The Art of Nursing:
Commentary on Nursing and Creative Health.
Creative health improves wellbeing, yet access remains unequal (NCCN 2024, Buse 2024). Nursing, as the largest health workforce, (WHO 2025) is uniquely positioned to bridge this divide by embedding creative health within everyday care. Drawing on Florence Nightingale’s publications on the art of nursing, Allen’s work on invisible work of nurses (2015), research on the arts and health (Stickley and Clift 2017), and our doctoral research Lynch (2022) and Clancy (2025) we at Art of Nursing.co.uk propose that creativity is integral to 21st century nursing, education, practice and to public health.
We practice what we preach and teach.
Art of Nursing webinars (Lynch 2025a) in partnership with Foundation of Nursing Studies and the Royal College of Nursing bring nurses and artists together to share their work.
A 2026 Kensington Palace art competition and exhibition entitled Nurses, Being Seen, Being Heard, Being is being planned for May 2026.
A nurses creative health special interest group (SIG)has been set up and is hosted by the NCCH. Our first webinar on ‘What is Creative Health? Is planned for 17th December 2025.12.30 -13.30
A community of practice is planned.
Why does this matter to nursing?
Evidence and policy support creative health and arts-based approaches to wellbeing, (Fancourt and Finn 2019, NCCN 2024) showing how this approach improves mental health, supports social connection, and contributes to recovery. Yet despite this evidence, access to creative health remains inequitable due to discrimination, socio economic barriers, systematic and structural barriers, lack of representation and cultural sensitivity, stigma and internation barriers (Buse 2024), and nursing’s role invisible due to a future focus on visible skills and technological advances (Lynch 2025b).
Much of the population may miss out on the benefits of creativity for health and wellbeing, despite evidence that such interventions could make a significant difference in prevention, resilience, and recovery if the workforce already trusted and skilled is not included in the plan for creative health. Nursing is the largest healthcare workforce in the UK and internationally (WHO 2025), and it is consistently ranked as one of the most trusted professions (ICN 2025). Nurses work across all communities and care settings, giving them unparalleled reach. This makes our profession well placed to democratise access to creative health. Nurses can role-model and deliver creative practices as part of everyday care, reframing creative health as a core component of public health and health promotion.
However, the connection between nursing and creativity is not new. Florence Nightingale (1969) understood the role of environment in healing light, sound, air, and surroundings as well as the importance of beauty and art for recovery. These considerations prefigured what we now call creative health. Likewise, the invisibility of nursing work (Carper 1978, Allen 2015) and highlights the aesthetic and relational and often unrecognised labour that underpins healthcare systems. “There is little that moves in healthcare that does not pass through the hands of a nurse.” (Allen 2015).
In addition to supporting public health initiatives, arts-based approaches can illuminate and honour this hidden work, making the contributions of nurses more visible.
Nursing has always carried a strong ethos of compassion, presence, and care. Arts practices align naturally with these values. The ability to hold silence, to listen deeply, and to create space for another person’s story are as much dramatic and creative acts as they are clinical. Nurses also face burnout, moral injury, and identity erosion leading to recruitment and retention issues (WHO 2025), and creative practices offer a form of such protection.
The arts enhance the therapeutic relationship and restore meaning, for both patient and nurse and such work will be visible in the exhibition. Creative health in nursing therefore also generates social value by sustaining the very workforce on which healthcare depends.
Whilst evidence (Fancourt and Finn 2019) and the APPG recommendation that creative health training should be included for health professionals, (NCCN 2024) help, the creative work of nurses is still invisible. We are making it visible. Current policy and practice recommendations align directly with the new definition of nursing, our scope and ethos (ICN 2025). By embedding creative health into nursing education and practice (Ridgeway et al. 2025) , nurses can address inequities in access and expand the reach of creative approaches to all. We are starting by raising awareness by linking nurses ,artists and creative health together.
How are we doing this?
The Art of Nursing is a series of 11 webinars exploring creative approaches to nursing (Lynch 2025a). The forthcoming exhibition at Kensington Palace, Nurses: Being Seen, Being Heard,. Being, will highlight nursing’s artistic and cultural dimensions, showcasing how the profession has historically integrated creativity and aligning the content to the current NHS Fit for Future Plan (NHS 2025) and forthcoming NHS Nursing and Midwifery Strategy.
Alongside these creative activities to support public health and professional wellbeing we are forming a nurse creative health special interest group and community of practice. In partnership with the NCCN we aim to showcase and support creative health in nursing. This will provide the structure needed for professional visibility, collaboration, learning, and advocacy. It will enable nurses to be a more visible and contributory part of the global momentum of creative health. Please contact us if you would like to contribute.
The invisibility of nursing must be challenged and the human element of care valued. By connecting creative practice with nursing scholarship, we shine a light on the intellectual, relational, and imaginative dimensions of our profession and contribute to a new way of knowing and a new professional narrative.
The emergence of artful intelligence ™ alongside artificial intelligence in health will keep the human in the non human health systems. Artful intelligence™ (Lynch 2025b) includes creative health. It is a conceptual framework that reclaims the relational, ethical and aesthetic and narrative dimensions of nursing in response to the growing influence of artificial intelligence (Lynch 2025b) to improve patient care and strengthen the identity and resilience of the 21st century nurse workforce.
By drawing on experts and advocates Nightingale (1969), Carper (1978), Crawford et al. (2015), Stickley and Clift (2017), Lynch (2022, 2025a, 2025b), and Clancy et al, (2025), and integrating creative health into education, policy, and service delivery, nursing can be champions of and a key part of the creative health evolution and health and wellbeing transformation. And ensure creative health initiatives are available to all.
Creative Health, Equity, and 21st Century Nursing.
Creative health demonstrably improves wellbeing, yet access remains unequal (NCCN 2024; Buse 2024). Nursing, as the largest health workforce (WHO 2025), is uniquely positioned to bridge this divide by embedding creative health into everyday care. Drawing on Florence Nightingale’s reflections on the art of nursing, Allen’s (2015) analysis of nursing’s invisible labour, the arts and health scholarship of Stickley and Clift (2017), and our own doctoral research (Lynch 2022; Clancy 2025), we propose that creativity is integral to 21st-century nursing, its education, practice, and contribution to public health. We practice what we advocate and putting creative health in nursing.
Through Art of Nursing webinars (Lynch 2025a), delivered with the Foundation of Nursing Studies and the Royal College of Nursing, Marion Lynch has created spaces where nurses and artists exchange practices and perspectives. Looking ahead, a 2026 Kensington Palace exhibition, Nurses: Being Seen, Being Heard, Being will bring the art work and health work of nurses together and align this with the NHS Fit for the Future (DHSC 2025) priorities. This, alongside the establishment of a nurses’ creative health special interest group and community of practice, will further amplify the profession’s creative dimensions. This is this time for creative health nursing to shine.
The policy landscape already affirms the value of creative health. Evidence shows its capacity to support mental health, strengthen social connection, and aid recovery (Fancourt and Finn 2019; NCCN 2024). Yet access for all is an issue. Creative health remains inequitable, shaped by discrimination, socio-economic barriers, structural exclusions, cultural blind spots, stigma, and international divides (Buse 2024). Nurses can help. Nursing’s role is often obscured by a narrow future focus on visible skills and technological advances (DHSC 2025, Lynch 2025b), risking missed opportunities to harness the workforce most trusted by the public (ICN 2025) and most present in people’s lives. We are more.
Florence Nightingale (1969) understood the healing influence of light, sound, air, and beauty, what we now call creative health. Carper’s (1978) aesthetic way of knowing, and Allen’s (2015) reminder that “there is little that moves in healthcare that does not pass through the hands of a nurse,” illuminate what is often invisible to others, the relational, and imaginative labour of nursing. Arts-based practices can make this visible.
Compassion, presence, and care have always been at the heart of nursing; the arts sit comfortably within this ethos. Holding silence, listening deeply, or making space for a story are creative as well as clinical acts. In turn, creative practices buffer against burnout, moral injury, and identity erosion (WHO 2025), sustaining the workforce on which healthcare depends. For patients and nurses alike, creativity restores meaning and strengthens the therapeutic relationship.
Despite strong evidence (WHO 2019) and policy recommendations that health professionals should receive training in creative health (NCCN 2024), nurses’ creative contributions remain overlooked. Our work on creative health in nursing seeks to make us visible and provide the evidence and opportunity to make nurses and nursing heard in creative health circles and ,make a difference to public health. By embedding creative health into nursing education and practice (Ridgeway et al. 2025), we can address inequities and democratise access. We are doing this in a number of ways.
Through the Art of Nursing webinar series (Lynch 2025a), the Nurses: Being Seen, Being Heard, Being exhibition, and the formation of a creative health community of practice, we are beginning to link nurses, artists, and policy together.
The Art of Nursing movement aligns directly with the new definition of nursing and its scope (ICN 2025), as well as with national strategies such as the NHS Fit for Future Plan (DHSC 2025). It also offers a framework for a sustainable workforce future. Lynch’s conceptual model of Artful Intelligence™ (Lynch 2025b) reframes the relational, ethical, aesthetic, and narrative dimensions of nursing alongside the rise of artificial intelligence. In doing so, it ensures that the human remains present within increasingly non-human health systems.
By drawing on foundational and contemporary scholarship (Nightingale 1969; Carper (1978); Crawford et al. (2015); Stickley & Clift (2017); Lynch (2022, 2025a, 2025b) and Clancy et al. 2025), and connecting this to education, policy, and practice, we argue that nursing must be recognised as both a champion and a driver of creative health. To democratise wellbeing, we must ensure that the benefits of creative health are accessible for all, and nurses can make this happen.
References
Allen, D. (2015) The Invisible Work of Nurses: Hospitals, Organisation and Healthcare, London: Routledge
Buse K (2024) What are the Barriers and Enablers for Equity, Diversity and Inclusion within the Creative Health Sector? Thesis. https://ncch.org.uk/uploads/Dissertation-EDI-in-Creative-Health-FINAL.pdfWHO SOWN 2025
Carper, B. (1978). Fundamental Patterns of Knowing in Nursing. Advances in Nursing Science, 1(1), 13–23.
Clancy Marie A. , Kight Caitlin R. , Stein Jessica , Glanville Naome , Wilson Anthony C. , Kyle Richard G. 2025 Co-producing a ‘creative toolkit’ to support the mental health and wellbeing of palliative care professionals: a community case study. Frontiers in Sociology. Volume 10 – 2025 https://www.frontiersin.org/journals/sociology/articles/10.3389/fsoc.2025.1488840
Crawford, P., Brown, B., Baker, B., Tischler, V. & Abrams, B. (2015) Health Humanities. Palgrave: London
Fancourt, D., and Finn, S.(2019) What is the evidence on the role of the arts in improving health and well-being?: A scoping review. Copenhagen: WHO Regional Office for Europe
ICN (2025) Renewing the Definitions of 'Nursing' and 'a Nurse New Definition of Nursing. Geneva. https://www.icn.ch/resources/publications-and-reports/renewing-definitions-nursing-and-nurse
Lynch M (2022) In conversation with Marion Lynch. Google Arts and Culture. https://artsandculture.google.com/story/in-conversation-with-marion-lynch-paintings-in-hospitals/CQVBy3R0zOUzDw?hl=en
Lynch M 2025a Reflections on the art of nursing. FONS Blog https://www.fons.org/blogs/reflections-on-the-art-of-nursing/
Lynch M 2025b Nurses’ role in a digital world. How to stay human in a non human world.
https://www.rcn.org.uk/congress/congress-events/nurses-role-in-a-digital-world-2025
NHS (2025) Fit for Future. 10year plan. DHSC. @dhsc.gov.uk ISBN 978-1-5286-5807-2
NCCN (2024) Creative Health Review https://ncch.org.uk/creative-health-review
Nightingale, F. (1969). Notes on nursing. Dover Publications.
Ridgway, V., Skyrme, S., Henshaw, R., Blain, J., Devine, J., Mitchell, D., Duffett, M., & McHale, R. B. (2025). Creative Health a joke or valuable learning experience; A mixed methods study. Nurse education today, 148, 106628. https://doi.org/10.1016/j.nedt.2025.106628
Stickley T and Clift S 2017 Arts Health and Wellbeing. A Theoretical Inquiry for Practice.. Cambridge Scholars Publishing. Newcastle upon Tyne.
WHO (2025) State of the world's nursing: investing in education, jobs, leadership and service delivery. Geneva: World Health Organization;
Reclaiming the Art: A Theoretical Framework Integrating the Art of Nursing into 21st-Century Care through Creative Health
Nursing’s Enduring Duality
Nursing has always been a profession suspended between two worlds: the scientific and the artistic. It is, as Florence Nightingale declared, both the application of knowledge and the cultivation of character. The science of nursing demands precision, evidence, and accountability; the art of nursing demands empathy, imagination, and moral presence. Together they form the whole. Yet in the 21st century, an age characterised by algorithms, automation, and artificial intelligence (AI), this delicate balance is under threat.
Across healthcare, AI systems promise transformation (DHSC 2025). They shall predict patient deterioration, personalise treatments, and reduce administrative burden (Robert, 2019). In nursing, AI is being woven into triage, documentation, and education, shifting the cognitive labour in nursing from human activity to machine activity (Martinez-Ortigosa et al., 2023). But as these nursing digital systems grow more competent, they also risk eroding what AI cannot replicate, the artistry of nursing care, the embodied intelligence in nursing that is the person centredness, the social justice, the presence in a human way that is not always seen, the person that listens, senses, and responds in ways that no code can. The question is, therefore, what is it that only human nurses can do?
The World Health Organization (2023) has warned that large language models, including ChatGPT, “imitate understanding” but do not possess it. They generate language without experience. In contrast, the nurse’s art lies precisely in the human lived experience, being with another person, the knowing when the silence is too long, the speech too short, when sympathetic presence of person centredness matters more than organisational procedure. This is in no way to ‘romance what it is to nurse or to replicate past pastoral or passive ways of working. It is a future professional epistemology grounded in practice. As Benner (2000) wrote, “the wisdom of our practice” resides in perceptual acuity, moral discernment, and the creative negotiation of complexity. This aspect of nursing is not noted so often as the AI aspects, yet it is the aspect of nursing that is most noticing when it is missing.
To ensure nursing remains human in a non-human health system (Lynch, 2025), we must balance the human and the non-human future of nursing and bring artificial intelligence and artful intelligence™ forward in tandem. Artful Intelligence is the term I have developed, to explain the conscious cultivation of aesthetic, ethical, and relational capacities into every aspect of 21st-century nursing. This paper establishes the need for such integration and outlines a plan for action using frameworks from arts and health and creative health policy. The need, in tandem with the fourth industrial revolution is to ensure that the human stays in the non-human system and we as nurses are able and supported to do what AI cannot do.
The Need: What Artificial Intelligence Cannot Do
Artificial intelligence, though dazzling in its computational capacity, lacks the essential qualities that make nursing a human practice. AI can detect vocal tremors that suggest Parkinson’s disease; it can forecast pressure ulcer risk. But it cannot perceive suffering and hold presence. It can provide mental health support; it cannot be the person alongside you. It can model probabilities; it cannot model the unique personal meaning that an illness takes in your life, or the future. AI works on past information not future imagination.
As Weaver (2021) clarified in her concept analysis of the art of nursing, art is not a decorative flourish added to science; it is an epistemic mode of knowing. Art in nursing is expressed by many nurses I speak to, in three simple words. Just be human. This is shown and experienced through empathy, presence, and moral imagination, it is the ability to discern and act compassionately amid uncertainty in partnership with another. These capabilities are what Loaiza and Rigobon (2020) called the five human capabilities that machines cannot replicate: empathy, presence, judgment, creativity, and hope. When I imagine the person with those capabilities I see a nurse. This is why it is useful to look at nursing theories from the past to inform nursing theories and practices for the future as imagine where the art of nursing, and the arts themselves in nursing fit into our future.
Leininger (2012) described caring as the “essence and central focus” of nursing, a cultural and moral phenomenon that binds human beings across difference. Alligood and Fawcett (2017) located the art of nursing within the practice of human care quality, asserting that art involves sensitivity, intuition, and the creative translation of knowledge into a relationship. This is not stipulated as a human relationship, however the question of relational care from robots is yet to be explored and is for another day! These are evidence-based capacities that correlate with better outcomes, greater patient satisfaction, and professional resilience, yet such capacities are yet to be included in any conversations about AI nurses and nursing.
Krick et al. (2020) observed, most studies of AI in nursing focus on efficiency rather than these human outcomes. The metrics that matter most to people, trust, empathy, connection, are the ones least visible to the algorithms being developed to decide what health is, and who needs help. The risk is not that AI will replace nurses, although the automation and augmentation of some care is a concern for many, but that it will redefine nursing around what is measurable, marginalising the art that sustains care.
The Fourth Industrial Revolution: Nursing’s Ethical Crossroads
The Fourth Industrial Revolution is here and is part of nursing. The Fourth Industrial Revolution fuses physical, digital, and biological systems (World Economic Forum (2016). It is reshaping not only work but what it means to be human. In this context, AI is often described as the “new electricity” (Roberts, 2019): an invisible infrastructure powering every facet of modern life. The human skills needed for the future have been defined as criticval thinking, creativity and managing complexity (WEF 2025). The challenge for nursing is therefore how do we develop nurses with these skills who will be able to develop others, deliver care and design safe, ethical, efficient systems all through the 21st century.
For nursing, and to take a creative approach, a parallel with Mary Shelley’s Frankenstein can help. As Marion Lynch (2025) and Cambra-Badii et al. (2021) have noted, Shelley’s story is more than a gothic tale about monsters, it may be read as a tale of about moral responsibility within an industrial revolution. Dr Frankenstein’s creation symbolised science without ethics, innovation without compassion. The same warning applies today in the fourth industrial revolution. If nursing adopts AI without embedding ethics and aesthetics, the understanding of meaning and the use of the arts to help, it risks creating a healthcare system that is efficient but inhuman.
To help guide the ethical approaches in health in the fourth industrial revolution WHO (2021) offers us six ethical principles for AI in health; autonomy, beneficence, transparency, accountability, equity, and sustainability. Nursing already embodies these principles through its codes of ethics and nursing care theories. The challenge, ahead for the future of nursing and nurses is therefore to not just import such ethics for technology into nursing but to export nursing’s ethics into this new technology. This will mean nurses as part of the process to design systems that reflect our relational values and emotional labour as well as our cognitive labour. This could be the future 21st century art of nursing.
Lima et al. (2022) traced a similar logic back to the 19th century world of Florence Nightingale, who viewed nursing as an art grounded in observation, environment, and moral integrity. Her letters to probationers (1897) urged them to “put the patient in the best condition for nature to act upon him”, an approach echoed in social prescribing and creative health approaches in 21st century care.
From Artificial to Artful Intelligence™
In response to this nursing ethical crossroad, artful intelligence™ emerges as a balance to the growth of artificial intelligence in nursing. Artful intelligence ™ is a conceptual and practical framework proposed by Lynch (2025) to complement not compete with AI. Artful intelligence™ is the deliberate use of aesthetic, emotional, and relational knowing to guide nursing practice, education, leadership and research, and guide the application of digital technologies in nursing. It aligns with Watson’s (2008) theory of transpersonal caring, Benner’s (2000) model of embodied expertise, and Leininger’s (2012) transcultural theory of care. Together, these frameworks affirm that the nurse’s presence is both therapeutic and epistemic. The comments from nurses about just being human can be about both the doing of nursing and ;being’ a nurse.
Artful intelligence™ also draws from the evidence base of Creative Health, a movement evidenced and championed by the World Health Organization (2019) and supported by the UK the All-Party Parliamentary Group on Creative Health (2024).
These bodies have demonstrated that participation in the arts improves mental health, social cohesion, and clinical outcomes. There is proof that the arts can improve physical and mental health, and build communities, creating a sense of belonging and wellbeing. The National Centre for Creative Health is co ordinating approaches to such work in health, and collating responses to policy documents to ensure that creative health is integrated into government policies. This has included creative health and nursing. (the briefing for the nursing and midwifery 15 year strategy). This may help form a future 21st century profession for nursing.
The integration of creative health and artful intelligence™ into nursing may sustain the empathic capacities that AI cannot automate (Knop et al., 2024) or reproduce, equip nurses to navigate ethical dilemmas that algorithms cannot resolve, and strengthen a new professional identity that supports critical; thinking skills, managing complexity, using creativity and being human in a non-human health system (Lynch 2025).
As with all such plans, synergy is useful. A familiar and evidenced approach to the implementation and sustainability of technology in health has already occurred and the NASSS framework has been developed. Originally developed to understand why technological innovations in healthcare succeed or fail, it identifies seven interacting domains: the condition, the technology, the value proposition, the adopters, the organisation, the wider system, and the processes of embedding and adaptation. The suggestion here is that, for future nursing thinking, this framework is used to implement and sustain the art of nursing, and the arts in nursing too.
The NASSS framework (Greenhalgh et al., 2017) provides the steps needed to move from artful intelligence™ theory into nursing practice. Applying this framework also reveals how artful and artificial intelligence™ can be harmonised in nursing.
The Artful Intelligence in Nursing (AIN) Framework (Lynch 2025)
Purpose:
To understand and guide how artful intelligence™, leadership, education and practice support the skills needed for 21st century nursing to be adopted, sustained, and integrated into nursing education, practice, and organizational culture.
1. Human Condition. How to be Human.
Nursing deals with “poorly served conditions” (Knop et al., 2024): loneliness, grief, moral uncertainty. To address these, the system must recognise the art of nursing as a clinical competence, and more, a professional way of knowing and being.
Core question: What human experiences and conditions does artful intelligence™ address?
1A. Nature of care context.
The emotional, psychological, and existential dimensions of patient experience.
1B. Cultural and narrative influences.
How and which socio-cultural values, identities, and collective stories shape caregiving, healing and meaning making.
2. Artful Modality: Making the Invisible Visible.
Most AI tools in nursing are still in early development (von Gerich et al., 2022) and rarely consider the invisible labour of empathy and ethical judgment. Embedding artful intelligence™ means co-designing technologies that reflect these values, and examining how the introduction of technologies challenges these too.
Core question: What forms of artful practice or medium are introduced, and how do they improve the quality of care, and caring approaches, engage perception, shift perspectives and expand understanding?
2A. Artistic medium.
Visual arts, music, poetry, performance, reflective writing, or multimodal expressions used in care.
2B. Process and participation.
The relational act of making, witnessing, or engaging in art as a form of meaning-making.
2C. Knowledge generated
Emotional insight, moral imagination, empathy, or aesthetic judgment derived from practice. The radical artful imagination of nursing.
2D. Model of engagement
Whether the artistic process is individual, co-creative, educational or community based.
3. Value Proposition: Balancing Efficiency and Empathy
For technology to be adopted, it must demonstrate value to nurses as well as institutions. AI promises efficiency; artful intelligence™ promises more. Together, they enhance both care quality and professional satisfaction. Creative health metrics, such as measures of person-centredness (McCormack et al., 2025) and wellbeing could be incorporated alongside traditional indicators of productivity.
Core question: What value does artful intelligence™ bring to nursing and care systems?
3A. Intrinsic value.
Growth in empathy, reflection, and human connection within caregivers. Being human in a non-human system. Being a nurse.
3B. Relational value.
Strengthened therapeutic relationships, improved team cohesion, and patient trust. Practising person centred care.
3C. Institutional value.
Reduction in burnout, enhanced communication, and innovation in holistic care delivery. Improving quality of healthcare, and quality of nursing care
4. Adopters: Building Trust and Capacity
Digital mistrust and low AI literacy remain barriers (Virtanen et al., 2021). Education must therefore build not only technical competence but confidence in its use and the ethical aspects of nursing practice it helps and hinders. Artful intelligence™ supports this by grounding new technologies in familiar human values and nursing principles.
Core question: Who engages with artful intelligence™, and what shapes their openness to it?
4A. Nursing professionals.
Our role identity, confidence with creative processes, and openness to reflective practice.
4B. Patients and families
People’s willingness to participate, perceived relevance of artful engagement to their care.
4C. Creative health practitioners and those working in neighbourhood settings and social prescribing roles.
People’s relational skills, interpretive sensitivity, and capacity to bridge art and care.
5. Organisation: Leadership through Aesthetics
Organisational culture is crucial to the quality of care. The shift from hierarchical control to compassionate leadership, aesthetic leadership, all leadership approaches that bring the human aspects to the fore will form a 21st century professions and systems for health. As I (Lynch 2025) argue, aesthetic leaders “create healing environments and spaces, not just efficient places.” Nurse leaders can model artful intelligence by fostering therapeutic and sympathetic presence, managing complexity and engaging in creative problem-solving. Embedding such values in leadership competencies will make visible the emotional and ethical labour often overlooked in current professional performance metrics.
Core question: How ready are nursing organisations and educators to nurture artful intelligence™?
5A. Leadership and innovation culture
Support for aesthetic leadership, creative inquiry and pegagogy and narrative capabilities within care settings, and a 21st century nursing profession
5B. Infrastructure for reflection
Time, space, and recognition for artful practices as integral to care, pedagogy, and development of critical thinking and person-centred practices.
5C. Integration into education and policy
Curriculum design, continuing professional development, and reflective documentation with links to the NMC code and revalidation.
5D. Sustainability and resources
Funding, partnerships with arts institutions, social enterprise organisations, and long-term embedding in ways of knowing of nursing.
6. Wider System
At system level, integration requires policy alignment. The Department for Culture, Media and Sport (2024) has monetised the impact of culture and heritage on wellbeing, offering an economic rationale for investment in creative health. Health policy could now explicitly recognise aesthetic care as a form of quality. The WHO (2019) review provides ample evidence: arts-based interventions reduce anxiety, enhance recovery, and improve workforce morale. This could all be part of nursing’s future.
Core question: What systemic and cultural forces enable or constrain artful intelligence™ in nursing?
6A. Political and policy context
National priorities for compassionate care, wellbeing, and role of culture in health. The building of human capital and maintenance of health as a human right.
6B. Regulatory and professional standards
Inclusion of aesthetic leadership as part of nursing leadership competencies, and relational competencies in professional codes.
6C. Societal narratives
Public perception of nursing as both scientific and humanistic practice.
6D. Artistic and cultural ecosystems
Partnerships with artists, galleries, theatres, and creative networks supported by national bodies and aligning with professional organisations such as the RCGP and the RCN.
7. Embedding and Evolution Over Time
Finally, sustainability depends on continuous learning. Montejo et al. (2024) highlight the urgent need for faculty training in both AI literacy and ethical pedagogy. Nursing curricula could integrate dual streams: the science of health data and the art of nursing presence. Creative placements, arts-based reflective assessment, and interdisciplinary collaborations can ensure these approaches happen and help.
Core question: How does artful intelligence™ become embedded, adapted, and evolved within 21st century nursing culture?
7A. Adaptation over time
Making sense. How artful policy, practices and praxis evolve with organisational learning and cultural maturity.
7B. Resilience and renewal
Making sensibilities. How aesthetic sensibilities sustain care ethics and organisational wellbeing.
7C. Generativity
Making science. How the artful approach inspires new practices, narratives, and research in caring science.
Conceptual Flow
Like the NASSS model, AIN unfolds as a spiral, moving from individual experience (condition and artful modality) through organisational and systemic contexts, and finally into the continuous evolution of 21st century health and culture and 21st century nursing practice.
Creative Health as the Bridge
Creative health provides the practical mechanism through which artful intelligence can be operationalised. It encompasses arts-in-health programmes, cultural prescribing, and aesthetic education—all evidence-based interventions that link creativity to wellbeing (WHO, 2019).
Policy Innovation
Policy should embed creative health principles into commissioning frameworks. For example, social prescribing, now part of NHS planning, could explicitly include nurses as both prescribers and participants, enabling us to use artistic engagement to support patient and staff wellbeing. Artful intelligence™ metrics could be aligned with social value frameworks to measure impact.
Education Reform
Curricula must move beyond digital literacy to include aesthetic or dialogical literacy. Poetry, drama, visual arts, and narrative medicine can teach empathy and ethical reasoning. Benner’s (2000) novice-to-expert model reminds us that expertise is embodied and experiential; arts-based pedagogy accelerates that embodiment by engaging the senses, the embodiment of learning and our bodies as sites of learning.
Leadership Development
Aesthetic leadership (Monge Moreno, 2019; Lynch, 2025) redefines influence through presence rather than position. Nurse leaders could be trained to model compassion, to curate spaces that are humane, and to value creativity as a leadership skill. Recognition of aesthetic capital as part of nurse capital, the moral and cultural currency nurses bring to organisations, can shift how leadership success is defined.
Research Agenda
Research could document the outcomes of artful intelligence™ as rigorously as those of artificial intelligence. Mixed-methods studies linking aesthetic interventions to patient outcomes, workforce resilience, and equity are needed. Collaborations between nursing, the arts, and data science can produce new methodologies that bring the radical imagination into nursing and show how it works and why it is needed.
Plan of Action: Nursing Next, the Future of Artful Intelligence and the Art of Nursing
Drawing together insights from my studies Lynch’s (2025), a pragmatic roadmap emerges for integrating the art of nursing and artful intelligence into 21st-century nursing care and nurses’ professional identity.
1. Build artful intelligence™ alongside artificial intelligence. Position them as complementary systems that support each other symbiotically,
2. Empower nurses as co-designers. Involve nurses in defining the needs, testing and shaping AI and creative health tools to ensure alignment with relational practice and nurses’ ways of knowing.
3. Establish ethical frameworks. Develop nursing-led moral guidelines for AI use, rooted in nursing care theory and patient autonomy.
4. Expand research partnerships. Collaborate across sectors, with the arts, humanities, computer science, to explore how creativity sustains care quality.
5. Tailor tools to complexity. Design technologies that support narrative documentation, cultural sensitivity, and reflective practice.
6. Ensure transparency and trust. Advocate for explainable AI systems and open communication with patients.
7. Value nurse-centred outcomes. Measure not just productivity but the professional development of presence, empathy, and wellbeing.
8. Educate for dual literacy. Combine AI literacy with artful intelligence™ training in all nursing programmes.
9. Promote equitable access. Ensure creative and digital opportunities reach all nurses, including those in under-resourced settings.
10. Use evidence-based frameworks. Apply the NASSS model and creative health evaluation metrics to guide implementation and improve this AIN model.
Discussion: Re-centring Humanity and Joy in Nursing in a Data-Driven World
The integration of artful intelligence™ is a forward-looking act of professional evolution for nursing. preservation. As AI becomes the infrastructure of healthcare, the nurse’s role as moral and aesthetic agent becomes more, not less, essential.
Motter, Hassler, and Anthony (2021) captured this spirit in describing the art of nursing as “a celebration of nurses.” Artful intelligence institutionalises that celebration, embedding artistry into policy, curriculum, and leadership. It transforms invisible skills, listening, noticing, being, into visible assets of health systems.
The alternative is a profession hollowed out by automation by and augmentation with AI. Without the art, nursing risks becoming task-based, procedural, and replaceable. With it, nursing remains relational, reflective, and irreplaceable. As West (2022) asked, “Is nursing an art or a science?” The answer, for now and even more for the future is, both, and it is the arts that keep the sciences, including nursing science, human.
Conclusion: Writing the Next Chapter of Care
Artificial intelligence can and will support nursing practice, but only artful intelligence™ will sustain it. The two together may form a dual intelligence model for 21st-century care. By embedding creative health approaches, aesthetic leadership, and ethical reflection alongside technological innovation, nursing can remain visible, viable, and valuable in an age of data. And joyful too, as this is what it is to stay human in a non-human system
As Alligood and Fawcett (2017) remind us, the art of nursing is the practice of human care quality. To be human in a non-human health system is the defining challenge of our time.
Nurses must therefore lead, speak the language of both computer code and nursing care, design systems that measure efficiency without mechanising our empathy. In doing so, we reclaim our professional identity as architects of a healthy humanity and a human nurse force for health.
The task before us is to write our future as both art and science, human and non-human, and imagine the next chapter of nursing care.