Editorial
Nursing practice: Tomorrow's solutions today
Edwina A McConnell
Independent Nurse Consultant, Madison, Wisconsin; Visiting Professor, School of Nursing, University of South Australia, City Campus, Adelaide SA
PP: 003 - 004
Article Text
Health care and health care systems in countries around the world are changing and Australia is no exception. People are living longer, and this longevity, combined with lifestyle-related diseases, have affected many changes. For example, patients in hospital are older and sicker and the number of patients at home with myriad medical devices is increasing.
In recent years much effort and untold resources have been directed to heroic high-technology nursing and medicine. However, people are becoming increasingly aware that the health care system is much more than this. It is also a very high number and diverse range of services offered to thousands of people in a host of different settings.
Already this diversity of health care services has changed professional nursing, including where registered nurses practice, how they practice, and indeed, how they and their public define professional nursing practice. Furthermore, the economics and technology underpinning this diversity have resulted in legal and ethical issues never before confronted.
In future a greater diversity of health care services will be required to protect, maintain, and in some cases, improve the health of Australia's citizens. This need presents endless opportunities for professional nurses. How will registered nurses, nursing service administrators, nurse educators, and nurse researchers meet these challenges and find answers to extremely complex questions? A ten letter word holds the key to tomorrow's solutions, and each letter stands for an essential element of the solution.
Collaboration is a process of give and take. It is founded on a belief that working together with people who have other points of view often results in successful outcomes. Collaboration requires both personal and professional maturity, a confidence to admit that we, either as professionals or as a profession, do not have all the answers. Inherent in collaboration are the consideration of new ideas and perspectives, openness and tolerance of review, critique and challenge, and a willingness to negotiate, compromise and work together.
Recreation and leisure are cornerstones of physical and mental wellbeing and evidence that we care for ourselves. This is important because if we do not care for ourselves, how can we care for others? We need to take ourselves lightly and our work seriously. If we focus only on the seriousness of situations, we become myoptic and lose our perspective. We become very unlike the man who was as bald as a billiard ball. He wore a T-shirt which explained, 'That's not a bald patch on my head. It's a solar panel that provides energy for my sexuality.' Education unlocks the gifts and talents unique to each of us. We all want, and need, to feel competent, and education is essential to competence throughout our careers. Education is a quest. It is a journey, not a destination.
Education helps us move from the known to the unknown. Learning more about our areas of professional interest promotes competence and expertise, while exposure to subjects outside our domain, helps us expand our horizons. This expansion promotes lateral thinking and potentiates novel approaches to situations.
Assertiveness means valuing ourselves and our profession and having the courage, commitment, confidence, and compassion to go after what we want. Active involvement in a profession of which we are proud and that we enjoy, helps us feel positive about who we are and what we do. It helps us maintain our enthusiasm for life.
Technology in health care is a double-edged sword. Occasionally equated with excessive, unwarranted expense, misappropriate use of resources and dehumanization, technology is sometimes considered antithetical to health care. However, health care technology is 'bad' only to the extent that it is inappropriately embraced or adversely valued within its organizational and cultural contexts. Nurses and professional nursing are key to the rational use of appropriate technology be it techniques, pharmaceuticals, equipment, or procedures.
Initiative means taking the first step and being willing to take risks and look ahead. It is asking 'why not' instead of 'why'. Initiative also means looking to research for answers to clinical, administrative, and educational problems. The focus of nursing research can be broad or narrow, depending upon its purpose. But regardless of its purpose, both the relevance and the statistical significance of the results must be considered.
Vision is the willingness to see things through new eyes. We must learn to scan the world, much as a person with hemianopsia does. When we turn our head from side to side, our peripheral vision changes as does our forward vision. Exposure to other worlds and ideas helps us understand who we are, validate our stand on issues, and clarify our values. Vision also enables us to build on the contributions of others, to make our own mistakes and avoid reinventing the wheel. Vision helps us see things as they might be not as they are. Two and two equal four, but so do 25-21, 11-7, and 5-1.
Intuition is the instinctive knowledge or belief about something in the absence of conscious reasoning. Gut level feelings and taps on the shoulder are part of intuition, which itself is a component of professional judgement. Because static and noise may dull our awareness to these hunches, we need quiet time to increase our sensitivity.
Tactics is the detailing and directing of forces in battle to achieve an aim or objective. Nursing is full of battles- battles for money, health care programs, and even the life and death of patients. Achieving an aim or task requires a plan of action. We must plan for change and develop plans that facilitate attainment of our goals and objectives, short and long-term. Change should not be made for the sake of making change and it must involve those people who are going to be affected by it. Equally importantly, we must look at plans to change the system because most of the time, the problem is the system in which people work, not the people themselves.
Yesterday's solutions may not be the answers to the problems of tomorrow, but we can reflect on yesterday's practices. We can also take the 'Yes' out of yesterday and say, 'Yes, we can make a difference. Yes, we can solve today's problems. Yes, we do have solutions to tomorrow's problems.' They are found in the ten letter word CREATIVITY.
Tomorrow's solutions require that each of us consider inconceivable alternatives and to question the worth of valued practices. For if we always do what we've always done, we'll always get what we've always got and that may not be good enough tomorrow.
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