The article looked to present information regarding how a group of nurses on a mental health/psychiatric unit at a small, rural hospital took steps to better their knowledge base and increase their functional autonomy through the use of action research. The authors felt that within an occupation, members have obtained autonomy when they “govern and control their own activities” (p. 76). Unless this has been achieved, they do not see the members as being autonomous and as lacking in power. A group of staff nurses and supervisory nurses initially set out to form a group to educate themselves, as they felt continuing education was lacking at their current facility. With their increased knowledge base and their sharing of knowledge and strategies they found their practice was changing. Rather than sitting back and following orders from physicians and social workers they found they were contributing more to the plan of care and initiating more treatment on their own with their patients. Through their session together they shared strategies for what was working and everyone’s practice flourished.
The participants were able to take their knowledge one step further by leading a hospital-wide education program for fellow nurses. As noted in the article, participants at this education program “liked the positive and relaxed sharing of ideas and knowledge on a peer-to-peer basis; they found that learning from their peer colleagues was both reaffirming and energizing” (p. 79).
The nurses involved in the initial action research group felt they walked away with three main things. They gained ownership over their practice and an increased sense of dignity and leadership. They “came to a new understanding of the art of nursing and found ourselves more willing to go out on a limb and to use intuition and creativity in our practice” (p. 79). They found that with their increased knowledge base and sharing of information they were focused more on the whole person with their clients, and particularly focused on wellness and healing. Finally, they began to see their clients as partners and “knowing subjects rather than as an object of nursing care” (p. 80).
As with all changes in practice, their change did not come without resistance from fellow nurses. Some nurses within their unit and within the hospital were very resistant to a new found sense of autonomy. It would seem there is comfort in simply following orders and trusting that those above you know best.
It was interesting to see how an increase in knowledge led to an increased sense of autonomy, and how much the nurses were able to learn from one another simply from sitting down and discussing issues once a week. How could you see the educational landscape change if teachers sat down or had a web 2.0 discussion board going to discuss what is working and what isn’t? Could we move beyond local or even regional discussions to share our ideas? Finally, why don’t we sit down with our students and work through issues. Much as the nurses learned to work with and learn from their patients, teachers can be learning so much from our students as far as how to change and improve our practice, but we are missing the boat.
Breda, K. L., Anderson, M. A., Hanses, L., Hayes, D., Pillion, C., Lyon, P. (1997). Enhancing nursing
autonomy through participatory action research. Nursing Outlook, 45(2), 76-81.