Translation evidence in nursing and health care practice

Nursing and Scholarship

Will Two-Hour Turning and Positioning Decrease Pressure Ulcers in the Elderly Population in Nursing Homes?

In order for a modern nurse to be both clinically and practically qualified to give exemplary patient care, they must be able to assimilate knowledge quickly and preserve the tenets of nursing while still excelling at the science of the field. . Within the subject of nursing, there are often times in which different aspects of the practice must be analyzed by using primary research from other scholars (Thoun, 2009). Scholarship is continually important for the nursing model, particularly so nurses may keep current in new methods, practice and techniques. At the locus of this model, though, is the extrapolation of technique -- the blend of art and science, and how the nurses of future generations will benefit from the experience of the current generation (Alligood, 2002). To do this, however, requires a new approach to the paradigm of nursing leadership -- strategic thinking, planning and action and above all -- appropriate integration of a more holistic and multidisciplinary approach to professional nursing and use of scholarship and academic information. If we do not disseminate the knowledge we glean through experience, research or scholarship, then we are wasting precious time while others re-do and rethink problems that may already have a solution (White, 2012).

It seems there are really two basic paradigms when it comes to the modern nursing model: Evidence-Based Practice and the dissemination of research information. EBP helps the medical professional focus on implementing proven techniques, based on evidence. While it acknowledges that there are clearly times for the use of intuition, it also asks that there be an ongoing focus of curiosity about the best evidence that will guide appropriate decision-making (Melnyk, B., et.al., 2009). EBP has a direct relationship to the quality of the learning organization for most nurses. However, recent research shows that there is not enough EBP used in most clinical organizations, and that nurses would relish improving the quality and quantity of knowledge through EBP in their daily duties (Estrada, 2009).

Both EBP and scholarship require a divergent ability to think differently than the past. Some define scholarship as those activities that advance the practice of nursing through inquiry in ways that are significant to the profession, are creative, documented, and replicated. In other words, this is not reinventing anything, but focusing on a stricter following of the scientific method. In many ways, though, the fundamental question for modern nursing relates to the philosophical viewpoint of seminal questions about how our universe works and how we relate to that universe - how do we know what we know? (Kim, 2010). Because nursing is, by its very nature, far more multi-disciplinary in the contemporary healthcare environment (business, emotion, leadership, management, clinical knowledge and more), we often realize that we do not understand things directly, but by the impressions and observations we place -- which are naturally unique and personalized -- on the world. This mode of thought complicates nursing because it combines the evolution of nursing care with the radical change in stakeholders. Nurses must be communicators -- but advocates as well; and in this they must balance the carative notion of patients with the pragmatic needs of the institution. In nursing, particular, the conception of knowing then reflects the balance and combination between intuition, past-knowledge (clinical and other), experience and empathy (Bonis, 2009).

Thus, the role of DNP nursing involves the process of continual interaction with colleagues, technicians, physicians, families, and others. There is a pattern of behavior implicit in nursing that we sometimes call past knowledge, sometimes experience, but it is far more valuable if this knowledge can be communicated to others. Knowing and knowledge are two concepts central to this -- knowing is the manner in which we perceive ourselves and the world around us, knowledge is the expression of what we know that may be communicated to others. It is also important to combine a moral and ethical perspective of this knowledge so that nursing can effectively combine cultural and social values with the responsibility of patient care and advocacy. This is done through a variety of combinations -- theoretical in some ways, tactical in others (Chin & Kramer, 2013).

Therein lies the overall new paradigm -- a modern nurse leader cannot be just one thing. We have moved from the bottom of a learning period in which facts were king, and realized that to be an effective nurse, we must combine a series of ways of knowing into a more holistic model of the patient and universe (Boyer, 1992). We now realize that individuals do not exist in a vacuum, but instead, are unique and hold individual experiences and feelings that directly interact with their health. We must use moral and ethical judgment, particularly when technology and science may be able to "do something," but potentially should not just because we can. Combining clinical theory as groundwork, then adding permission to use personal feelings with ethical and moral behavior as well as an understanding that sometimes situations call for more than clinical knowledge is emancipatory -- but as one saying notes: "With great power comes great responsibility."