3. The Clinical decision aspect of nursing
Ethical
Policy
Practice
Clinical
Non-Clinical
4. How social factors influence the Art &
Science of Nursing
Social Factors
Income and social status
Education
Physical environment
Social support network
Genetics
Health Services
Gender
World Health Organization. (2016). Retrieved from http://www.who.int/en/
5. Art and Science of Nursing
Art of Nursing
Caring
Compassion
Engaging
Effective communication/Positive
interaction
Holistic care
Science of Nursing
Nursing process
Knowledge of disease process
Critical thinking
Continued education/Evidence Based
Research
Skills
https://youtube/r26JmQz1uUY
6. Caring
Caring theories are based on the idea that caring is an essential asset for a nurse
to have.
The act of caring helps to promote health, build a good patient nurse relationship,
and provides a healing environment.
Jean Watson’s Caring Theory
Care and love are requisite for our survival and the nourishment of humanity
Care and love constitute the primal and universal psychic energy
7. How did the art of nursing shape
It first started out with Florence Nightingale. She was
the first to describe nursing as both art and science.
In the 1900s the theory of nursing started to get
attention for nurses discipline.
In the 1980s the theory of nursing started to shape
and the theory as scholars began to be recognized.
One of the philosophy theory's came from Jean
Watsons: the nursing goal is to help all patients to
attain the highest level of harmony within the mind-
body-spirit.
One of the highly recognized organizations that help
shape nursing is the American Nurses Association
(ANA).
The ANA fostered the nursing profession by
standardizing the highest level practice and promoting
the rights of nurses in the workplace.
The definition of Nursing by ANA:
“Nursing is the protection, promotion, and
optimization of health and abilities, prevention of
illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and
advocacy in the care of individuals, families,
communities, and populations. “
(Nursing Scope and Standards Workgroup, 2009-2010,
2010, p. 1)
8. How did the art of
nursing shape
• The art of nursing is also based
on the framework of caring,
dignity and integrity.
• As nurses we acknowledge the
process of spirituality, holistic
healing, empathy, and the
mutual respect of our patients.
• We also embrace the healing
through our compassion,
helping and being tolerance to
all needs of our patients
Image provided by: www.slideshare.net
9. How the science of nursing shapes our
practice:
Evidence Based Nursing Practice
• Nursing research encompasses a wide scope of scientific inquiry including clinical research, health
systems and outcomes research, and nursing education research. (AACN 2016)
• EBP (Evidenced Based Practice), is one reason facilities designated as Magnet hospitals by the
Magnet Recognition Program have been so successful: They’ve set up systems that foster
evidence-based care, bringing improved patient care and nurse satisfaction. EBP also serves as the
foundation for the disease management work done by nurse practitioners (NPs) and many other
nurses. (“Nursing-Today and Beyond,” 2006).
• Clinical outcomes (endpoints) of importance vary from patient to patient or by clinical population
and include mortality, length of stay, self-care ability, adherence to treatment plans, and
maintenance or improvement in functional status. Serious errors or complications often lead to
poor clinical outcomes. So far, very few positive clinical outcomes have been studied by staffing-
outcomes researchers, probably because of limited measures and data sources. CLARKE &
DONALDSON, 2008).
• Nurses are basing their practice guidelines from Nursing Research, Nursing Education, and State
and Federal guidelines to enrich both the patient and the nurse.
10. References
American Holistic Nurses Association. (2016). Retrieved from https://www.youtube.com/watch?v=nYoCW1DQWQE
Clarke SP, Donaldson NE. Nurse Staffing and Patient Care Quality and Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville
(MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 25. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2676/
Dawson, D. (2006, Dec). The art of nursing: A hidden science?. Intensive & Critical Care Nursing, 22(6), 313-314.
Grady, P. A., & Gough, L. L. (2015, November). Nursing Science: Claiming the Future. Journal of Nursing Scholarship, 47(6), 512-521.
doi:http://dx.doi.org.contentproxy.phoenix.edu/10.1111/jnu.12170
Johansen, M. L., & O'brien, J. L. (2015). Decision Making in Nursing Practice: A Concept Analysis. Nursing Forum Nurs Forum, 51(1), 40-48. doi:10.1111/nuf.12119
Manchester, A. (2009/2010, December/January). The art and science of nursing. Kai Tiaki Nursing New Zealand, 15(11), 15-19. CINAHL Complete.
McQueen, J. S. (2007). Florence Nightingale's Nursing Practice. Nursing History Review, 15(), 29-49.
NURSING RESEARCH. (2016) Retrieved from Http://www.aacn.nche.edu/publications/position/nursing-research
Nursing Scope and Standards Workgroup, 2009-2010. (2010). Scope and Standards of Practice Nursing 2nd Edition (2nd ed.). Silver Spring, Maryland: Library of Congress Cataloging-
Publication Data.
Nursing-Today and Beyond. (2006, October ). American Nurse Today, 1(1), . Retrieved from https://americannursetoday.com/nursing-today-and-beyond/
Shoulders, B., Follett, C., & Eason, J. (2014). Enhancing Critical Thinking in Clinical Practice. Dimensions of Critical Care Nursing, 33(4), 207-214.
doi:10.1097/dcc.0000000000000053
Watson, J. (2009). CARING SCIENCE AND HUMAN CARING THEORY: TRANSFORMING PERSONAL AND PROFESSIONAL PRACTICES OF NURSING AND HEALTH CARE. Journal of
Health and Human Services Administration, 31(4), 466-82. Retrieved from http://search.proquest.com/docview/200024998?accountid=458
World Health Organization. (2016). Retrieved from http://www.who.int/en/
Editor's Notes
What is critical thinking? Are we as nurses born with it, or is it something we develop over time? There are many definitions of critical thinking but when it comes down to it it’s actually being able to look at your patient, lab values, vital signs and hopefully being able to predict what’s coming next through experience, knowledge and a little intuition. Without critical thinking nurses are just performing task oriented care. According to Shoulders (2014) “Skilled critical thinking nurses respond quickly to changes in patients’ conditions, changing priorities of care based on the urgency of the situation.” We are not just looking at the numbers but also assessing the accuracy and relevancy of the data to see the bigger picture and center in on the problem to better care for our patients. Using the clinical process and evidence based research helps guide nurses for making clinical judgements. Our critical thinking skills help us to communicate with other members of the care team in making sound judgements in the care of our patients.
We initially learn to begin to use critical thinking in the academic arena and then develop our skill over time in the clinical setting to where this type of thinking becomes automatic as we gain confidence in our skills and knowledge based on experience. Using reflection on past cases, interventions and outcomes will help develop critical thinking skills.
The decisions nurses make affect patient care, safety, and outcomes. Nurses must understand the concept of decision making so they develop good problem solving skills. According to Johansen (2016) “Good decisions or judgements are not only directly influenced by the cognitive process but also by how the information is weighted, prioritized, and the nurses ability to recognize and respond to salient aspects of an ambiguous clinical and non clinical scenario”. We are required to make quick decisions under conditions of uncertainty using subjective and objective data that we are constantly gathering. Nurses learn the art of using cues and data that we can appreciate to make decisions and forsee changes in our patient's status and can anticipate orders staying within our bounds to care for our patients.
To understand how social factors affect the art and science of nursing, one must understand what social factors are. According to the World Health Organization (WHO) website social factors include income and social status, education, physical environment, social and support network, genetics, health services, and gender. "World Health Organization” (2016).
Nursing requires art and science. The science of nursing involves application of knowledge from education, skill, evidence based research and practice, skills, nursing process and critical thinking. The art of nursing requires a nurse to apply the knowledge and education, use the nursing process to critical think through the disease process, and apply the skills to provide the best possible safe and quality care for the best possible outcome for the patient. The nurse must also use evidence based research and practice when caring for the patient.
This all occurs while the nurse does the following:
Establishing a relationship
Making meaningful connections
Practicing effective communication with patient and family
(Manchester, 2009/2010).
When social factors are considered and the art and science of nursing are effectively combined the “nurse, healthcare team and patient form a partnership, that results in the best possible outcome for the patient” (Grady & Gough, 2015).
According to “American Holistic Nurses Association” (2016) ”Holistic nursing is a specialty practice that draws on nursing knowledge, theories, expertise, and intuition to guide nurses in becoming therapeutic partners with people in their care. Holistic nurses honor each individuals subjective experience about health, health benefits, and values”.
It has been reported in research that nurses who are not able to practice caring can become hardened, brittle, worn down, and robot like (Swanson, 1999).
Jean Watson’s caring theory was centered around the fact that caring is the essence of nursing and is the unifying focus for practice. She also believes that caring was more then a feeling but also an attitude and a way of being.
Health care organizations have moved towards a more “Caring” form of representation.
“Hello human kindness” –Dignity Health
Florescence Nightingale started her nursing notes in 1859 which started her definition of nursing. She viewed nursing as a based on religion and not solely on the nursing principle of medicine.
One of Watson’s Theory was that nurse's have a human to human transaction that is meaningful, authentic, intentional, honoring the person and sharing human experience that expands each person’s spirit leading of new discovery of self and other and new life possibilities.
Nurses needs to explain the difference between the art and science of nursing. The nursing science is based on data observation and has endless and sometimes useless information.
The art of nurses is the qualities that we set forth for our patients and that we intact with our patients with character and our nursing reputation as caring and with dignity and integrity….
Nursing research reviews patient outcomes, disease trends, and the impact of nursing care on the healthcare system.
Evidence based practice is research which is verified and affects nursing care in various types of facilities.
Evidenced based practice is also investigating “nurse staffing ratios”, however, there are many variables from the patient side which also have an impact on their outcomes; per the research.
