Have we lost the "art" of nursing?

[Barbara Hunter]

As a member of the "aging baby boomer" generation, I have often wondered where has the "art of nursing gone"? There is little doubt that medical science is an integral part of nursing. However, it is often difficult to see if the "art of nursing" is practiced. In fact, I find myself asking if this unique art has been lost. Is it being taught to nursing students in the 21st century, or is it simply a lost art? What is the art of nursing, you may ask? Simply put, in many ways, the art of nursing has to do with the logical and common sense approach to nursing.

In other words, doing the little things that brings relief to a patient without having to get a doctor's order. For instance, back in the day, when I was in nurses' training, we gave patients back rubs at night before they went to sleep, or fluffed up their pillow and turned it over to help them get settled down for the night; even sometimes washing the pt's feet (if time allowed). You know, the little things that provided comfort, and often appreciated by a patient. I know you are probably thinking "wash feet, back rubs, who has time to do those extra things?" By the time you finish doing meds and treatments there is no time for the little things. Believe me, I can relate! But again I pose the question, has the "art of nursing" been lost?

[anotherone, BSN, RN]

[quote=Esme12;7486307

In the last 10 years it seem the bedside nurse has become an undesirable place to be and those who really like it are viewed as....unambitious and having no goals. I remember on an interview I was on a few years ago.....I was asked what were my long term goals were.....I replied that I wanted to stay as close to the bedside as possible where I love being......that I wanted to advocate for my patients and ensure they had the best care possible.

I was asked why I lacked any ambition to further my career with an advanced degree ....as if being a bedside nurse was unacceptable and beneath the profession itself. That made me sad. Bedside nurses are looked down upon these days when they are the backbone of everything we do.....as if being the best bedside nurse I can was being somehow....lazy. I am proiud that I care well for my patients...that I can make them comfortable in clean neat linen....to give them some comfort that someone in the room of strangers is in thier corner and has their back.....that someone cares.

I didn't become a nurse to become something else......I don't feel being a bedside nurse is degrading or anything to be ashamed of.....yet I hear so many these days who walk away from graduation talking about how they are going to get out of the bedside.....however it is the bedside nurse who will be caring for you one day when you need it most.

I think we are educating ourselves out of the bedside as if it is some sleazy place to be....and I find that sad.

Very well said. I hear this all the time. It is one thing to be seen as unambitious and lazy by outsiders for being a bed side nurse and having no desire to be an np, crna etc.... but it pretty annoying when it comes from other nurses like educators, managers, supervisors etc.

[StudentOfHealing]

But in the old days we did hourly rounds. It was expected....and done. I was a new grad 11-7 on a surgical floor of 30 patients. It was a LPN, an Aide, and I. This was in the day that "simple" surgeries of today returned from the OR with foley's, NGT, drains and multiple JP's and T-Tubes. Chest tubes were 3 bottles on the floor and the Gomco suction machine was brought in for the extra suction.

We still managed to fluff and tuck each and every patient...tidy the room, give back rubs, and empty trash for early rounds by the nuns. We shaved patients, we brushed their teeth. Even when I went to ICU 6 months into my career it was the little things that were emphasized.

I think we have lost some of that....it did get lost with corporate America. With the fixation on higher and higher degrees and the world using bedside nursing to the real paying jobs of CRNA or NP so they can have their "autonomy" ........it seems those who believe it is a calling are a rare commodity. When I went into nursing it wasn't about the money for we were barely paid over minimum wage..... it was a love for what we do.

In the last 10 years it seem the bedside nurse has become an undesirable place to be and those who really like it are viewed as....unambitious and having no goals. I remember on an interview I was on a few years ago.....I was asked what were my long term goals were.....I replied that I wanted to stay as close to the bedside as possible where I love being......that I wanted to advocate for my patients and ensure they had the best care possible.

I was asked why I lacked any ambition to further my career with an advanced degree ....as if being a bedside nurse was unacceptable and beneath the profession itself. That made me sad. Bedside nurses are looked down upon these days when they are the backbone of everything we do.....as if being the best bedside nurse I can was being somehow....lazy. I am proiud that I care well for my patients...that I can make them comfortable in clean neat linen....to give them some comfort that someone in the room of strangers is in thier corner and has their back.....that someone cares.

I didn't become a nurse to become something else......I don't feel being a bedside nurse is degrading or anything to be ashamed of.....yet I hear so many these days who walk away from graduation talking about how they are going to get out of the bedside.....however it is the bedside nurse who will be caring for you one day when you need it most.

I think we are educating ourselves out of the bedside as if it is some sleazy place to be....and I find that sad.

There's this fellow classmate of mine, I perceive that he genuinely looks down on nurses/nursing. He one day expressed his awe for physicians, stating "It must be awesome to be a doctor, all the honor and respect. No one respects nurses"

As we made our way to our clinical. Same classmate one day was talking about our professors, one in particular.

He said, "Man, Professor Madeupaname knows her stuff".

I replied, "yeah she sure does! She's been a nurse for 30+ years"

He said, "Yeah but she's more than a nurse, you know?"

I was a bit taken aback by his response, I said "No, she IS a nurse. She's A nurse. She's a nurse!"

On another occasion we were all discussing our future plans and he shared how we should all advance our degrees, which I AGREE with.

I responded to his suggestion by telling him that "I want to stay in bedside for a while, and learn, you know? soak it up!"

He said, "But you want to be more than (here it comes) ... JUSTa nurse, right?"

Gosh, I want to pull my hair out around this person.

[wannabecnl]

One of the reasons I love the PACU is that I get to focus a lot of attention on my patients, albeit for a short time. I find it is the little things--and being proactive about them, because post-op pts don't always know what to ask for--that make a huge difference. An extra pillow, offering to reposition them, and the good ol' ice chips and warm blankets go a long way. We had a patient with severe foot cramps who was staying with us for other issues; our LNA rubbed his foot and leg for a good 30 minutes while we attended to his other needs, and the patient was so appreciative and more relaxed because of it. These are things that patients start to ask for (or their families do) when they are on the floor, but I have the luxury of anticipating their needs and addressing them promptly because I usually have no one else to take care of (or one more patient in the next bay).

Before I worked in the PACU, I had a very short stint in a cardiac step-down telemetry unit. During orientation, I had a day when I was able to provide this level of care and attention, when I connected with both of my patients and really felt like I helped them. This was the day I got reamed out for spending too much time in the room and not enough doing my documentation. That was two days before I quit. (A week prior, I was laughed at for giving a back rub to a patient with chronic neuropathic back pain whose huge doses of narcs weren't working at all) This is not to say that nurses cannot provide that "art of nursing" touch on a floor--I know a lot of the nurses on our regular floors to whom I am THRILLED to bring my patients after their stint with me, because they have mastered that balance between technique, skill, time, and caring. I just don't know if I could do it as well or at all if I were not in the PACU.

[vintage_RN, BSN, RN]

There is a girl in my class that makes it known constantly that she wants to become a physician, and that nursing is beneath her (why she is in a practical nursing program is beyond me). When we observed a surgery in the OR she said "Oh, I didn't even watch the nurses...I was interested in the surgeon and residents, because I want to be a doctor. I don't really care what the nurses do."...and when it comes to basic patient care - like washing, re positioning, dressing etc. she turns her nose up saying "I can't wait til I'm a physician and I don't have to do this stuff"....I looked at her point blank and said "Then why are you here?"

I'm all for advanced education, but the reason I went into nursing is to be there for people and provide them comfort. Nothing is beneath me, I'm glad to help people in their greatest time of need.

[Meeh619]

We had our first day of nursing school yesterday & I was surprised when they said we were watching a movie, I thought really a movie!! Well I guess this fundamentals teacher starts all first time nursing students with a Florence Nightingale movie to show what passion & art of nursing should be. I thought it was awesome for her to do that!!

[XcrMat]

Nurses are no longer trained, they're educated. I think with advancing education and higher involvement in research, nurses are and should be more of decision makers and thinkers. In other words, more science and less touchy feely stuff...

[applewhitern, BSN, RN]

I was thinking the same thing~ I wasn't "trained," but rather educated! "Trained" sounds like something you do to a dog or monkey.

[ricksy]

Too many laws and Cover YOUR A$$.

[starlisa14]

Art in itself without looking at any dictionary says to me, be creative within yourself to make something happen. We live by standards in the nursing field, but as human beings we live by our hearts -PERIOD. All I have to say is at 37, 2nd degree, 3 years in: I live by my heart. There is no nursing standard to respond to a resident that feels lonely (and if there is oh well just proves my point that art comes from the heart and not a piece of paper because I haven't read that standard), so I get on my knees to face them in their lowest bed position and I talk to them or sing to them; I hold their hand and gently squeeze; I rub my fingers through their hair and tell them I love them because I truely do; and all the while I'm checking change in responsiveness, body temp, position of equipment -tubes, foleys, pullups, etc. Then, because I am in a place to 'make things happen' I can write an order, or sit a little longer because frankly it will not kill those after this resident to receive their meds a little later and when I get to them I will do the same or whatever your needs call for I'll react. The art of nursing is created individually between the nurse and patient and I'm so very blessed to be an artist.

[NickiLaughs, ADN, BSN, RN]

You mean like my sickle cell patient last night who waited 14 hours with her husband to be seen, and when I finally got her in a gurney at 5 AM and was post medicated for pain and could actually relax, I switched her room to another where there'd be enough room for a second gurney for her equally exhausted husband.

We don't really get a lot of time to usually go the extra mile for patients but if I ever get a chance, hell yeah I do it. :)

Although I haven't had time to give a foot massage since ICU nursing, I try to do the little "5 second or 2 minute things" when I have time, especially if a patient asks.

I was thinking the same thing~ I wasn't "trained," but rather educated! "Trained" sounds like something you do to a dog or monkey.

Interesting... most of the physicians, younger and older, with whom I converse regularly refer to their 'training' when they're speaking of their residencies. They do this with me and among themselves.

[That Guy, BSN, RN, EMT-B]

Interesting... most of the physicians younger and older, with whom I converse regularly refer to their 'training' when they're speaking of their residencies. They do this with me and among themselves.[/quote']

But this is why we are different than doctors and nursing is different than medicine

I personally dont care which we are called, it is all semantics to me.