When I was young, I was naive.

I believed it was enough to teach nurses to meet basic requirements in providing care. I believed it was unreasonable for us to ask our students to love everyone. (That is still not a realistic expectation.) I used to believe in standards, quality audits and core competencies. (I still believe in some of these things, but in a different frame of reference.) To my mind, as long as everybody did his or her job properly, that would do.

I was wrong. It is not enough to teach our students to meet standards, have their competencies verified by tests or check, through peer- or self-appraisals, whether they have mastered the required skills.

There are so many different systems of accreditation being developed nowadays. Under modern accreditation systems, piles of documents explain protocols, guidelines and procedures about how things are done in a particular context or setting. They have a limited connection with the quality of care. Having documents in place doesn’t mean that the things said in the documents are or will be observed. It only means that specific instructions exist about how something should be done (and is believed to be done), and when and why it is done in certain ways.

As I grow older and, I hope, slightly wiser, I have come to realize that standards and competencies are not enough on their own. As I lecture, work with students on projects and supervise them in field practice, I am gradually coming to see how flawed my thinking was.

The most important thing about nursing is caring—caring about, not just for. It is only when we care about something that we strive to do well, to do better. When we care enough, we show it in our work and how we carry ourselves in practice. It is only when we care about those we serve and our profession that we strive to become better nurses and people.

But the global trend embraces the science of nursing more than the art of it. Something is amiss, but are we aware of what we are missing?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.