The Lost Art

of Nursing HILE nursing is on its Odyssic quest to develop the science W of nursing practice, the universal humanistic art of nurs-

ing lies unattended. At one time the Winged Victory, Venus deMilo, and other famous Greek sculpture lay buried and unat- tended. . . until the French appreciated them and housed them in the Louvre in Paris. The Greeks have now learned, after losing much of their treasure, to recover and restore their own.

The Art of Nursing

As a verb the word “nurse” conjures up the most tender of all living acts. It is the essence of love, of receiving by giving. It is the essence of life as two souls are nurtured. . .the purest of the arts. What is art. . .

. . .but the means of union among people,joining them together in the same feelings and indispensable for the life and progress, toward the well-being of individuals and humanity (Tolstoy ).

The art of nursing is the universal act which. . . transmits the very simplest feelings common to all men (Tolstoy).

In the beginning a large part of nursing practice was the intui- tive application of this art. Today, the scientific technological procedural demands have forced a new emphasis for nursing

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by Jean Watson

practice. The true art of nursing lies buried, underdeveloped, or carted off by others in the helping professions..

Hippocrates, the father of all helping relationships, recognized that one of the first conditions for cure is giving the patient the in- spiration to live. How long has nursing neglected the develop- ment and practice of this truly humanistic art?

Even though the science of nursing is supposedly ethically neutral and objective, the humanistic art of nursing need not be. The art of nursing demands that those who practice it form and hold to a strict set of human values. The artistic activities of nurs- ing allow unlimited expansion of humanistic creativity. The ac- tive search and discovery of reaching out and making contact with another human is a truly artistic endeavor.

Discoveries in art are as important as discoveries in science, but with an important difference: there are certain values generated by an art which are not generated by the practice of a science. These are the values of tenderness, of kindliness, of caring and concern for another human being.

An art’s focus emphasizes communication and development of the mind and emotions; these skills belong to the heart of higher education and professional nursing. A foundation in the arts makes other kinds of scientific and professional knowledge lasting and significant.

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Much energy is now expended by nurses in the acqusition of scientific knowledge. A primary task of nursing is to identify, describe, and research those central scientific factors essential to effecting positive health change. However, the primary forces necessary in “caring for” another human being lie somewhere between the arts and sciences.

In the past it was held that learning was neutral with regard to values. That view is now being challenged. Educators, especial- ly those in nursing, are again seriously concerned with the full range of human development, including the foundation of moral and esthetic values (Chandler, 1976).

A conscious effort from the medical profession and society itself to control disease, prolong life, and alleviate pain has brought dramatic results. It is now possible to define an out- come of scientific activity (e.g., prolongation of life, test-tube pregnancy) without referring to its esthetic-humanistic aspect (e.g., the quality of life and death).

It is paradoxical, at this point in time, that in order to enjoy the full benefits of our newest discipline, science, we must re- examine the moral principles by which we act, and turn to the arts, humanities, ethics, and philosophy, our oldest disciplines.

One reason for the need to revert to the arts and humanities for answers is because science does not and cannot provide us with answers for what we need; medical technology and ad- vance treatments still do not eliminate the need for the human element and human value choices regarding care and treatment concerns of human beings.

It is crucial for nursing, in its quests for finding itself, to know the important functions that science cannot perform for practice behavior and the important functions that the humani- ties and arts cannot perform for the knowledge base. Under- standing the differences may help the profession reclaim and combine both perspectives.

Science is largely concerned with ordering human behavior and producing detachment from individual experiences.

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Science seeks neutrality with respect to human values. Science is concerned with methods, generalizations, and predictions. However, there are important functions that science cannot perform, because it asks different kinds of questions than the arts and humanities.

The artdhumanities address themselves to the understanding and evaluation of human goals and experiences. They are con- cerned with a person’s emotional responses to experiences. The art/humanities look for individual differences and uniqueness. They examine the diversity and quality of the human experi- ence. Imagination and insight are validated from within, without “scientific” justification.

On the other hand, the artdhumanities cannot necessarily provide predictable solutions to the problems of human nature.. They cannot give the hard data base that comprises the intellectual factual content of nursing.

One of the difficulties confronting the nursing profession to- day is its ambivalence and divisiveness as to where to place its loyalties - individual human experiences, humanistic care values, ethics, feelings, or technological procedures and tasks for development of new nursing knowledge, a science base, and advanced theories of nursing. Because of each nurse’s own value system, he/she may tend to emphasize one domain and neglect the other.

The point is that both domains of knowledge, experience, values, and directions are crucial to nursing. The struggle often comes in not understanding what each domain can and cannot contribute to nursing. Furthermore, nursing is becoming an ever more distinct discipline that interfaces with science and the artdhumanities. The nursing context today is embedded in a relationship with other content areas, e.g., history, philosophy, psychology, physiology, sociology, and anthropology. Nursing covers an area of knowledge somewhere between the biophysi- cal, behavioral, social sciences, and the artdhumanities.

The art of nursing actualizes the human content of nursing

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science. To fully actualize the human content of nursing science one must adhere to artistic values as well as scientific values and retain them. Nursing has a basic foundation and heritage which is often overlooked. To be a “nurse” in the purest, truest sense, it is critical that the profession explore the meaning and purpose of the humanistic/artistic values inherent within the profession.

The values of kindliness, concern, caring, and tenderness, generated by art, are buried deep in nursing’s consciousness. Just as there is a scientific quest in nursing today, so there also must be an artistic quest. Without the humanistic art of nursing how can nursing hope to offer anything “indispensable for the life, progress, and well-being of individuals and humanity?’’

There is an underlying value question in nursing which con- flicts with the humanistic component. The value question is related to the rapid advancement and demands for technology, procedural skills, and medical aspects of care without regard to humanistic aspects.

The artistic, creative, humanistic behaviors generated by artdhumanities challenge nursing to develop the use of self as a basis of nursing care. Regardless of how scientific and technologically advanced nursing becomes, without a more sys- tematic and advanced development of the basic art of the therapeutic humanistic use of self, there is evidence that nursing care can not only be non-helpful but can actually be destructive to another human being (Truax, Carkhoff, 1967).

If nursing is indeed concerned with the well-being of individ- uals and humanity, it must address itself to these issues. The real substance of nursing lies somewhere between a true art and sci- ence. Until the humanistic art is discovered and emphasized, the scientific theory and various identities are destined to go the way of the water of the Danaids. Like the mythological Danaids who forever fill their jars with water only to have the water leak out through the holes, nursing constantly refills its leaking jars while others take up the true treasures and claim them for their own (Watson, 1981).

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References Tolstoy, L. (1896), “What is Art?” in The Writers’ Craft J. Hersey (ed.) New York: Alfred A. Knopf, 1975, pp.25-30. Traux, C.B. and Carkhoff, R.R., Toward Effective Counseling

Psychotherapy: Training and Practice, Chicago: Aldine, 1967. Watson, Jean, “Nursing’s Scientific Quest,” Nursing Outlook, 29 (July)

7:413, 1981. . . . . . . . . . . . . . , The Philosophy and Science of Caring, Boston: Little,

Brown and Company, 1979.

Bibliography

Bronowski, J., “The Educated Man in 1984,” Science 123:710, 1956.

. . . . . . . . . . . . . . .,Science and Human Values, New York: Harper and Row, 1965.

Chandler, J., “Moral Values and Liberal Learning,” The Wake Forest Magazine, 23:28, 1976.

Conant, J., Modern Science and Modern Man, New York: Colum- bia University Press, 1959.

Dobzhansky,T., Genetic Diversity and Human Equality, New York: Basic Books, 1973.

Harcourt, B. (ed.), Science and Creative Spirit, Toronto: University of Toronto Press, 1958.

Harvey, O.J., “Belief Systems and Education: Some Implications for Change,” in J . Crawford (ed.), The Affective Domain, Washington, D.C.: Communications Service Corporation, 1970,

Hawkins, D. “The Creativity of Science,” in B. Harcourt (ed.), Science and the Creative Spirit, Toronto: University of Toronto Press, 1958, pp.130-131.

Kramer, McD. and Reed, J.L., “Self-Actualization and Role Con- ception of Baccalaureate Degree Nurses,” Nursing Research 21:111, 1972.

Morganthau, H.J., Science: Servant or Master? New York: New American Library, 1972.

Prior, M.E., Science and the Humanities, Evanston, Ill.: North- western University Press, 1962.

Ruf, H., “Philosophy and Critical Reasoning,” Chronicle of Higher Education, May 10, 1976, p.40.

Snow, C.P., The Two Cultures and the Scientific Revolution, New York: Cambridge University Press, 1959.

pp.67-91.

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