Art and science of nursing

Art & Science of Nursing

Since its very inception, there has been a conflict within the nursing profession about its status as to whether it is a science or an art. This is due to the fact that the profession of nursing includes within its tradition both scientific and artistic aspects.

The opposition between science and art has existed from the beginning of modern nursing. Nightingale championed the view of nursing as a moral art, while Fenwick argued for registration and insisted that nursing was an independent profession allied with science and technology.

(Le Vasseur J. 1999)

On the one hand, nursing viewed as a science implies objectivity and distance while on the other hand it can be seen as an art form which implies subjectivity and detachment. There has been considerable debate about these two apparently opposing points-of-view, as well as attempts to find areas of consensus between the two parallels. However, in my opinion this division is artificial in that both art and science form an integral function of the nursing experience and should rather be seen as complementary to one another.

Science forms part of the craft of nursing. I believe that the art of nursing as a science refers to the technical and objective part of the profession. Science refers to a certain type of knowledge that the nurse must have in order to perform his or her task well. This objective or empirical knowledge includes an understanding of the medical process and procedures as well as other technical issues that are essential for the nurse working in a scientific environment. This knowledge, while essential, is only part of the necessary requirements for nursing.

Nursing can also be viewed as an art form. Theoretically the view that comes closest to the understanding of nursing as an art form is John Dewey's theory of art as experience. For Dewey,

... A work of art is primarily a mode of experience; conceived of as an object; it is a source, origin, or possibility of experience. But the key pragmatic idea is that the nature of art is to offer itself as an experience with all the dimensions of experience: temporal, spatial, and meaningful." (Le Vasseur J. 1999)

In the above sense nursing is an art form in that it imaginatively transforms experience in the awareness of the patient and his or her needs. However, I also believe that the understanding of nursing as art must be seen in an even wider context. Nursing also requires other specialized knowledge besides the scientific. This specialized form of knowledge is awareness and a developed intuition of the experiences of those around one. This also leads to the nurses' ability, which is an art form, to understand and actively interact in the healing process. This means that the nurse must comprehend and respond to the needs and requirements of the patient in a way that is different to and transcends the knowledge of scientific quantification. In fact, I would suggest that the idea of art as experience and engagement is an essential and not a peripheral qualification of nursing. Without this concept of nursing as an art form, the profession - I believe - loses its central and identifying mode of knowledge. This relates to the underestimated art of caring, which is such an important component of the nursing experience.

The details and nuances of relationships between patients and nurses are significant because they are part of this experience of illness and this is why the deeply engaged stance of caring matters. Without engagement, the nurse is no longer a stakeholder and nursing art is not possible. Engagement is a precondition of experience. (Le Vasseur J. 1999)

Dewey also emphasizes this point in that nurses must be related to 'loving'. In other words they " ... must care deeply for the subject matter upon which skill is exercised. An engaged, emotional commitment is a precondition for nursing art and effective intervention." (ibid) Engagement and intervention is a subjective stance which is an essential part of the complex art of nursing. In many ways the nurse is an active agent in changing the experience of the patient and transforming this experience in the healing process. ":Chinn, Maeve and Bostick found that nursing art often was a deliberate attempt to 'shift or shape the experience of the patient.' "(ibid)