When Paradigms Collide: Implications for Transforming Nursing Practice

Dyess, Susan M.

Monday, 31 October 2011: 2:05 PM

Susan M. Dyess, PhD, RN
Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL

Learning Objective 1: ...discuss the findings of a collaborative participatory action research project focused on transforming nursing practice in an acute care setting

Learning Objective 2: ...describe the implications of conflicting practice paradigms on preserving the practice discipline of nursing.

There is compelling evidence to support the link between healthy work environments, quality healthcare outcomes, patient safety, nurse retention and satisfaction in acute practice environments. Additionally, numerous professional organizations acknowledge the importance of not only achieving the stellar environments of care, but also advancing a conspicuous link to nursing theoretical frameworks within the practice environments. In response to the evidence and within a participatory action research (PAR) approach, a college of nursing and a for- profit acute healthcare organization developed acollaborative initiative to integrate caring theory within a specific nursing practice environment. The ongoing research initiative yielded findings at one year that highlight an awareness of a collision of paradigmatic thinking. More clearly, the findings suggest that current measures of nursing care quality and outcomes do not embrace the focus of the discipline of nursing’s unitary-transformative perspective. This realization caused all participants in the PAR to pause and re-focus on the transformative nature of nursing and the importance of preserving the discipline. Implications for nursing practice, research and education include restructuring current models of clinical practice to support nursing’s unique contribution to health, re-aligning reimbursement to advance opportunities for nursing professionals to delegate and orchestrate care along the continuum of caring, re-thinking the workforce issues to mandate differentiation of practice and redesigning job descriptions to expand the capacity of and for the professional nurse.

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