The registered nurse is constantly bombarded with information regarding the patient, but knowing what are the important considerations at the time, is where the ‘art of nursing’ will thrive. The science part of nursing stems from lab values, known pathology of disease and vital signs. Note, all of these values must be interpreted and decisions made for care from them, along with the nurse’s sense of what the patient’s needs are. When a nurse learns to combine the science of nursing with the art of nursing, it is then he and/or she will succeed in carrying out her duties as a registered nurse and be a strong advocate for there patients.

Conclusion-

  With the advancement of medicine, evidence-based nursing has become specialized in order to keep up with the high demands of their physician’s based practice. There are more demands placed upon the registered nurse today with a higher proficiency placed on the nursing staff. As demand are growing for an aging generation, more is expected. Therefore, the nurse must keep his and/or her skills in-tune regularly, just as you would change the oil in your car. Remembering, at all times your evidenced-based reasoning skills in applied nursing. Also, take heed as recorded thousands of years ago, “…For he who hath an ear, let him hear…” 15 Become a patient pro-advocate, listener, and counselor , applying research evidence to a specific patient in a particular clinical or hospital setting through clinical expertise and fitting patient values to medical intervention.

  The word ‘nursing’ now becomes a verb of action with “…the ability to solve problems by making sense of information using creative, intuitive, logical and analytical mental process… “ 16 Also, the wisdom in dealing with particular individual patients, specific needs, and detail of practical cases or actual situations. Therefore, as a critical base, you will learn to think outside the box.

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1. Dept. of Philosophy, Univ. of Guelph. Logic Outline  7th ed, rev. Guelph, Ontario, Canada:  Univ. of Guelph; 2006
2. American Association of Respiratory Care (2005). Clinical practice guidelines: Respiratory Care, 38, 495-499.
3. Fuller, J. & Schaller-Ayers, J. (2004).  Health assessment:  A nursing approach (4th ed.). Philadelphia:  Lippincott Williams & Wilkins.
4. Seidel, H,M., al. (2004).  Mosby’s guide to physical examination (5th ed). St. Louis:  Mosby.
5. ACC/AHA Task Force on Practice Guidelines (2005) ACC/AHA Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmic Devices. American College of Cardiology Foundation and Amer. H. Assoc. Inc. (2009) review, www.acc.org/clinical/guidelines/pacemaker.
6. ACC/AHA 2008, Guidelines Update for the Management of Patients with Unstable Angina. American College of Cardiology Foundation and Amer. H. Assoc. Inc.  www.acc.org/clinical/guidelines/unstable.
7. (2009) ACC/AHA Guidelines Update for cardiac exercise testing.  Circulation 136: 1884-1892.  www.acc.org/clinical/gudelines/update/exercise/summary  2007.
8. K.L. McCance, S.E. Huether editors (2008) eighth edition. Pathophysiology, Mosby, Inc.  St Louis, 1445-1520.
9. G.D. Goldberg, PhD (2008) Critical Thinking for Registered Nurses in Assessment, Angeles College of Nursing (State Approval for Licensing and Examination for Medical Professional 2008).
10. Murphy, E.A. The Logic of Medicine 4th ed.  Baltimore, Md:  The John Hopkins University Press; 2001 cited from www.acc.org/clinical/updated (2008).
11. Feinstein, A.R. Clinical Judgment.  Baltimore, Md:  Williams & Wilkins Co. 1970 ed.  Cited from a (2007) abstract on Nursing Skills and Assessments @ www.ameri.nursing.assoc.com// 
12. Copi, I.M, Cohen, C., Introduction to Logic.  12th ed. (2005) Upper Saddle River, NJ:  Prentice-Hall.
13. Schaffner, K.F. Philosophy of medicine. In Conscise Routledge Encyclopedia of Philosophy. London, England: Routledge; 2004.  Cited: New England Jour. of Med. Vol.358 No.5 (2007) www.nejm.org/
14. Wolpert, L. Science:  an unnatural practice.  The Samuel Gee Lecture 1995. J.R. Coll Physic Lond. 2006; 40:155-160
15. The Holy Scriptures, according to the Masoretic Text.  The Jewish Publication Society 2007 ed. Psalms 17: 1-5. Also, The KJV (1611 version) Rev. 3:22.
16. Davis, F.D. Clinical Reasoning, and Pellegrino’s philosophy of medicine.  Theor Med Bioeth.  2005; 24: 178-190.

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Short Bio of Dr. Gary D. Goldberg, PhD 

Over 30 years experience in the Medical field, At UCLA and Pacific Hospital of the Valley, as a Chief Technologist and Analyst, Visiting Professor and Instructor for continuing education at UCLA School of Nursing and Writer/Speaker at the School of Medicine from 1978-2008.

From 2003-2008 Dr. Goldberg has collaborated and published through Blackwell Publishing Co. (Medical Division) and Journal of Americana College of Cardiology plus 15 published abstracts with UCLA Dept. of Bio-Medical Engineering and the Dept. of Cardiology.

Current title, Clinical Professor of Medical Education with Angeles College of Nursing, in Los Angeles, Ca.

Dr. Goldberg has written two major academic course textbooks for Angele College of Nursing and has represented advanced nursing education course curriculum through the State Dept. of California and approved by the ANA for CEU(s) and the AMA CMU Level 1 Credit for physicians.

Also, Dr. Goldberg is currently an adjunct Professor for Kaplan University (Owen by the Washington Post Inc.) South Florida, in the Dept. of Health and Science plus the Dept. of Humanities.

Cindy L. Capute, has been a registered nurse for over 20 years and has managed a 300 bed acute care facility with over 200 professional nurses from RN’s through CNA in the Los Angeles area. She keeps her ear in-tune with up-to-date nursing data and advancements in medical education. She has co-authored with me in 2005, paper presented to the Cardiology-Electrophsyology Research Group that has changed the dynamics of elector-static reading with regards to acute atrial anomalies. This finding allowed me to publish the Goldberg Protocol for Cardiac placements in the field and under clinical supervision using a tilt-table and the 12 +3 Leads or the vector poisoning for additional cardiac patient information.

To reach Dr. Gary D. Goldberg, please use e-mail address: g.goldberg@live.com or admin@angelescollege.com or to speak with his wife a Clinical ADA nurse with the Kaiser Permanente Foundation Inc. Cindy L. Capute, BSN, RN through her e-mail at clcap@msn.com or cindylcapute@kp.org

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