Nursing has always suffered from a bit of an inferiority complex.
As science and technology (and eventually bureaucracy) wrapped their tendrils into the developing health system, nursing became more uncomfortable.
It took a look at what it did and couldn’t quite put its finger on what that was.
There was never any doubt in its importance. Everyone seemed to appreciate that.
But when the profession looked at what a nurse did it just didn’t seem to be enough.
Nursing was a profession that just didn’t seemâ€¦wellâ€¦. professional.
So it looked lustfully at how doctors had developed medicine into a science and saw the respect and prestige that it had achieved.
It sure looked greener â€˜upâ€™ there.
And so over the past decade nursing has made great inroads into developing a foundational integrity in areas of academia and research. Nursing became a science.
Nurse as a master craftsman.
This advancing of the science of nursing is vitally important. There is not the slightest doubt of that.
But as our professions rush to the head, we must not forget the treasure that lay in our hands.
A master craftsman is not constantly going off to do courses, and workshops to improve her work. Rather, she evolves her mastery by pattern recognition gained through years of repetition, by constant reflection, attention to quality, and the transference of something beyond words and letters from her own mentors.
Perhaps besides the usual courses and workshops and competency assessments we need to develop a new set of measures that recognise the value of the flourishing perspicacity1 that a nurse may in fact possess.
Perhaps that is what nursing is after all, not so much a science as a master craft.
Basic nursing care.
We need to take the â€˜basicâ€™ out of basic nursing care, re-value and celebrate these skills and qualities.
We must show less experienced nurses the challenge and importance of constantly infusing excellence into the so called basic activities we are called to perform each day.
To show them the deep satisfaction that can be found in cleaning a patient and giving them fresh sheets.
Or the importance of priming a drip properly and with great care for no other reason than the value that is added by doing it this way.
Or the powerful impact they can have on someones quality of life by the simple act of caring for a wound.
Or the privilege of helping someone to die with dignity.
Instead of short cuts, we must teach nurses the art of the long cut.
Instead of multitasking to meet KPI’s2 we must give ourselves time and space to slow down and â€˜beâ€™ a nurse.â€¨ Space to explore those intimate interactions and processes that take place directly between the nurse and the patient at the bedside, in their homes or in the community.
We must begin take considered notice of the deep gratitude and appreciation that a patient can feel towards a nurse who is able to practice with art and with craft, and ask ourselves what is the value in this?
The great challenge is to re-imbue our profession with a pride and prejudice in this nursing craft.
I put it to you that at a fundamental level there is no difference in the skill or the value of a surgeon removing a brain tumour and a nurse caring for that patient after the operation. And before you scoff at this, let me assure you that the ability of many surgeons to provide the sort of care a nurse delivers is pretty much on par with the ability of most nurses to perform a craniotomy.
The difference is in our perception of their importance.
Take activities that on first blush are often taken as simple or menial such as re-dressing a wound. Drawing up antibiotics. Repositioning a patient. Making a bed. Counting respirations.
These simple things interact and inter-relate to the healing process in subtle ways that are no less important than prescribing a medication or removing an appendix. In some ways they may be more important.
Nursing is more a verb than a science.
Just the other night the news ran a story of a high-profile businessman who had suffered a heart attack. Tears streamed down the cheeks of this man as he spoke of the care he received from the nursing staff.
Not everyone will have such a positive experience, but we have all seen similar instances of people moved by the care they have received.
What these people often struggle to express is their exposure to something that our profession still cannot seem to put its finger on.
Unless you have actually experienced quality nursing care in the midst of a life threatening illness, the explanation of what it is that we do will probably never be really understood let alone described. I’m sure we don’t even appreciate it ourselves.
But it comes from our hands.
And it comes from our hearts.