Is Nursing really an Art and a Science

GracefulRN · May 20, 2004

Snake,

I didn't attack you personally, so I will assume that that ad hominum remark was not directed at me. I like a lively debate myself, so I'll throw my hat into the ring again. I must point out, however, that by insulting the intelligence of other people you are "responding in kind". That being said, after reading you other posts I no longer find you comments disturbing and I look forward to your future response.

1. science, scientific discipline -- (a particular branch of scientific knowledge; "the science of genetics") discipline, subject, subject area, subject field, field of study, study, branch of knowledge - (a branch of knowledge; "in what discipline is his doctorate?"; "anthropology is the study of human beings")

2. skill, science -- (ability to produce solutions in some problem domain)

=> ability, power -- (possession of the qualities (especially mental qualities) required to do something or get something done; "danger heightened his powers of discrimination")

In my estimation nursing meets both of these criterions. Nursing is a branch of specific knowledge as much as genetics or physics is. Nursing requires advanced knowledge/skill in many areas. Your comment that we can know things is puzzling, because if you concede that nursing is an acquired skill using specific knowledge, how can you say that nursing is not a science.

Science: Now a baseball catcher, for example, has to know his team mates' strengths and weaknesses, know all the batters he is up against, essentially running the game while being a major participant. This does not make him, or the manager, or the team owner a scientist.

This sounds a bit like the straw man argument you accused me of making. DEF: A fallacious argument that states that one argument's conclusion to be wrong because of flaws in another argument. e.g. Present a misrepresentation of your opponent's position, refute it, and pretend that you have refuted your opponent's actual position.

Thanks for the education by the way; I had to look up what that meant. You cannot compare apples to oranges snake, come now, be reasonable.

The knowledge the baseball player has is based on his experience with/knowledge of the people that he is interacting with. That type of knowledge is different from the knowledge that a nurse applies, which is firmly grounded in science.

A scientist objectively formulates and tests a hypothesis, observes and reports results, and those results must be reproducible using similar method. We use someone's scientific results, but we do not in the clinical setting use the scientific method

.

I think you are wrong. What is the clinician doing when they takes the history of a patient and draw certain conclusions if they are not "forming an hypothesis"? If the test performed on the pt. are not "testing the hypothesis" what are they for? And finally what are the established treatment protocols for patients if they are not "reproductions" of past "experimental" treatments.

Any action or interpretation a nurse takes must be backed up by a doc to whom the nurse reports, who is backed up by standards of care, which are backed up by higher ups and so on. That is not creative scientific practice.
It is technical skill. The scientist is the person who developed the test, procedure, intervention or whatever. Using a device developed by someone else does not make me a scientist, for if it did, reading a speedometer would grant us all that title.

It seems to me that you are neglecting the fact that scientists are "trained" to do science. The principles and practices performed in the lab are usually from protocols derived from other people. By your definition the only people who are performing science are the ones creating a new procedure, which is completely inaccurate. Science builds on itself and discoveries and breakthroughs are a result of the scientists "critical thinking" (hmmm.....that phrase sounds familiar) not his methodology.

Art: I think I adequately addressed that in my post. Caring is not an art. It is a verb, an action, an affect. It is something that must be communicated to have an impact. If we agree, however, that the quality of caring is an art, and that nursing is by definition an art and science, then those few in the ranks who truly don't care, and simply do a job are excluded from being a nurse regardless of how well they perform. Also I am yet to know of a true scientist or artist who punched a clock, or was told how to arrive at his own conclusions, or which color of paint to use, except in the WPA days.

I think the main problem here is that our definition of art is different. And by the way, art is a noun.

1.art, fine art -- (the products of human creativity; works of art collectively; "an art exhibition"; "a fine collection of art")

2.art, artistic creation, artistic production -- (the creation of beautiful or significant things)

3.art, artistry, prowess -- (a superior skill that you can learn by study and practice and observation; "the art of conversation"; "it's quite an art")

Clearly I am using definition 3 while I you are using 1 or 2. Art can be a skill in much the same way that science is a skill and that is why medicine/nursing defines their practice as both. Please explain why you say that nurses are told how to arrive at their own conclusions? They are given tools (like scientists and artists) and as far as I know they are free to come to their own conclusions.

Psychology and Psychiatry:A disease is defined and continues to be defined as an identifiable lesion or infective process which is troubling and/or threatening to the victim. We have yet to define anything anywhere which accounts for thought process, or thought disorder. As soon as a lesion is noted, it is no longer psychiatry, it becomes the realm of the science of neurology and the psychiatrist is no longer involved except perhaps forensically. To sum that up, give me one example of a reputable medical pathology book that identifies any psychiatric disorder out of the realm of neurology, such as neurosyphillis, tumor, endocrine disturbance and the like and I will be happy to read it. But I'm not holding my breath waiting.

Ok, maybe I am misunderstanding you here, but didn't that last sentence state that psychiatric disorders are currently evaluated using scientific techniques? Wouldn't that go towards the validation of psychiatry as a science?

I just don't see that we have an artistic or scientific leg to stand on, or else we would be more highly respected and better paid

.

Alright, now I perceive some common ground. After I read the Raskin article (which I think is very insightful) I think that the powers that be in nursing may be on the wrong track when it comes to how nursing approaches validating their research.

A definite effort should be made to insure that people who have the necessary background to create a rational critique from within be given that opportunity.

I hope to hear everyone's thoughts on this soon!!

talaxandra · May 20, 2004

Modified; originally posted on the thread "I wish I'd have known...B4 nursing school, post #51 (https://allnurses.com/forums/showthread.php?t=65489&page=6&pp=10)

Coming from a hospital-based background, and with my post-grad qualifications in health ethics, most of my contact with nursing theory has been self-directed. Despite my current academic supervisor's strong championing on nursing theory and professionalism, I must confess that I am sceptical about the value of all nursing academia in general, and nursing theory in particular. By 'nursing academia' I mean that it sometimes seems lacking in rigour. This opinion is admitedly from without, but I've helped a lot of colleagues with assignment revision, and heard even more talk about how lecturers were more interested in hearing their pet theories parroted back than in engaging in debate or in hearing contrary opinions.

One article I found particularly interesting was Jef Raskin's "Humbug: Nursing Theory" (http://www.jefraskin.com/forjef2/je...oryForSite.html), and Quackwatch's on-going debate about therapeutic touch (http://www.quackwatch.org/01Quacker...dTopics/tt.html) seems convincing to me.

I appreciate that this is a heretical position, and I can appreciate that a lot of members will feel really strongly about it. I don't want to trigger a flame war, but I'm really interested in a dialogue - how about it?

talaxandra · May 20, 2004

Oops! And now I find that GracefulRN has started this same thread already :imbar Please direct your responses to Is Nursing really an Art and a Science (https://allnurses.com/forums/showthread.php?t=67337)

talaxandra · May 20, 2004

Sorry, GracefulRN - I didn't see this thread and started my own version, which I'm happy to have closed and make this the official "Is nursing a science?" thread.

Here's what I posted to get the ball rolling:

Coming from a hospital-based background, and with my post-grad qualifications in health ethics, most of my contact with nursing theory has been self-directed. Despite my current academic supervisor's strong championing on nursing theory and professionalism, I must confess that I am sceptical about the value of all nursing academia in general, and nursing theory in particular. By 'nursing academia' I mean that it sometimes seems lacking in rigour. This opinion is admitedly from without, but I've helped a lot of colleagues with assignment revision, and heard even more talk about how lecturers were more interested in hearing their pet theories parroted back than in engaging in debate or in hearing contrary opinions.

One article I found particularly interesting was Jef Raskin's "Humbug: Nursing Theory" (http://www.jefraskin.com/forjef2/je...oryForSite.html), and Quackwatch's on-going debate about therapeutic touch (http://www.quackwatch.org/01Quacker...dTopics/tt.html) seems convincing to me.

I appreciate that this is a heretical position, and I can appreciate that a lot of members will feel really strongly about it. I don't want to trigger a flame war, but I'm really interested in a dialogue - how about it?

Dixiedi · May 20, 2004

It is my personal belief that Nursing is both a science and an art;however, apparently that is not a universal view.
:)

MMM, the art or medicaine. Not the science of medicaine.

Science definately plays a huge role in practicing the arts of medicine and nursing but it still an art.

Imagination (art) can not be set aside even in the earliest phases of assessment. The art of listening.

When performing a procedure, a dsg change or IV stick perhaps, science has taught us how to protect the pt and the nurse from contamination or undo pain, there is art involved in actually performing the procedure without "breaking the rules" science dictates. Have you ever met a nurse who can recite the steps to starting an IV but stick over and over and never get it? I have. She has the science but lacks the art.

Nursing is first and foremost an art, without it, the science is not needed because you will never get an acurate history for the assessment nor will you hit a vein! (as in the two examples above)

psychomachia · May 20, 2004

Modified; originally posted on the thread "I wish I'd have known...B4 nursing school, post #51 (https://allnurses.com/forums/showthread.php?t=65489&page=6&pp=10)
I appreciate that this is a heretical position, and I can appreciate that a lot of members will feel really strongly about it. I don't want to trigger a flame war, but I'm really interested in a dialogue - how about it?

What the nursing "profession" needs is more nurses to admit that nursing theory is useless and does little to make a "profession." This never ending quest for acceptance by other professions has allowed for such laughable "theories" as Rogers "Science (?) of Unitary Human Beings."

True research is being done, but not to distance nursing from science. I feel that nursing has much to offer in the understanding of things such as wound healing/treatment, pain management, maternity care, and family / patient dynamics. But to resort to paranormal modalities such as therapeutic touch does not nothing but diminish the real research / scientific study being done by nurses.

Welcome to the nursing heretic society...

...you may now remove the wool from your eyes...

talaxandra · May 20, 2004

Edited for typo

Science definately plays a huge role in practicing the arts of medicine and nursing but it still an art. Have you ever met a nurse who can recite the steps to starting an IV but stick over and over and never get it? I have. She has the science but lacks the art.

Isn't that really practice/technique/skill? That's not to say that I don't think there are some individuals who are amazingly good at, for example, phlebotomy. I work with a guy who is a savant at inserting NG's, but I don't know that it qualifies as an art.

psychomachia · May 20, 2004

Sorry, GracefulRN - I didn't see this thread and started my own version, which I'm happy to have closed and make this the official "Is nursing a science?" thread.
Here's what I posted to get the ball rolling:
I appreciate that this is a heretical position, and I can appreciate that a lot of members will feel really strongly about it. I don't want to trigger a flame war, but I'm really interested in a dialogue - how about it?

Here's my response from the other thread:

What the nursing "profession" needs is more nurses to admit that nursing theory is useless and does little to make a "profession." This never ending quest for acceptance by other professions has allowed for such laughable "theories" as Rogers "Science (?) of Unitary Human Beings."

True research is being done, but not to distance nursing from science. I feel that nursing has much to offer in the understanding of things such as wound healing/treatment, pain management, maternity care, and family / patient dynamics. But to resort to paranormal modalities such as therapeutic touch does nothing but diminish the real research / scientific study being done by nurses.

Welcome to the nursing heretic society...

...you may now remove the wool from your eyes...

Nurse Ratched, RN · May 20, 2004

Talaxandra - I went ahead and merged the threads so as not to lose any responses already posted. Good topic!

Edited to add - oops - y'all were too quick for me lol! I see you've already put your responses here.

GracefulRN · May 20, 2004

No problem talaxandra. I hope that we can get a good discussion going.

:wink2:

llg, PhD, RN · May 20, 2004

OK. I'll bite ... and try to make a contribution to this thread -- though I have not been reading the posts in the other threads leading up to it. As an older nurse who has been around academia for a while, I hesitated to get involved in this thread because I didn't want the aggravation. And I may withdraw from the thread if it gets too frustrating. But it seems that the group is trying not to get nasty, so I will add a little.

The thing I want to say most is that it makes me a frustrated with nurses who criticize the "major nursing theorists" in a hurtful way without cutting them a break. I agree that we have a problem with rigor in nursing -- but that is everywhere and not just in the early attempts of nurse theorizing. We have a discipline in which very few of its members have the skills necessary to fully appreciate, critique, or apply serious scholarship. We also have faculty members who are not doctorally prepared, who are not fully qualified to evaluate scholarly work, and who sometimes do a very poor job of bridging the gap between scholarship and practice. Sometimes, it is the blind leading the blind.

Back in the mid-late 20th century, there was a political need for nursing to get some theories out there in the literature. There was a need to establish doctoral level programs in nursing. There was a program that helped nurses get PhD's in other fields so that they could use some of those skills and ideas from those other ideas to establish a foundation for nursing. That lead to a mish-mash of disciplinary and philosophical perspectives that is still being sorted out.

It was/is inevitable that, in the effort to establish a philosophical and theoretical foundation for nursing that was suitable for scholarship at the doctoral level, there would be some "growing pains." It is normal and healthy for the philosophies and theories of a discipline to undergo revision -- even dramatic revision -- especially in its early years. We happen to be living in the early decades of serious nursing scholarship. We should expect lots of disagreement as the discipline tries to organize its knowledge base and define itself.

We should also be kind to those who worked so hard in previous (and current) decades to establish a foothold within the academic community for nursing. As a scholarly discipline, we still have a long way to go. But those theorists got our foot in the door and we should be appreciative of their efforts and grateful to them. We should not speak ill of them as people while we refine and revise the knowledge base they began. Just because their work is not "perfect" is no reason to be disrespectful. None of us here has accomplished as much as they have.

As for me, I strongly belive that nursing is both and art and a science -- with the science signifying that part of our knowledge base achieved through scientific methodology (as young and imperfect as it may be at present) -- and the art signifying the expression (i.e. performance) of our philosophical base through the application of our scientific knowledge.

I think we stop a little too short when we speak only of art and science. I think we need to give a little more attention to the philosophy part.

llg