Donna Frost

Chapter 6 196 back pain is not unsatisfactory. Yet practising in this more instrumental way would have felt unsatisfactory to Margaret. Although an outsider may have described her approach as ‘going the extra mile’, for Margaret it is just the way she approaches her professional work. When discussing this aspect of professional artistry we often referred to the difference between giving adequate care and giving care that met our own standards. The guideline forms an important framework, but it is not the ‘whole’ truth. It is not all there is. Fulfilling the demands of the guideline is not the same as achieving fulfilling practice. (AafjeNPI-Mtg 4 -Rec 3 of 5 ) ‘First do no harm’ is very limited – good beginning but too limited for me – I want to do GOOD. (JanNPI-Mtg 12 -Rec 4 of 8 ) Patients, family members and residents made remarks in similar vein. They have their lists of course. Everyone has those lists. She [Jane] didn’t have a list but she got to the nub. (RNI- 2012 Fam 04 Con-p 6 ) It’s not that the hospital gives bad care you know, it is all very good. Everyone does their best. Some achieve more than others you know? She [Anna] is one of those. (NPI- 2014 Fam 03 Con-p 13 ) Working in this way required a commitment to one’s ideals, and the ideals of one’s profession, often in the face of contexts in which such ideals are espoused but not really promoted. The commitment holds true for the relationship with the patient as well. During the NP inquiry there was a lot of data generated and discussion held about those situations in which things do not go easily, or do not go well. We concluded that professional artistry resided in the not giving up, in the “ hanging in there ” (NPI-Mtg 8 -Rec 5 of 5 ), in findingways to maintain or rebuild the relationship, for example, or in ensuring the patient was appropriately supported and helped, even if by somebody else. A nurse demonstrating artistry does not abandon the patient to their despair or hopelessness, and does not leave problems unaddressed, once identified.