Aesthetic Leadership: Its Place in the Clinical Nursing World

Clinical leadership has been identified as crucial to positive patient/client outcomes, across all clinical settings. In the new millennium, transformational leadership has been the dominant leadership style and in more recent times, congruent leadership theory has emerged to explain clinical leadership in nursing. This article discusses these two leadership models and identifies some of the shortcomings of them as models for clinical leadership in nursing. As a way of overcoming some of these limitations, aesthetic leadership is proposed as a style of leadership that is not antithetical to either model and reflects nursing's recognition of the validity of art and aesthetics to nursing generally. Aesthetic leadership is also proposed as a way to identify an expert clinical leader from a less experienced clinical leader, taking a similar approach to the way Benner (1984) has theorised in her staging of novice to expert clinical nurse.     

A "dialogue" between the aesthetics of nursing and philosophy

Nursing aesthetics belong to the broader school of aesthetics, a branch of philosophy, as well as the nursing arts, an element of professional nursing. The philosophy of aesthetics recognizes the connection between an author and appreciators and identifies both substantive and abstract aesthetic experiences in interpersonal communication through the fine arts. Nursing aesthetics values the meaningful moments of patients, is sensitive to the influences of different circumstances and situations, and appreciates the unique qualities of humanness. Nursing aesthetics is emancipatory knowledge and involves empirical, ethical and personal knowing. The article is based on a search of OvidSP and Chinese Electronic Periodical Services (CEPS) database references using key words including aesthetic, aesthetics, art of nursing, or nursing aesthetics as well as a review of books related to aesthetics, knowledge construction, and nursing aesthetics. Authors determined definitions as defined by nursing experts and the applications thereof in clinical practice. This article aimed to illustrate that the ultimate concern of philosophy is "goodness" and that the foundation of caring behaviors is "love". In practice, nursing aesthetics is expressed through empathy, appreciation, inspiration and the therapeutic use of the self. Through aesthetic knowing and enhanced perceptual sensibility and reflection, nurses can transform intuitive knowing into art-acts and ultimately enhance nursing care quality.     

Nursing as an art

It is more important now than ever to define the goals of nursing by using an aesthetic approach. In every day practice the nurse must explore and adopt these functions, which constitute the essence of nursing as an art. The aim of this paper is to firstly explore the notion of nursing as an art, underpinned by the philosophy of art and to secondly discuss the hidden connections and the criteria for nursing seen or thought to be an art. In this paper, the aesthetic values have been used to depict and to expose the invisible qualities of nursing. Through the written text the attempt to explore the nature of nursing by an aesthetic approach, reveals that the essence of nursing is constituted by the same origins, which define the essence of art. This exploration of the literature led to the recognition of the quality of imitation as an attempt of the artist to awaken individuals to understand what a piece of art represents. Respectively, a nurse by represents a picture of wholeness for the health, attempt to stimulate patient to move forwards regaining control and achieving the state of well-being. The search of the expression as one of the sources of the aesthetic values has brought to the surface that nursing is expressed as a whole of unique functions containing love, advocacy, calmness, care and empathy. The exploration of the combination of the elements, their articulation or their structure exposes the beauty itself. The beauty of a statue as Venus of Milo as well as, in terms of nursing, the beauty of caring as the heart of nursing. However it is difficult to capture the totality of nursing in this paper, which attempts more to portray this beauty of nursing rather than to seek for a clear answer of what nursing is.     

The art of stained glass: metaphor for the art of nursing

The art of stained glass: metaphor for the art of nursing
The aesthetic is a way of knowing the meaning of and the meaning in the art of nursing. The art of creating stained glass offers a personal metaphor for nursing's essence; the art of caring. Both arts aim to fulfil the potential of their subjects to achieve a harmony that goes beyond their individual components. Stained glass artistry and caring in nursing require technical expertise, yet technical skill and knowledge are not the substance of either art. Both transcend space and time, and the art of stained glass and the art of nursing are influenced by the artist's/nurse's personal, social and cultural history. Just as die artisan transforms the glass and lead and is transformed in the creative moment, so does the caring transaction transform both patient and nurse. This personal reflection explores the nature of caring in nursing as mirrored by the author's work with stained glass.     

护理美学在门诊护理管理中的运用

目的探讨护理美学在门诊护理管理中的运用效果。方法结合门诊实际情况,对门诊护士进行护理美学相关知识及技能的培训,并进行实际操作考核;并对进行护理美学教育前后门诊服务质量情况进行分析。结果进行美学学习前后门诊服务质量,经统计学分析,差异有统计学意义(P<0．05)。结论对临床护士进行有针对性的护理美学教育,对提高护士的职业素质有着积极的作用。     

Understanding personal narratives: an approach to practice

AIM: This paper explores the need for and nature of personal narratives and their relevance to nursing practice. It proposes that the co-creative aesthetic process can be used to understand and co-create personal narratives through an emphasis on self-defining memories and metaphor. BACKGROUND: Many authors in nursing and other human sciences have recognized the need for and importance of personal narrative, its relationship to aesthetic knowing and its value in qualitative research and in practice. The role of memory and metaphor in the creation of meaning in personal narratives, however, has not been sufficiently explored in nursing literature. DISCUSSION: The nature of personal narrative is explored, focusing on the way meaning is created from self-defining memories using metaphor. Then, the importance of personal narratives in nursing practice is considered, followed by discussion about how meaning in personal narratives may be co-created between clients and nurses using an aesthetic process developed by the author. CONCLUSION: The co-creative aesthetic process is an example of nursing as art and can be used to co-create personal narratives in practice. The experience of co-creating a self story with a nurse can be healing, as the self story is heard by a caring person, memories are understood in new ways, and the self story is both confirmed and recreated.     

现代健康观与护理的审美价值取向

目的 确立现代护理的审美价值取向。方法 文献资料法、逻辑分析法。结论 现代健康现是一个具有美学价值追求的概念，它体现了人时自然生命、社会生命、精神生命的健康理想追求。护理在满足人时生命的人体美、社会美、精神美的追求时，便获得了审美价值。现代护理的审美价值应以综合开发人的生命意识为取向。     

护理伦理至护理审美的逻辑趋向

从伦理学视野研究护理审美价值的意义,体现在护理美学和护理伦理学在对功利和社会效益的认识上是一致的;新护理模式的实施需要护士的人道伦理意识加以保证;引入审美情感机制,是实现护理道德与护理审美统一的有效途径;寻求护理伦理与护理审美的统一是护理美学发展的理论诉求。中外伦理学和美学研究都强调美与善的统一。护理伦理与护理审美是人之生命的两种精神性存在方式,在对人的终极关怀方面表现为一个逻辑的过程。即护理的关怀照顾通向审美超越,护理道德人格走向审美人格。     

Missed nursing care as an ‘art form’: The contradictions of nurses as carers

This article draws on the free‐text commentaries from trans‐Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self‐effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms.     

Starry night: using story to inform aesthetic knowing in women's health nursing

AIM OF THE PAPER: This paper describes the use of story as a vehicle to inform aesthetic knowing in nursing. Because health care demands that nurses know two distinct languages, the language of nursing science with its quantifiable outcomes as well as the experiential observations of health and illness, it is critical that nurses be fluent in each discourse. BACKGROUND: Nursing scholars have long voiced a commitment to two epistemological domains: scientifically derived knowledge (empirics) as well as the expressive, creative, intuitive application of knowledge (aesthetics). In recognition of the need for these interpretive paradigms for practice, nursing scholars have sought to identify the kinds of knowing which provide the nursing discipline with its unique perspective. DISCUSSION: Stories mould every human encounter and telling one's story in the context of a trusting relationship allows women and nurses to journey together to uncover and discover the meanings inherent in the story. Through this mutual process of unfolding the story, nurses engage the women in deep reflection and focus on what 'might be' so that possibilities for the future are illuminated. This is important in all nursing, but particularly in women's health nursing because the emergence of story suggests that contextual, phenomena-centred knowledge has found its voice in the nursing care of women as a way of knowing that focuses on personal experience and relies on methods in which woman-to-woman caring facilitates the disclosure of the human health-illness experience. CONCLUSIONS: Storytelling is a useful strategy to inform aesthetic knowing in nursing. Stories supply a foundation for nursing scholarship because truly to hear women's stories require nurses analyse information, formulate hypotheses, and seek to understand the causal relationships as expressed by women. Through this analysis and attention to detail, nurses are able to glimpse possibilities for the future, thus transforming the experience.     

Aesthetic Methods as a Means of Knowing for Nursing

This paper introduces aesthetic methods as a means of knowing for the nursing profession. The importance of aesthetics for development of nursing knowledge is highlighted. This paper provides the background for the following series of three papers addressing use of aesthetic methods within nursing practice and education.     

Organization aesthetics in nursing homes

hujala a. & rissanen s. (2011) Journal of Nursing Management 19 , 439–448
Organization aesthetics in nursing homes Aim The aim of this study was to make visible the material dimensions of nursing management. Background Management theories have mainly ignored the material dimensions, namely the physical spaces in which management actually takes place as well as the physical bodies of organization members. The perspective of organization aesthetics enhances our understanding of the role of materiality in nursing management. Methods The data were collected in 2009 using observation and interviews in eight nursing homes. Qualitative content analysis with critical interpretations was used. Results Three main issues of organizational aesthetics related to nursing management were identified: (1) the functionality of working spaces and equipment; (2) the relevance of ‘organizational’ space; and (3) the emotional–aesthetic dimension of daily work. Conclusions Materiality is closely related to management topics, such as decision-making, values and identity formation of organizational members. Aesthetic dimensions of care are constructed by management practices which, in their turn, influence the nature of management. Implications for nursing management Nurse managers need to be aware of the unintended and unnoticed consequences of materiality and aesthetics. Space and body issues may have considerable effects, for example, on the identity of care workers and on the attractiveness of the care branch.     

Dialectical Analysis Concerning the Rational Aspect of the Art of Nursing

It is often claimed that nursing is both a science and an art. Science, it is argued, involves a rational process in which empirical findings are used to determine what is the case. Art, on the other hand, is associated with creative and intuitive activities. The author steps back from this position and examines the question of whether the art of nursing is properly conceived as involving a rational aspect. The study upon which this paper is based involved the analysis of a discourse contained in the work of 43 nurse scholars, published between 1860 and 1992. A philosophical approach is used to examine two contrary positions regarding the place of the rational aspect in relation to the art of nursing. The analysis attempts to expand the discourse by delineating questions and concerns that, as yet, have not been fully considered.     

住院病员对护理美学的要求

笔报道住院病员对护理美学的要求，阐述其内容有：环境舒适，心理舒适，社会舒适的护理美学要求，保持病人良好的自我形象的护理美学要求，信息交流和人际沟通的护理美学要求；护理技术操作的护理美学要求，并制定实施措施，以满足患对护理美学的要求。     

Aesthetics in Nursing Practice and Education

Nursing's historical commitment to holistic ways to come to know and understand through multiple modes of awareness necessitates an expansion of nursing assessment, intervention, and educational strategies. Aesthetic modalities in nursing practice expand our understanding of the human condition of the clients for whom we care and enhance our awareness of the meaning of being alive in health-illness situations. As a method of assessment and intervention, aesthetics provides unique means through which clients and nurses can explore personal perceptions of aspects of their world and fosters a creative sense of self-awareness. It is proposed that aesthetic techniques in nursing practice and education bring forth unique patterns of understanding that defy conventional communication and nursing therapeutic techniques. Further, the use of aesthetics in nursing practice begins during the educative process. The incorporation of aesthetic knowing into nursing education fosters caring, compassion, and fluidity in practice.     

Can the underlying principles of art be applied to nursing?

It is a common assumption that nursing is an art, yet the art of nursing is a term for which there is little definitional agreement and understanding. Problems surrounding the art of nursing are rooted in dilemmas connected to philosophical issues and ideas, as well as the strong value associated with science. The concept of art is embedded within many theories and distinctions, for which there is no consensus of opinion. This article reappraises the literature on the artfulness in nursing, and by examining aesthetic theories, offers a different perspective to that of considering the existence of an art of nursing as a foregone conclusion.     

Preceptorship: shaping the art of nursing through practical wisdom

With so much emphasis having been focused on the development of nursing science and most recently on evidence-based practice, little attention has been directed toward the art of nursing or the practical wisdom that constitutes the spirit of that art. Practical wisdom is the performance of actions intended to preserve and enhance the well-being of others regardless of the context or circumstances involved. Although technically and from a knowledge perspective, nurses consider the most effective and efficient way to administer care, it is through their use of practical wisdom that they actually engage in the art of nursing to provide that care. Because preceptorship is so pivotal to influencing students in the way they approach their nursing care, this approach to teaching-learning in the clinical environment provides an excellent modality by which to cultivate practical wisdom and ultimately to shape the art of nursing.     

Introduction to nursing aesthetics

Empirical, aesthetic, ethical, and personal knowing are the four fundamental patterns of knowledge inquiry. Of these, the aesthetic knowing pattern is least discussed in nursing literature. This article discusses the definition of nursing aesthetics; its utilization in practice; and correlations between aesthetics and clinical practice. One of the advantages inherent to nursing is its ability to deliver skillful care directly to patients. Skillful performance is essential to reduce discrepancies between goals and patterns. Aesthetic nursing addresses more than the form of nursing. It further addresses the crucial elements of nursing knowledge. The science of nursing is influential in its ability to attain harmony among abundant empiric content, power of beneficence, and pleasure of aesthetic experience. In clinical practice, nurses can employ aesthetic nursing through various channels to create meaning and promote the professional image of nurses. Concepts listed in this article may be utilized in clinical supervision, practice and education.     

Intersections of the arts and nursing knowledge

The arts and nursing are profoundly connected. While the relationship between nursing and art has persisted over time, the majority of nursing scholarship on the arts has historically centered upon the art of nursing practice and the cultivation and application of aesthetic knowing. However, there is a burgeoning use of arts‐based strategies is nursing education, research, and practice. Correspondingly, there is a need to understand how such approaches can uniquely contribute knowledge to the nursing discipline in order to support arts‐integration for nursing scholars. We structure our inquiry into arts’ contributions according to two dominant methods of engaging with arts‐based strategies: knowing about (e.g., phenomena) vis‐à‐vis art‐viewing, and knowing through (e.g., embodied knowing) vis‐à‐vis art‐making. In doing so, we explore critical contributions of art to nursing research and educational practices, including arts’ capacity to augment traditional research and communication approaches, democratize the research space, challenge issues of representation, and facilitate education, dissemination, and reflexivity.     

Toward an understanding of art in nursing.

The art of nursing is a term on which there is little definitional agreement. Nursing includes both artistic and scientific traditions; at times, the balance between these two approaches is an uneasy one. An examination of aesthetics offers a perspective to ground practice in nursing art through John Dewey's philosophy of art as experience. Differences and similarities between science, art, and craft are examined. Nursing art is defined as helping patients create coherence in lives threatened by illness and change.