I intentionally use the term ‘flesh’ here, because it was used in the New Testament and is imbued with the meaning of Christ’s body, which should be treated with great respect, in much the same way as we should treat our respectable patients. In their editorial, Watson and Thompson (2009) highlight the threats to nursing that are embodied in the dolls and mannequins used in current nursing training. While reading the editorial, I have a strong image of nursing training in a skills laboratory with the non-flesh. Is this in line with what nursing is and what nursing is for?
I wonder if nursing is undergoing a transformation, from a human work to a technical work, from nurse–patient dynamics to nurse–non-flesh relations. It is understandable to have mannequins for practising nursing when nursing students are still at the beginning of their training and have only acquired preliminary nursing skills. At that stage, it is more crucial to protect patients from any potential harm caused by nurse students who are not sufficiently confident and have not acquired relevant nursing skills. However, counting on dolls and mannequins in training will result in negative impacts on students in terms of viewing the actual nurse–patient relationship and adopting the mistaken belief that caring for patients is similar to handling mannequins.
Some alternative views claim that mannequins share many features of patients, like physiological functions and the ability to deliver a verbal message to the students. Even some computer programs can be preset in the mannequins, making them react according to the expectations of programmers or the nurse teachers. In this way, technological solutions create artificial patients that act in a similar way to real, flesh-and-blood ones. With such intentions, this is appropriate.
On the other hand, once a wrong message is delivered to students there is not a big difference between the mannequin and the flesh. Additionally, nursing schools everywhere count on the scientific and sophisticated functions of mannequins to play the roles of patients in students’ clinical practice. In this type of teaching and learning culture, training students in all these unnatural settings with these non-human patients, the ideologies and execution of nursing will become less human, less creative and less flexible. Because the best and most appropriate way to learn and acquire nursing skills is via real nurse–patient encounters and interaction, it is only when students use their five senses and their nursing instinct to feel the needs of their patients that they can grasp the spirit and nature of being a real nurse for a real patient. In contrast, if students perceive that practising on mannequins can provide an opportunity for them to escape patients’ expectations and lessen their stress and fear when facing unpredictable patient responses and health conditions, they will not be allowed to explore their passion for nursing and their artistic caring skills on patients’ bodies.
I wrote this commentary in an attempt to confirm my perspective that nursing training reliant on mannequins (the second generation) is not a long-term method, and that we should instead be going back to basics. Nightingale demonstrated what nursing is and what it is for. She belonged to the first generation – it worked!