Embedding the Humanities into Nursing Education

*Mei-Yu Yeh*

## **Abstract**

Humanistic education in nursing began in the 1980s. At that time, nursing education emphasized the human being and regarded each person as a unique individual with potential. However, modern developments in medical technologies and changes in the health-care environment have led to a trend toward dehumanization of the healthcare industry. Various developments, particularly in genetics, have raised issues related to human dignity, value, and ethics. The development of a humanized care model based on both scientific principles and a humanistic ideal has become an urgent issue in today's professional nursing education environment. A humanistic education in the nursing profession will allow nurses to develop a broader perspective, to cultivate insight, to understand and to feel the unique experience of patients, and to look at problems from multiple perspectives, especially in complex situations. The challenge of today's nursing education is using multiple teaching strategies to improve humanistic cultivation of humanities education in the nursing profession.

**Keywords:** cultivation, humanities, humanistic education, nursing, nursing education

### **1. Introduction**

In addition to the COVID-19 pandemic severely affecting healthcare services worldwide, the innovation of high-tech and precision medical resources in the twenty-first century has also greatly improved. This improvement and innovation will also change the future medical care environment and trends [1]. Moreover, the nursing profession in this new era of information and biotechnology development has been affected by technological developments and is bound to continue to be affected by ever-changing scientific and technological achievements, of which genetics raises issues related to human dignity, values, and ethics [2]. Rapid changes in medical technologies have resulted in dehumanization of the healthcare industry [2]. Although compassion is a core value of the nursing profession, the decline of compassion in the broader medical environment has led to a similar decline in this core value in the nursing profession. The nursing profession will face unprecedented challenges if nurses cannot embody empathy and compassion when caring for patients [3]. How to develop and provide a humanized care model based on science and humanities has become an urgent issue in today's professional nursing education [4–6].

The value of humanistic education to the nursing profession is to provide an affective experience of humanity, care, and esthetic appreciation; to develop broader perspectives; to cultivate insight; to help nurses understand and feel the unique experience of patients; and to look at problems from multiple perspectives, especially in complex life situations. The challenge of today's nursing education is how to use multiple teaching strategies to improve humanistic cultivation in the nursing profession's humanities education. However, modern nursing education focuses on acquiring professional knowledge and ignores cultivating a humanist spirit. In order to help nurses, adapt to the rapidly changing medical environment and express professional and humanistic caring, the six Es framework (Example, Explanation, Exhortation, Environment, Experience, and Expectation) should be promoted in humanisticnursing education [3, 6].

### **2. The meaning of "Humane" or the "Humanities"**

In Confucian thought, the term "humane" connotes benevolence, righteousness, morality, and etiquette. These characteristics regulate the relationships between "people and themselves," "people and others," "people and society," "people and nature," and "people and the supernatural." Compared with the East's Confucian humanistic thinking, the West was very eager to get rid of the bondage of God during the Renaissance, develop humanism, and establish thinking with "people" as the central concept. At that time, it followed the example of ancient Greece and Rome, focusing on the Seven Liberal Arts (grammar, rhetoric, dialectic, arithmetic, geometry, astronomy, and music), and advocating liberal education [7].

From the perspective of historical development, this can be called "humanistic education." After the Renaissance and the Reformation, the core value of humanism, with people at the core, remained unchanged. Comparing the aforementioned connotations of the "humanities" and "humaneness' in the East and the West, humanistic thought in the East is influenced by mainstream Confucianism, emphasizing the "interpersonal norms of benevolence, righteousness, morality, etiquette, and ethics." By contrast, Western humanities take "people as the main body of thinking" and centers on people as the thing to be valued. In short, humanity includes three aspects. The first aspect refers to human thinking, which involves respecting oneself and the value of human life. The second aspect refers to the viewpoint of inter-subjectivity between human beings, emphasizing that people should respect each other. The third aspect refers to the establishment of a harmonious relationship between people and society [7].

Humanitas in Latin means humanity and upbringing. Humanistic care is the exercise of the humanistic spirit and having a humanistic spirit is having the ability to become attached to others and to have the courage to love and care for people. It includes the ability to be inspired to change thoughts or behaviors and to connect with others and make them feel the power and mystery of life [8]. Humanistic literacy regulates relationships between people of various ethnic groups, cultures, genders, and beliefs. Humanistic literacy can make up for aspects that science cannot cover, including encouraging critical reflection on technology, preventing overspecialization, and arresting tendencies toward dehumanization. Humanities and social sciences can include literature, art, philosophy, history, sociology, ethics, etc. Literature and the arts provide opportunities for individuals to describe their feelings and observations to understand suffering, the situations of others, and the essence of human nature. It can also heighten insight into other people's responsibilities and improve the core

*Embedding the Humanities into Nursing Education DOI: http://dx.doi.org/10.5772/intechopen.110615*

competencies of caring, such as observation and analysis, empathy, self-awareness, and reflection [9, 10]. Throughout history, nurses have established their profession's position and role in society and confirmed the value of their contributions. Sociology helps to understand the nursing profession's place in a cultural and social context and the effect of culture on healthcare behaviors [11]. Ethical inquiry helps nurses cultivate their moral sensitivities and become practitioners of reasonable care [12]. When the humanities and social sciences are integrated into professional teaching, the improvement of humanistic literacy will naturally give rise to a uniformity in the actions of nursing staff and realize the purpose of humanistic education [13].

### **3. Importance of humanities education in nursing**

Humanities are one of nursing's professional competencies. Nurses must have a human touch to ensure the physical and mental well-being of patients. In the process of patient care, nurses must have humanistic literacy to see the human side of the patient; reflecting and implementing humane care are the basis for the physical and mental healing of patients and is one of the nursing profession's core values. Therefore, a lack of compassion in nursing education may lead to clinical care being dominated by a conception of patients as mere objects to be subjected to medical instruments and procedures without any voice of their own [3]. Therefore, nursing staff must develop the ability to be aware of the unique experiences of patients [14]. In addition to teaching professional knowledge, nursing education should cultivate compassion to assist nurses to be empathetic [15, 16]. When nurses face the humanistic needs of care recipients, they use their emotional awareness and reflection to develop a sense of themselves and their patients' life stories. It is necessary to activate the energy of humanistic nursing care through systematic teaching strategies [17, 18] to enhance nurses' cultivation of humanism in their own lives and express the humanistic spirit of caring, concern, and compassion in nursing [8, 19].

Calman pointed out that allowing nursing students to experience other people's life experiences can increase their own sensitivity to others' suffering [20–23]. Reflecting on their own and their patients' life stories can help nurses to be more compassionate. Through empathy and reflection, nursing students can enhance their understanding of patients' life experiences, promote empathy, and improve their literacy to face complex situations [9, 10, 24–26]. Then, nursing students can internalize the characteristics of humanistic care. William Osler, the father of American medicine, believed that a good doctor must possess the humanistic qualities of the 3Hs: humility, humanity, and humor. These three humanistic qualities align with society's expectations for humanistic medical care [27]. Humanistic care is a core value of the nursing profession. A qualified nurse must be able to empathize with patients and understand their unique life experiences. Only a compassionate nurse can care for patients and provide humane care [28]. The nurses that impress patients the most are those who are respectful, empathetic, caring, professional, sensitive, and enthusiastic [3].

Through qualitative in-depth interviews, Yeh found that for the nursing profession, the essence of nursing humanities includes caring, respect, enthusiasm, and professional sensitivity. Among these, "caring" is the most important humanistic-nursing characteristic, which refers to having "empathy" or "sympathy" and being able to "show compassion from the heart." In addition to caring, respect is essential in the nursing profession because respect is the process of interaction; respect can correct an indifferent attitude and show self-discipline and politeness. Furthermore, a qualified

nurse must possess professionalism sensitivity. In addition to having professional knowledge and skills, nurses also need to observe keenly, synchronize with patients, be emotionally present, understand, and interpret the patient's body language and nonverbal meanings, and help solve the patient's problems in a timely manner. At that point, the beauty of nursing humanities will also be fully displayed [29].

The development of the nursing profession should focus on humanistic education and be committed to caring for the whole human being. Nursing professionals must empathize with patients to help them. Understanding a sick "person" goes beyond reading instruments and performing routines; it involves perceiving a truly complete and living "person" with pain, expectations, and anxieties. In addition to the scientific and objective understanding of "disease," the understanding of "human beings" must rely on subjective life experience and feelings, putting oneself in the shoes of others, empathizing with them, and treating patients professionally and confidently with humanity and wisdom. Therefore, the meaning and substance of humanities are emphasizing human dignity and value, and the "human being" is the main body of scientific knowledge [3].
