The “Evidence Debate” and the core of nursing


One of the “ideals and principles” in the nursing manifesto reads:

  • It is our firm conviction that there is a body of knowledge that is specific, if not unique, to nursing’s concerns and interests. We think that this knowledge is grounded in appreciation of wholeness, concern for human well being, and ways in which we accommodate healing through the art and science of nursing. We value theoretical and practical plurality with the centrality of nursing knowledge at the forefront of practice and knowledge development.

Advances in Nursing Science (ANS) has just published-ahead-of-print and article that is a wonderful current-day exploration related to this principle. It is titled “Particularizing the 36-3 coverGeneral: Sustaining Theoretical Integrity in the Context of an Evidence-Based Practice Agenda” Sally Thorne, PhD, RN, FAAN, FCAHS and Richard Sawatzky, PhD, RN.  You can download this article free while it is “ahead of print!”  So head to the ANS web site  to get your copy now!  There is already a very interesting dialogue on the ANS blog about this article!  So check it out and add your comments here, or on the ANS blog, or both!

On the nurse manifest project and creating change


I had the pleasure yesterday of presenting the NURSE #65X89 story to holistic nurses at the American Holistic Nurses Association.

We started the workshop with a brief grounding and centering exercise and moved on toward my reading the story. Then the participants had an opportunity to dialogue about the story and its meaning, and we then beagn some goal setting around creating the future of holistic nursing, one that exemplifies the values of the Nurse Manifesto, and also supports the vision of how nurse Jane in the story lives holistic nursing. For some participants, very concrete goals that were measurable emerged; for others what may have emerged was the need to do self care and find ways to let things go so that they can begin to realize holism and healing for themselves. As I have blogged about previously, it is a must that we have our own self-care in place if we are going to be able to create change in systems and the science of psychoneuroimmunology supports this need.

Meanwhile, the idea arose for us to perhaps collect more nurses’ stories, to do another round of Rogerian Narrative Inquiry Analysis on the stories of nurses, but I wonder about what differences may have emerged over the last 11 years. I suppose my concern is that the stories will continue to be reflective of the struggles of nurses and nursing toward emancipation, and I wonder if the new patterns emerging would be any different then the patterns we identified those years ago? Or perhaps the story of nursing is declining even further, and maybe I need to realize that perhaps this part of the chaotic change process, part of the bifurcation where a new pattern may emerge.

My intention from here is to stay in touch with these amazing holistic nurses, create ways to continue to communicate about their goals, use social media to stay connected, to share our light as we head back toward the institutions where darkness may seem to still rule and oppress our desires for healing and holism.

However, I wouldn’t be doing this work if I didn’t believe that a shift is possible, that light shall reign supremer, that healing is emerging… and so let’s all shift together.

Nurses’ Week: A Narrative Poem of Light, 2013


She will come and be with you

Guiding you on that deep and personal journey

Shining a light ahead for you

A light that only comes from within

And creeps into your lonely places of suffering.

~

He will speak kind words in the dark of night

Opening your windows to fresh air

Holding your hand gently and bringing about peace

And acting as a guide for you on your path toward the unknown.

~

They will walk with you

On your personal healing journey

Supporting your capacity for healing, and ending suffering

All brought about by Love

And skills developed during the nurses’ own healing journey.

~

These nurses of healing and light

Inspired by Florence Nightingale and purveyors of human caring,

They are shining the light into the darkness of healthcare

They are healing the heart of the world.

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Dreaming in nursing


I woke up at 0430 this morning with my heart pounding. Occasionally this happens, I have a “nightmare” about nursing.

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In this particular dream, I was working a night shift and at the end of the shift I was chatting with the nurses. I was getting ready for report, and I couldn’t remember seeing any of my patients; no names, no faces, no recollection at all. I began to feel anxious and I asked one of my fellow nurses, “Gee I hope I finished my charting” and she replied, “No I don’t think you closed out your charts.”

In a panic I ran to the charts. Of course in the dream they were not electronic, they were huge paper charts, perhaps as big as they could be about 6 inches thick, with hand written notes. I was trying to decipher the handwriting and figure out what was going on with a particular patient. As I read through the chart I realized I had not assessed this patient. I must have slept through entire shift. How could that be? Clearly from the diagnosis this patient would have needed pain medication, turning, toileting, and so on. Who was caring for this patient? I had nothing to chart and I realized that I would, at this last hour, have to go and check on all of my patients, assess them, check their meds, and then chart. My 5-year-old daughter arrived in the dream and wanted to play and I had to tell her no.

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Somehow, I woke up and had to convince myself it was just a dream, nobody was harmed, I was safe in my bed. For the record, I haven’t work the floor since the late 1990’s, though I worked as a hospice nurse and taught clinical in the hospital until 2005. Around that time, I finished my PhD, and began to focus on just honing my skills as an educator while I had two babies and raised them into young children.

I have this type of dream several times a year. I suppose I could do a dream analysis, look for the Jungian archetypes, or focus on my own life-anxiety and how it is related to my work. But I am really wondering about here is the dreams that nurses have: the good, the bad, the sleep time dreams, and the awakened dreams.

What is it that our hearts desire in our practice? What are we “dreaming of” in nursing practice and education… and how do we get there? Do we find reward in a broken healthcare system and as the largest providers of healthcare in the nation, how do we take back our practices of caring and compassion? How do we partner with others to create change? How can we use the Nurse Manifesto created by Peggy Chinn, Richard Cowling, and Sue Hagedorn to our benefit?

I would love to hear nurses’ stories about what they desire. I myself wrote a story about what nurses experiencing versus what we desire and you can read about that here: https://nursemanifest.com/research_reports/2002_study/nurse65x89.htm

This story was recently published in Creative Nursing journal. I am also presenting this story and supporting nurses in creating a personal plan of action at the American Holistic Nurses Association Annual Conference in Virginia Beach, VA this June. I hope to see you there!

Physicians become more like nurses!


I was so excited to see this article today! My first thought was, “Wow! They are finally teaching physicians to be more like nurses!” These principles are the very same ones I learned in nursing school twenty years ago. Did you? Do we still use them in nursing? Healthcare has evolved over those twenty years, and I must admit I have not been in a bedside nursing role for most of them. So I can’t really say if nurses in hospitals are using effective communication skills, patient-centered language and the like. In diabetes education (a multidisciplinary specialty) we are still pushing for improvements in these areas.

And patients are demanding this change! Patients are being asked (required?) to be more “engaged” in their health care, and many want to be. We are evolving into a health care system of connections, and away from the assembly-line, “do what you’re told” mentality. If this is ever going to be effective, we all have to play ball – nurses, physicians, patients, and everyone else.

Let’s do this!!