Tradition, Rituals and Standards, in a Realm of Evidenced Based Nursing Care

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Tradition, Rituals and Standards, in a Realm of Evidenced Based Nursing Care

Kathryn Zeitz
State Nursing Officer (SA) St John Ambulance; PhD Candidate, Department of Clinical Nursing, University of Adelaide, Adelaide SA

Helen McCutcheon
Deputy Head, Department of Clinical Nursing, University of Adelaide, Adelaide SA

Abstract

Evidenced-based nursing is seen as the future of nursing but the real world in which practice occurs is limiting the possibilities for change. The practice of post-operative (PO) vital sign collection in the general ward setting is described as an example of the complexities that surround practice.

Despite the ongoing work around evidenced-based practice, elements of nursing practice remain based on tradition. Routines and rituals are driving care rather than clinical judgement. The complexities of practice limit the possibilities for change. These complexities include the systems in which nurses' practice, the fear of medico-legal repercussions, and the sense of security that rituals provide.

This paper discusses these themes including the barriers to change and the implications for practice. The development of evidenced-based practice is only one component of the solution to the provision of best practice. Care is required to ensure that the evidenced-based movement does not lead to recipe book care rather than patient centred practice.

Keywords

post-operative vital signs, ritualised practice, clinical judgement, evidenced-based practice, standards

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