Perhaps you are thinking, “Why are some people so creative? I never would have thought of that!” Or, if you are inventive, “I should do something with my ideas, but where would I start?” The truth is that we can all be creative and use innovative thoughts to energize our personal lives and enhance our professional practice. And there are steps you can take to unlock your own creative juices, to stimulate imaginative thinking, and to get connected to the excitement and zest that creativity fosters.

The Need for the Creative

Although technological development has heated up during the past 20 years, the future pace will be explosive. For example, researchers at UCLA recently created carbon-based molecules that are simple logic gates, a basic component of computers. They project that this invention will lead to the development of microprocessors that will be billions of times faster than today’s computers. The lead scientist is hopeful that the computational power of 100 workstations will reside on something the size of a grain of sand within a decade.¹

The fact that humans can create a machine so powerful, tiny, and wonderful speaks to the awesome power of human innovation. But what does this have to do with creativity and nurses? Continually evolving technological development and change will produce challenges that nurses must confront. Nurses as individuals and nursing as a profession must be willing to shift easily and to adapt creatively to the tsunami of ongoing change.

Human economic development can be segmented into four distinct phases that have shifted the destiny of human beings. Alvin Toffler, the man who introduced us to the concept of “future shock” more than 30 years ago, describes the first three — agricultural, industrial, and information — as waves.² More recently, the Nomura Institute identified a fourth stage: the creative.³ We are now moving into the creative stage. Professionals who lack creativity — those without the adaptive capacity to ask new questions, seek new answers, create new paradigms, and tolerate living without the “right answer” — will not thrive.

This new millennium will require intuitive leaps and creative insights, not just the linear thinking and logical science of the last century. There will be no easily defined goals and solutions. Instead, there will be “potentials that will form into real ideas, depending on who the discoverer is and what she [or he] is interested in discovering. Only by venturing into the unknown do we enable new ideas to take shape.”⁴ At the same time, issues, such as those related to gene therapies, healthcare funding, and the aging of baby boomers and their nurses, will demand innovation and creativity from the nursing profession.

In a time of unprecedented challenge for nurses personally and for the profession as a whole, there is a lack of published work on creativity in nursing, which is disheartening. A February 2005 review of the literature disclosed an increase in the number of articles linking nursing and creativity compared to the search done in 2002. Several addressed the issue of teaching creativity in student populations.^5,6

A reason that nurses may not recognize — and share and celebrate — their creativity is that nurses solve a problem in the moment, then move on to the next task, not recognizing the broader implications of their solutions. Peggy Chinn, RN, PhD, FAAN, in an editorial about nursing creativity, described this phenomenon as an “everydayness factor.”⁷ Our creative expression is impacted by the response of others. For example, one study of preadolescents found that rewarding students doing one task led to greater creativity in subsequent tasks; and these findings were replicated in a college student population.⁸ Other researchers have found that exposing less creative persons to novel approaches led to an increase in “paradigm-breaking responses.”⁹ A creative program taught to male undergraduate engineers led to an increase in creativity after only six weeks,¹⁰ and another study found that students who scored higher in creativity also had higher level coping skills.¹¹ We can’t generalize the above findings to nursing, but we can conduct similar studies using a nursing population, and then utilize the findings to facilitate successful resolutions to the challenges facing our profession, especially the nursing shortage.

During times of stress, nurses’ defense systems tend to close them down to novel ideas and practices, according to Hall in her article about creativity in clinical practice. She summarizes, “Only when nurses dare to give their creativity full reign will they enrich the parched land of their practice and their profession and move into different ways of being and healing.”¹²

It is no secret that nursing is a high-stress profession and has become more so as resources have shrunk and workloads have increased. A Google search on “stress and nursing” revealed 636,000 citations. High levels of stress are antithetical to creativity. Fasnacht, in an effort to clarify the concept of creativity in nursing, initially searched thousands of articles in the fields of nursing, education, business, and psychology and selected a sample of 48 articles.¹³ Among her findings, a nurturing environment and a willingness to take risks are important factors in increasing creativity.

Her perspective was echoed in a recent issue of Fast Company,¹⁴ whose December, 2004 issue was devoted to creativity. Using a wide variety of criteria to select the most creative company in the U.S., Fast Company chose Wilbert T. Gore, founder and manufacturer of Gore-Tex and Glide dental floss. Gore’s culture fosters creativity — and high profits. He threw out the rules. Gore created a place with hardly any hierarchy and few ranks and titles.

John Bryne, editor of Fast Company, makes the following bold statement: “Creativity drives growth, and creative people drive every great enterprise.”¹⁵ In the world of health care, how would you rate the organization you work for in facilitating creativity? How would you rate yourself?

Perspective on Creativity

Creativity is the process of taking something that is pure energy — for instance, your thoughts — and converting it into a production or a process. Creativity turns energy into matter. John Kao, a Harvard Business School professor and jazz pianist, in his book, Jamming: The Art and Discipline of Business Creativity, defines creativity as the process where people develop and transform their ideas into something of value.³ All of today’s scientific, technological marvels started as someone’s idea.

Creativity is as natural as breathing. We are all born with a capacity for creativity, just as we enter life with an ability to learn language. And just as people can develop their language capacity and become fluent in multiple tongues, people can also cultivate their creativity.

Playfulness and experimentation — core components of the creative process — are inherent in childhood. Children are creative because they are unhampered by worldly experience of how things are “supposed” to work. Lacking adult data and knowledge, they make their own novel connections and explanations. However, by the time children have spent 15 years or more in educational systems that teach “right” answers, they may no longer see themselves as creative. When originality is unrewarded, devalued, or discouraged, people shut down their creativity. As educated professionals, nurses are well schooled in looking for the “right” answer, but their disowned creativity can be reclaimed.

What does it take to remain creative? Creative people enter into mindsets that lead to conceptualizing problems and finding solutions and answers in novel ways. Creative people are assertive, proactive, spontaneous, expressive, and self-directed. They are future-oriented, rather than past reliant. They are highly self-confident, competent, and intuitive, and they can accept change and integrate opposites.^16,17 Creative people learn to be persistent and outlast the competition.^16,17 For example, the creative genius of Walt Disney prevailed because he had the persistence to face down bankruptcy and ignore naysayers.

Psychologist Nathaniel Branden, PhD, describes creative people as autonomous and respectful of their inner experiences.¹⁸ With finely honed skills, master painters draw on more creative options than the neophyte. Likewise, the wide range of experience, knowledge, and understanding of nurses gives them a springboard for innovation. Expert nurses can bring a tapestry of experiences to bear on the creative process.

Creativity in Nursing

The left-brain thinks linearly, reasons sequentially, and controls language, reading, and speaking. It is the source of verbal rather than social intelligence. The right-brain is artistic, creative, and intuitive. It controls emotions, reads body language, and interprets emotions. As a source of social intelligence, the right-brain gets the “big picture.”

As both science and art, nursing requires both left-brain and right-brain capacities. The nursing process is an elegant model of logical, left-brain thinking. Intuitive, creative skills — the products of highly developed right-brain functioning — are also essential to nursing practice. For example, a nurse who knows that a patient is deteriorating, even when there is no apparent objective data to support this judgment, is operating intuitively in a right-brain mode of thinking.

Nursing education tends to emphasize and reward left-brain functioning. Almost 30 years ago, Myra Levine, RN, a noted nursing theorist, warned about the danger of nursing’s emphasis on the objective and pragmatic, as contrasted with a more creative stance.¹⁹ Today, the danger is exacerbated. A noted nurse metatheorist, Jaqueline Fawcett, RN, PhD, has noted the disproportionate value that is placed on nursing as a science.²⁰ In addition, articles and research on nursing creativity are lacking. Although some attention to creativity exists in the literature of nursing leadership and education, nurses lack information about how to foster creativity among their own colleagues.²¹

Barriers to Creativity

Finding a balance between science and art can be challenging to nurses. In the fluid, dynamic state of health care, they need to cultivate a stance of ongoing adaptation, modification, and adjustment. To move easily and creatively in a world of tumultuous change requires that we open ourselves to all possibilities. However, one difficulty in being creative, a right-brain activity, is breaking it down into component parts, a left-brain activity, and to identify things that impede or facilitate the process.

One barrier to creative thinking is habit. Unfortunately, people who focus on the way things usually are become those who miss the way things could be. Creative people have an ability to practice kaleidoscopic thinking — the ability to turn things around and see a new pattern. In the words of Roger von Oeck, a popular creativity consultant, creativity “consists of looking at the same thing as everyone else and thinking something different.”²² And to do this, nurses must step outside their ordinary routine.

Creativity requires a state of perceptual and attitudinal flexibility that can be derailed by stress, tension, and dependence on the usual ways of looking at things. We need to avoid what Naomi Wolf, a noted feminist, calls “trousseau reflexes,” a term that describes the foolhardy actions of some American women who refused to give up trousseaus of family silver and other keepsakes during their westward migration.²³ Unable to transport their full cargo across the prairie, some pioneer women foolishly held on to their family treasures — items they perceived to have the greatest worth — and threw out vital items needed to survive in the frontier, endangering themselves and others. Trousseau reflexes inhibit creativity because they focus people on the usual solutions, such as holding on to treasures that might not have relevance to the future.

The tendency of organizations, families, and societies to hold on to and protect the status quo can be another barrier to creativity. Virtually all creative geniuses throughout history encountered resistance and sometimes persecution from established authority. But they persisted and brought about their creations.

The process of translating an idea to concrete reality usually requires time and effort. For example, a poet who starts with a glimmer of insight or a perception must expend great, repeated effort to shape a poem into a final form. The photographer may take hundreds of shots before he or she is satisfied. The nurse who creates a video or a new education process for a diabetic patient may need to conceptualize, write, evaluate, and rewrite many times before the new product is complete.

A perceived lack of time, energy, and money can work against the creative process. Many organizations tend to devote time and energy to productivity, rather than creative pursuits. It’s little wonder that nurses may feel they don’t have the time, energy, money, support, or connections to follow through on a creative idea. But wisdom lies in the adage, “If you think you can, or think you can’t, you are probably right.” Nurses who believe they have creative capacity and the ability to find or create the resources needed to bring an idea into being will be able to.

Given the finite resources of healthcare, how can creativity be fostered? A better question is that if nurses don’t get more creative, what will happen to their personal health and well being, to the profession, and to patients? Or, what problems can be solved and what opportunities can be seized when nurses use their creative capacity? To meet current and future challenges, nurses need to achieve a better balance between the art and science, a stronger equanimity between right- and left-brain functioning, and a more holistic integration of their hearts and their minds. Creativity could uncover options that may lead to better productivity and increased job satisfaction for nurses, as well as better care for their patients.

Creativity Rules

Paradoxically, adherence to a few rules can enhance your capacity for creativity — invest your energies in the following ways and harvest your creativity.

1. Claim creativity as your birthright. We are all born with creative capacity. Our choice is whether we opt to develop it. An excellent resource for reconnecting with your inherent creativity is Julia Cameron’s book, The Artist’s Way,²⁴ which includes a 12-week program to salvage creativity from a variety of inhibitors. The Artists’ Way at Work, written by Mark Bryan, with Julia Cameron, and Catherine Allen,²⁵ details a 12-week program to increase creativity in the workplace. Imagine the growth and fun you and a few of your colleagues could create if you decided to devote one after-work hour a week for completing the program. What positive changes could you effect in your workplace?

2. Value your own uniqueness. Do you ever stop to recognize that there has never been anyone else just like you on the face of the earth and that there never will be? Recognizing your uniqueness and value frees you from the tyranny of comparing yourself to others — a major block to creativity.

3. Avoid mental ruts. A major creativity-killer is the “I’m not creative” rut. Eradicate it by starting to tell yourself how creative you are. Deliberately breaking out of your routine, such as taking a different route to work, eating dinner foods for breakfast, reading books of a new genre, exploring different websites, or taking a nonnursing course, are sources for new thoughts.

We need a supply of fresh thoughts to fuel creative possibilities. When our lives are dominated by “to do” lists, creative thoughts have difficulty emerging. We need to create space in our schedules and minds for the necessary incubation process. One of the most effective ways is meditation. By regularly sitting quietly for 15 to 20 minutes and focusing on breathing or on the flame of a candle, we can quiet the mind, obliterate stimulation from the environment, and create an empty space. In actuality, the space is not empty, but rather a field of infinite possibilities.²⁶

4. Recognize freedom and play as the DNA of creativity. Playing with ideas, concepts, and “what-ifs” has its own intrinsic value, whether it leads to the creation of a useful product or remains play. If you fill a room with paper, crayons, flowers, old boxes, and clothing, most children will immediately play with the materials. Adults will wait for directions. If you put on music, children will spontaneously start to dance. Adults will wait to be invited. Invite yourself to play and dance.

5. Learn to minimize the fear that impedes creativity. Stress and fear trigger emotions that can reduce the activity of the cerebral cortex, physiologically hampering our ability to be creative. One way to minimize this problem is through “fear drills.” Learn to break the fear barrier by deliberately engaging in goals or activities that seem to intimidate. Ask yourself, “If I didn’t care what anyone else thought, how would I do this?” or, “If I wasn’t afraid of being fired or labeled a dreamer, what would I suggest?”

6. Go with the flow. Intuitive, creative people are healthy in every way and fully engaged in the flow of life. They don’t waste energy grousing about things over which they have little control, but focus on the positive elements of human experience, such as joy, creativity, and total involvement with life.²⁷

7. Exercise your creativity muscles regularly. People who want to stay in physical shape exercise their entire bodies on a routine basis. If you want to remain creative, you need to develop your whole mind, including the right-side of the brain. Meditation, music, drawing, dancing, and exercising, especially outdoors, can develop and integrate right-brain resources. But just as it takes time and practice to develop physical muscles, time and practice will be needed to pump up your creativity. Not many people bench press 250 lbs during their first week of training, so don’t expect to write the great American novel or design the perfect staffing pattern on the first attempt.

8. Join other people to power creativity. Additional minds and hearts can enhance the creative process. Groups absorbed in the fun, playful aspects of innovation will always come up with more and better ideas than a single person. The zest, energy, and joy we generate when we are fully engaged in a community of creativity only stimulate more original thinking.

9. Disregard all rules that fail to stimulate new insight and creativity. Creativity in nursing can be a collaborative process that allows nurses to bring their knowledge, experience, capacities, and skills to improving patient care. At the same time, it is not arbitrarily changing protocols and procedures. Prudence must temper how and when the creative process is brought to bear. For instance, a code is probably not the time to get creative, but a debriefing afterward might be the time to search for more innovative ways to manage resuscitations and their fallout. Because much of nursing practice requires effective team functioning, care is warranted in the design and implementation of creative activities. Effort should be made to include all stakeholders who will be affected by the creation and implementation of innovative ideas. Just as the entire mind — both right- and left-brains — can enhance the creative process, the inclusion of the whole health team can provide more inspiration for innovative ideas so vital to future patient care.

Einstein is quoted as saying that the thinking that caused the problem is inadequate to solving the problem. It’s imperative that nurses develop enhanced creativity as part of their arsenal of skills, especially during this critical time for the profession. Empirically understanding nursing creativity and fostering its development in students and practicing nurses can facilitate identifying successful strategies to recruit and retain nurses.