Donna Frost

Chapter 8 252 In the pattern of engagement described in Chapter 6 as ‘Committed to the ideal’, the nurse practising with professional artistry is less concerned with meeting the immediate, instrumental goals, or completing particular activities, although these things are attended to, and more concerned with meeting broader goals, such as contributing to wellbeing and creating the conditions for human flourishing. Aiming for the ideal, going the extra mile, not being satisfied with meeting the immediate, simpler goals of the interaction, are aspects of professional practice that are discussed in some of the literature around professional expertise (Charness & Tuffiash, 2008 ; Alderson, 2010 ; Ackerman, 2014 ) and mastery (Bennink, 2008 ; Ladkin, 2008 ; Donders & Sommer, 2012 ). Bereiter and Scardamalia ( 1993 ), for example, argue the idea that instead of reducing complex practice problems to their most simple and easily dealt with form, particular kinds of experts are able to perceive and deal with the more overarching goals, those concerning human interests. Such experts are concerned not with practising satisfactorily, but in practising with excellence. Gastmans and Dierckx de Casterlé ( 2000 ) too highlight the moral and ethical imperative of excellent nursing practice and discuss paying attention to ascertaining the patient’s goals as a person and not as a patient. This is furthermore in line with aspects of nursing expertise as presented, for example, by Hardy et al. ( 2009 b) and Phelan and McCormack ( 2016 ) and with the outcomes aspired to within person-centred practice (McCormack and McCance, 2016 ). Being committed to the ideal, then, involves commitment to one’s ideals as a nurse, to the ideals of the profession, and to the human interest goals of the patient. Several key aspects of professional artistry as presented in Chapter 2 are therefore recognisable in this pattern of engagement. The complex and challenging practice situations in which professional artistry often occurs mean that the practitioner is faced with a plurality of reasonable responses (eg. Beeston and Higgs, 2001 ; Cowan, 2007 ), so that a decision requires discretion and professional judgement (eg. Wright, 2004 ; Lehmann, 2008 ; Smith et al., 2011 ; Williams and Paterson, 2009 ; Titchen, 2019 ). Active experimentation or dialogue with the social and clinical situation, using one’s whole self, helps in making that judgement (cf. Klemola & Norros, 2001 ; Grainger, 2003 ; Stockhausen, 2006 ; Titchen et al., 2007 ). The theory and ethical principles of nursing helpeddefinewhatwas appropriate andmeaningful in the nursing encounters observed and investigated within the CCCI (cf. Andresen and Fredericks, 2001 ; Beeston and Higgs, 2001 ), supplying a set of principles and professional goals (cf. Conway, 1996 ; Cherry and Higgs, 2011 ; McCormack and Titchen, 2014 ). Such frameworks did not act as a blueprint or restraint however. When demonstrating professional artistry the nurses balanced competing interests