorism, which I felt was adequate for training mice to run mazes, but had prescious little to do with people. I've never disputed that operant conditioning can work, but the mere title of Skinner's Beyond Freedom and Dignity damns the whole movement. To me--and I'm right about this--there is nothing beyond freedom and dignity. Without them, my cats' lives wouldn't be worth living, and they understand that, even if Skinner couldn't.
Still, behaviorism was the rage, and I know why. Psychologists had an inferiority complex. Physical sciences dealt in objective, quantifiable data and repeatable experiments. Psych dealt in feelings and wanting to have sex with your mother and other unscientific stuff. So, behaviorism to the rescue: a theory of psychology that is repeatable and quantifiable, and if perhaps not entirely objective, at least dispassionate. Hurray!!!
Except, of course, that psych was still 50 years behind the times, because the physics of the 20th century has taught us that that which is quantifiable, repeatable, and objective is merely an approximation of reality, workable for such everyday tasks as putting a man on the moon, but inadequate to fully explain how he got there. Not long after mathematicians proved that a logical statement can be both true and false, physicists found particles that behaved in just that manner. To over-simplify quantum electrodynamics, all of reality is invisible electromagnetic fields. And while theories have supplanted QED, they haven't made reality more concrete. The distinctions between actual concrete and a vaccuum just get more and more vague.
So, here we are in nursing, some arguing evidence-based practice and you have to treat what you can measure, when the most fundamental of sciences tells us what can be seen and measured is just the tip of the iceberg, and others saying, no, no, no, you have to treat the soul as well as the body (and often trying to show measurable, objective data to support their position.)
I tend to get fidgety when people start talking about the profession of nursing. I was a carpenter for most of my working life, and I never saw anything wrong with a good, honest trade. But carpentry was not just a trade, it was (and still can be) a craft, because wood isn't entirely dead. It isn't steel, it isn't plastic, it moves, it breathes, it retains an element of the chaos that the tree had when it was a living being. And I really like the idea that nursing is both an art and a science--a craft, if you will--because we do need evidence-based practice, but we aren't diesel mechanics. Our medium moves and breathes and poops and cries and has fears and dreams and freedom and dignity, and when we are able to synthesize all of these conflicting values, it's not merely a profession: it's magic. It's nursecraft.Apr 29, '13Great example summit.
I've realized that what we do is NOT "just a job" it is a craft. I think if all the critical thinking skills I have used, especially in places where there was really no supplies, but found ways to fulfill my patient's interventions. Very crafty indeed...May 1, '13thats exactly how I feel from the "undesirables" to having their back....i hate nights like last night but man I take pride in being a nurse. I absolutely still love it 11 years later!May 18, '13Quote from hopefulwhoopYou need to leave the profession immediately.Nursing is neither an art nor a science. It's just a job.
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