Paper
Monday, November 14, 2005
This presentation is part of : Complexity, the Science of Relationships. Nursing, the Profession of Relationships
Complexity in Nursing Care: Reinventing the Nursing Care Delivery Model
Marjorie S. Wiggins, RN, BSN, MBA, CNAA, BC, Maine Medical Center, Portland, ME, USA

Nursing may be facing the greatest challenge in its history…….SURVIVAL. The future shortage of 400,000 to 800,000 nurses by 2020 will only add to the growing dissatisfaction of nurses in the United States. If nursing continues its present course it will be unable to provide the care that is needed. What role will nursing play and what will nursing look like in the future?

Over the years nursing has tried to adapt to changes that effect our profession. Most of our changes have been in reaction to external forces. Our focus has been our workforce, not the work itself. In hospitals nursing still looks the same with medication schedules and tasks framing the nurses day. If anything has changed it's the speed in which care is now delivered. The focus of care planning, problem solving and conversations with the patient and family have been minimized and sometimes handed off to others. The day is driven by the clock and non-deferrable tasks. Patient safety relies on the nurse to think on the run, assess while multi-tasking and detect subtle changes in patients she may have never seen before.

This presentation will explore how we can make substantive change in such a high speed complex environment by: learning to embrace complexity and understand the nature of the dynamic environment in which nurses practice; calling upon complexity science for a new way of viewing our work and understanding nursing's role in the delivery of care; looking at the interrelatedness of providers and recipients of care in a way we never have before; embracing the wisdom of those with broader and different views; and finally letting go of the belief that we have all the answers and must be in control our environment.