art and science

It has been a long time since I've posted, but my goal is to update this at least once per month. My other goal for the new year is to exercise and I have been doing that with success, so I will accomplish this!

I have been reflecting upon what is the art and what is the science of nursing. When I was taking my undergrad, instructors would refer to this and though I acknowledged that there was both within nursing, I don't know if I considered how this looks in mental health.

One of the reasons that some in nursing don't like mental health is because there are not a lot of physical skills, like inserting a catheter, starting an IV etc. Most of our time is spent talking, listening, and intervening in those fashions.

I think I kept trying to quantify the communication as science, and I think many in psychiatry do this want to make mental health a 'real nursing' job, with quantifiable measures and recognized by the dominant medical discourse. Hence the overreliance on medications as a 'cure'-it meets scientific/biomedical standards-medications are studied extensively and the medical community can measure side effects, efficacy etc. Not to mention our society's determination to find cures through pharmaceuticals, but that's a whole different topic.
Really, I think within mental health, the art piece is foremost, and how do we measure that?
Specifically, I was thinking of how I intervene with a patient who is angry, distressed etc. Sure, I can set out some guidelines on how to speak, what my body language should look like, but how do you scientifically quantify empathy, understanding, and gentleness?

I had a situation with a patient, who was angry and suggested to the nurse that since I had a fairly good rapport with the patient, perhaps I could try intervening. It all turned out well and the patient resettled, but when thinking about what I did, versus what could have happened, I don't know if I could quantify what I did. Obviously, I made eye contact, had open body language, listened, but how do you exactly replicate caring, and isn't that caring and empathy, the art of nursing? Now if I had jumped in and had a more intrusive intervention, such as calling a code white and giving a medication intramuscularly, perhaps it would look like I was doing more-that kind of thing lends itself to measuring much easier, held patient this long, gave this medication in this spot with this dose, this many people present. Perhaps that is part of the reason people want to jump in and deal with the situation physically and quickly-it seems like a more societally valid form of intervention? Follows the biomedical discourse?

I think within mental health, it is the artful ability to listen so that the patient knows you hear them, and the genuine connection between nurse and patient, it is not the science of 'maintain a leg's length distance while keeping direct but not intense eye contact'

Within nursing there is a difficult balance between keeping scientific rigour in our practice, while recognizing that it is the art of nursing that differentiates this branch of health from medicine. We need to balance evidence based practice with the artful interactions and human compassion. If we nurse while only using the scientific background, the empathy, caring and humanness is lost. If we only use the art of caring, it can degenerate into doing things because we've always done it this way, leading to care and interventions that may or may not work.

Interesting stuff, maybe next time I'll reflect on the biomedical reliance on medication to cure.