Have we lost the "art" of nursing?

Nurses General Nursing

Published

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?

Ah yes - "PM Care" - I remember it well & my clinical practice has been 100% critical care.

Not too long ago, I had my first 'patient experience'. During the admission process, I was asked about bedtime habits/practices. Subsequently, each of the 4 post-op evenings that I was on that unit, a staff member came into my room at 9 pm to offer a snack, freshen/straighten my bed, help me with washing up, tidied my room, adjusted room temp, made sure that everything I needed was close at hand, ensured my pain was well managed & adjusted lighting so I could use my Kindle. No, I didn't get a backrub - but that may have been because I was ambulatory. They also hung the "I'm trying to sleep" sign on my door to minimize noise & interruptions. The entire process didn't take longer than 15 minutes or so. So - it CAN BE DONE. BTW, that facility is long-time Magnet & consistently awarded top national honors in a number of clinical services.

Yep - I did take the time to complete my post-DC survey & gave them major Kudos.

15 min or more (for an ambulatory patient) in addition to the 9pm med pass or was the "art of nursing" grouped together with the med/treatment pass?

That makes a huge difference.

I haven't lost it, it's either in you or not.

The corporate bottom line stole it.

To HouTx;

Wouldn't it be lovely? Every patient deserves that. However, this sounds like a facility with a 3:1 ratio.

My last hospital position, I had 7-8 patients on the afternoon shift. That would be 2 hours out of my 8 hour shift... I was lucky to get my meds passed and eyeball my peeps!

Specializes in PCCN.

corporate america has made us lose the art of nursing. Now its more like an assembly line of sick people, and the customer service focus has taken away the ability to be a real, caring nurse.:-(

Just to be clear: As a group, we have chosen 'corporate America,' it hasn't been thrust upon us.

We have chosen it by our economic choices... the single largest example of which is Wal*Mart.

We have chosen it by our social choices... the antipathy toward labor unions and public employees... the ferocity of the criticism of those who ask for solid benefits and pensions rather than the demand of same for ourselves.

We have chosen it by our political choices... the prime example of which is the Supreme Court's decision that spending money is equivalent with free speech, that political parties and candidates can solicit and accept unlimited contributions, and that corporations are people.

Don't expect America and the world to become less 'corporatized;' rather, recognize that we've recently moved through an inflection point.

Interesting thread.

I think that some of the lack of compassion shown BY nurses is a reflection of the lack of compassion shown TO nurses.

Additionally, scripting, hourly rounding and parroting "I have the time" has removed some autonomy of the nurse to create a sense of individualized care.

I include the art of nursing in my daily practice. I'm known for going the extra mile with my patients.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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.

Specializes in Pediatrics, Emergency, Trauma.
I don't think the art of nursing is lost, but maybe we don't recognize it as such. I enjoy the "reconditioning" nursing interventions of a deconditioned patient. Getting them up to the chair, taking a stroll around the unit, etc. Seeing them get stronger is very satisfactory to me. I also enjoy medication education, and I've often requested changes/reconsideration of meds based on the patient's feedback. To hear a patient say that the new med is working or an intolerable side effect is gone is great! Pain management of musculoskeletal issues can be addressed through repositioning in conjunction with pain meds. When a patient states he/she is feeling less pain through a two-minute reposition, I can't help but smile. I also like when I'm able to liberalize the diet of someone who has lost his/her appetite and to see them actually enjoy the food being eaten.

No, the art of nursing is not completely gone. I bet most of us do it, if we think about it.

I agree...in the midst of increasing ratios and other advances, I believe in "quality time" with my pt; not quantitative time; meaning, I establish the therapeutic relationship, I round, I engage the pt all while giving meds, ADLs, assessments and skilled care...and still am able to document, have my lunch break and go to the bathroom. It's about using your time with each pt. I learned to do this many moons ago as a nurse assistant. I was on a telemetry floor and had to do manual BPs, point of care ADLs, EKGS, everyone was a falls risk, post of thoracotomy, post ablation, CABG, and document for 14-28 patients. I just added the additional pieces of my nursing practice, and built upon those practices. 13 years later, I do the "art" very well. And they are teaching the "art" in school...it really is up to the student and then nurse to "craft their art" so to speak; it's FAR from a generational...it's HUMANE.

Specializes in Oncology; medical specialty website.
To HouTx;

Wouldn't it be lovely? Every patient deserves that. However, this sounds like a facility with a 3:1 ratio.

My last hospital position, I had 7-8 patients on the afternoon shift. That would be 2 hours out of my 8 hour shift... I was lucky to get my meds passed and eyeball my peeps!

​Totally agreed. And it's good seeing you post, BTDT. I missed your comments.

Well said Esme12. You remember and really do see what is happening today.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

I think the art of nursing is still very much alive and it all depends on perspective. Nurses practice in all sorts of settings now and the "back rubs and foot massages" of days past no longer makes a lot of sense in this era of sicker hospitalized patients. I am going against political correctness here by admitting that I am a nurse practitioner who has all but relinquished my "nursing roles" in favor or "medical thinking" and medical management. However, I still see a greater role for the "touchy feely" side in health care. I also feel that much of these acts that we allude to as providing comfort have its roots in the patient advocate role nurses excel at.

For example, despite the advancements in how we keep people alive these days, nurses have a responsibility to ensure that patients are not unjustly exposed to the undue discomfort of unnecessary treatments that will only prolong suffering and not quality of life. This is an opportunity where nurses can make a difference in educating patients and families about their options, something providers like myself can get lost in our day to day attempt to focus on treating an underlying condition. Not surprisingly, Palliative Care is an area that nursing has pioneered in and now has also become a physician specialization.

Another example I can think of is delirium in hospitalized patients. This is a very common consequence of hospitalization and is associated with a significant mortality rate yet with all the drugs we can use in this world, probably the biggest impact in its prevention is how nurses can manage the transition from home to hospital by preserving the patient's circadian rhythm by ensuring quiet sleep at night with minimal unnecessary interruption, keeping sunlight or anything that simulates it shining into the room during the day, and advocating for minimal polypharmacy that predisposes patients to competing adverse drug effects.

I can think of a lot more but I doubt readers would want a long post on the topic.

+ Add a Comment