Introduction
In recent decades, there have been widespread deliberations in the nursing literature about the art and science of nursing practice (Parker 52). As the conflict on whether nursing is an art or science still persists, academics suggest that nursing is seeking to articulate itself as a discipline in its own right and assert a knowledge foundation proportionate with its situation within higher education establishments where knowledge has conventionally been divided into the arts and the sciences (Rose & Parker 1004). Indeed, the terms ‘art’ and ‘science’ are intrinsically significant for the practice of nursing, not only because they carry a particular connotation but also due to the fact that their defining characteristics assist to elucidate the nature and scope of nursing practice (Peplau 8). The present paper proposes that nursing practice is underpinned by the philosophies of art and science, and therefore the discipline is defined and described as both an art and a science.
Understanding Nursing as an Art
The Florence Nightangle school of thought, which originated from the United Kingdom, embodies the first expression of nursing as an art in contemporary times. In this school of thought, “…nursing as an art is conceived of in relation to the character of the nurse and the importance of character training in nursing education programs” (Parker 52). Arising from the Enlightenment age where the domain of science was a preserve of men, it can be argued that within nursing education and practice, nursing as an art was perceived by the Nightangle school of thought to include the character of the nurse in the exercise of feminine values, as well as the cardinal significance of training in the development and actualization of nursing as a female-dominated profession (Parker 54). In this perspective, according to this particular author, science was out of place for women as the scientific enterprise was male-dominated and, within the health institution or medical settings, belonged to the physician.
Second, during the formative years of nursing practice, “…nursing as feminine art was developed through character training that resulted in non assertiveness, obedience, and compliance with medical directives” (Parker 55). While student nurses were judged on their intrinsic qualities, including trustworthiness, orderliness, quietness, temperance, honesty, and trustfulness, specific nursing arts comprised practices such as bathing, bed-making, positioning patients, and comforting techniques (Darbyshire 124). Today, many of these virtues and procedures are still sought after in nursing, demonstrating the artistic side of the nursing practice.
Third, nursing can be considered as an art as it entails expression of ideas and communication of emotions. Extant literature demonstrates that in nursing, the emotions a nursing professional might wish to communicate to their patients include moderated love, calmness, care, faithfulness, trust, hope and confidence (Rose & Parker 1005). The challenge with this perspective of art, according to these authors, is that people have diverse emotional responses to the same stimuli, implying that a nursing professional seeking to communicate confidence, for example, by sharing information with the patient might instead instill fear or hopelessness. This confusion provides the context for the generation of nursing theory, thus the entry of the science of nursing (Peplau 10).
Fourth, it is revealed in the literature that “…art could be used to communicate social conscience as a reflection of what already exists within a culture, or in order to promote it in a culture where it is lacking” (Rose & Parker 1005). In this context, the expression and practice of nursing revolves around a reflection of, for example, beliefs about the nature of the patient, the environmental setting, health and well-being, or it could be utilized to positively influence the society towards a particular perspective, such as the importance of observing personal hygiene.
Lastly, nursing has been described by scholars and practitioners as an experience lived between human beings, implying that it is largely construed as an art in this context. Indeed, it is argued that the art of nursing practice is created from the humanness of the nurse and patient and that the discipline is taught as a component “…of the hidden curriculum – the curriculum of subtle socialization, of teaching student nurses how to think and feel like nurses” (Idczak 67). It can be recalled that, conventionally, the art of nursing practice is taught in institutions of nursing using lecture notes, or in amenities that are best suited to offer behavioral communication proficiency. However, an increasing number of critics refute the claim that the art of nursing can be truly delivered in these amenities because of their conviction that the authentic art of nursing can only be generated in the human realm; that is, the actual interaction between the nurse and the patient. The fundamental core of the nursing practice, which invariably is the art of nursing, is the nurse/patient interaction, in a mutually fulfilling relationship with or being with a patient (Idczak 67).
Understanding Nursing as a Science
Today, more than ever, the nursing profession is becoming increasingly immersed in scientific principles and inquiry. Extant literature demonstrates that “…science is the most sophisticated method of acquiring knowledge that humans have developed and that problem solving, although fallible, is more reliable than tradition, authority, experience or trial and error” (Rose & Parker 1005). Nursing as a science paradigm has its roots in the shift of nursing education to institutions of higher learning in the United States. This predisposition triggered the emergence of strong schools of nursing thought that were credited with the establishment of conceptual and theoretical models for nursing practice.
Extant literature demonstrates that “…the science of nursing is based on the acquisition of skills and knowledge across the curriculum, as well as theoretical knowledge of nursing” (Idczak 67). It is important to note that the conceptual models and skills acquisition not only led to the emergence of nursing as a science, but also to the development of nursing schools that were in direct opposition to medicine, and understood nursing practice as a behavioral science, a holistic science or a purely caring science (Parker 58). Due to the disengagement between nursing theory and practice, however, there were calls to test the differing conceptual frameworks against practical experience and to refine them. Although these developments received a lot of resistance from nursing professionals, academics argue that they were the pillars on which the domain of nursing as a science was mounted (Darbyshire 125).
Moving on, it is a well known fact that “…the principles of scientific inquiry include research for the advancement of knowledge, and theory development in an effort to provide descriptions, explanations and predictions related to phenomena” (Rose & Parker 1005). Not only is scientific knowledge dependent on meticulous data gathering, analysis and interpretation, but its values are grounded on skepticism, uncertainty, objectivity and detachment. Academics are of the view that, because of these variables, scientific inquiry is perceived as an advanced type of knowledge, which enjoys high academic status (Rose & Parker 1005). This perception, according to the authors, may have led to the prominence of scientific inquiry in nursing and the emergence of the phrase ‘nursing science’ some six decades ago. Nursing students and professionals to date engage in scientific investigation, with the view to not only explain phenomena but also strengthen conceptual frameworks and theoretical frameworks in nursing practice (Jasmine 416). The perception notwithstanding, this exploration of facts demonstrates how and why nursing is regarded as a scientific discipline.
From the ongoing, it can be deciphered that “…science is the technical doing of nursing and that nurses should open up to feeling and the being of nursing” (Idczak 71). Certainly, it is the role of scientific inquiry and research to provide nursing professionals with the empirical and tested knowledge on which to base their nursing knowledge and decisions; however we should always remember that it remains the principal role of the arts to orient the professionals towards the assessment of the value preposition that inspires and motivates their practice. It is through scientific inquiry that nurses are able to discover knowledge and translate this knowledge into practice recommendations as well as evidence-based practices (Jasmine 417). Consequently, the value of science in nursing practice cannot be underestimated.
Conclusion
The present paper has amicably demonstrated that nursing practice can only be defined and described as both an art and a science, and that the two are inexorably related and rationally justified as core ingredients towards the shaping of the modern-day professional nurse. It has been demonstrated how both the art and science of nursing are fundamental to each other, and how their distinct values can enlighten and nurture each other. For instance, it has been demonstrated that while the values of art include subjectivity, compassion, kindness and involvement, science values include objectivity, testing, empiricism and detachment. All these values are important to a contemporary nursing professional and, therefore, it can only be argued that nursing is both an art and a science.
References
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