EBP and Nurse Caring Authenticity is an Oxymoron

We’re in a crazy world.

Nursing is caught between so many forces.

I just read this AM, in AONE’s October’s Nurse Leader editorial, “Becoming More Original” by Rose Sherman,


“Staff are more likely to be innovative when they know that their jobs can be modified, when their conversations are not scripted, and that they are expected to take action to improve their work.”

Oh, this is so true. I knew this as a hospital nurse leader x 30 years. Don’t we all long for nurses to feel and be innovative? But how?

  • There are EBP standardization …
  • And all the great stuff from Toyota Lean practices ….
  • And the technologies that ensure standardization of safety practices….

The trouble is getting to that place where the vision, desires, expectations, timing, resources and will …. all come together to spark real change, the kind that nurses can feel, can know and respond to and … RIDE ….


I used to say, “As nurse leaders of this nursing service, we are to create a Caring Engine within our organization’s culture where nurses can come to work (from their complicated lives) and just come aboard our Caring Engine and ride through their shift where they have confidence in

  • following the clear standardized practices we had outlined
  • using the technologies that we had puzzled together
  • knowing that we leaders care about them and their patients

so that they feel freed up to find their caring selves.

Of course, there is more to it.


But I have to confess that I was always looking for the golden turn key to be revealed that would ease nurses’ workloads and to make the leadership path more clear to me and others.

The goal was always to go deeper into caring, where our theoretical nursing model would take hold and nurses would see, feel and practice the vision.

Anyway, I know that there is progress being made in some organizations with this.

And I also know, as I step away from organizational life, that there is a reverberating call for nurses to bring authenticity to their caring, … to allow the authentic self to rise.


It is our obligation to bring this possibility to nurses now.

I know that nurses need more in their professional lives than to just deliver EBP*.

There is a great chapter in Davidson’s et al book, Nursing, Caring, and Complexity Science For Human-Environment Well-Being (2011) called “Why Six Sigma Health Care is Oxymoronic in Hospitals” by Bruce J. West.

This certainty reveals that the solutions for health care are more complex than our current approaches.


The Pew Health Professions Commission and the Fetzer Institute came together in 1992 to develop a curricula to promote an integrated approach to healthcare. They stated,

We must find new ways to speak of and teach a transformed approach to health care, an approach that has as its center the relationships within and among people. … The biggest psychosocial problem facing us in this coming healthcare transformation is our own personal transformation – to understand and promote change within ourselves.

This simplicity is at the heart of healthcare’s complexity.

EBP* = evidenced based practice
Davidson A, Ray MA, Turkel MC. Nursing, Caring, and Complexity Science For Human-Environment Well-Being. New York: Springer Publishing Company; 2011.
Sherman R. Editorial-Becoming more original. AONE’s Nurse Leader, 2016, October.
Tressolini CP, Pew-Fetzer Task Force. Health professionals education and relationship-centered care. San Francisco: Pew Health Commission;1994. http://rccswmi.org . Accessed March, 2016.

2 thoughts on “EBP and Nurse Caring Authenticity is an Oxymoron

  1. mo willis says:

    So tired of our practice continually being force fit into business models…I feel my life force seeping out.

    1. pmcclendon says:

      Oh…. I feel the pain in your statement. We are in such a hard place, caught in the middle. You are the important one. Keep focusing on yourself and helping yourself celebrate the gifts you give to those around you. Thank you for sharing yourself. pat

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