Public health nursing (PHN) educators and administrators increasingly call for the development of evidence-based practice for the purposes of validating and advancing practice. Current notions of evidence, however, are primarily limited to the findings and outcomes of clinical trials. This narrow definition of evidence dismisses practical knowledge and clinically-based notions of success and obscures the content and process of nursing care. This reservation is evident in the analysis of nurses' narratives from our two completed interpretive studies of PHN practice in the midwest. The clinicians in our studies occupy what Schon (1994) refers to as the "low ground" of practice, which is "messy and indeterminate", in stark contrast to the "high ground" of rigorous research designs and theoretical reasoning. PHNs' notions of success reflect the possibilities inherent in the situation--rather than the disembedded outcomes that are prescribed in advance and irrespective of the particularities of clinical situations. The findings from these two studies suggest that a broader understanding of evidence-based practice is needed that appreciates and makes visible the practical skills, contexts, and processes for achieving reasonable outcomes in complex situations.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Distinguish between scientific reasoning and practical reasoning. 2. Examine clinical narratives for articulating notions of PHN success. 3. Describe approaches that recover the practical skills, contexts, and processes for achieving reasonable outcomes
Keywords: Public Health Nursing, Outcomes, Public Health Nursing
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.