Creative nursing: processive care and more?

The authors describe a crisis point which led them from considering a reorientation of the present BSc (Nursing) curriculum at the University of Cape Town, South Africa to undertaking a radical revision of the degree programme. While examining final year students they realized that the nurses' excellent personal qualities apparent in everyday relationships, were not being used in their professional practice on hospital wards. It is suggested that this is due partly to an educational programme which neglected what the students already had (common sense and logic) and what they already knew from life experience and from instinct and intuition. It is also supposed that when hospital wards are their first clinical learning areas, nurses divorce patients and disease from the 'real' world, from the essentials of daily living and from the components of an individualized lifestyle. A staged process of learning experience, to include looking after healthy, elderly and disabled individuals in homes and institutions--with minimal nurse supervision--before exposure to hospital life, is advocated. In its present form the nursing process is seen as limiting the creativity of nursing practice and the authors suggest that further development of this approach is necessary if nursing science is to be interpreted as an art. Finally, the authors outline an experimental curriculum which takes cognisance of their experiences and syllogistic reasoning, together with a brief description of the first few months of its implementation at the University of Cape Town.