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Nursing, Professionalisation, Knowledge And Research Utilisation
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Nursing, Professionalisation, Knowledge And Research Utilisation.
As well as this general movement towards an evidence based NHS, nursing has also been developing its own internal links between research and professional activity. The relationship between knowledge and decision making has been a crucial element of nursing’s attempt to increase its professional status. A number of commentators point to the requirement for professional occupations to possess and develop a relatively esoteric body of knowledge as the basis for practice (Freidson, 1970), (Millerson, 1964). How a professional group uses this knowledge determines, in part, its position as a profession. Macdonald suggests that for nursing in particular the interface between nursing’s knowledge base and practice (represented by clinical decisions) is characterised by three constraining factors on nursing attaining ‘full’ professional status: the nature of nursing knowledge itself, indeterminacy in application, and a lack of objectivity in practice (MacDonald, 1995).
Perhaps as a response to the need for research which contributes to the needs of Health Services generally, and not just the UK NHS, (Niesson, Grijseels, & Rutten, 2000) nursing has seen a shift away from the heavily theoretical work of American nursing academics in the 1970s and 80s to a stronger emphasis on ‘practice’ (Traynor & Rafferty, 1997). Nursing has also begun to explore and map those parts of the existing knowledge base which might contribute most to particular forms of clinical decisions. For example, randomised controlled trials (RCTs) for decisions concerning the effectiveness of different nursing interventions (Cullum, 1997). Research is, perhaps for the first time in nursing’s recent history, being asked to respond to the challenge of reducing the uncertainty associated with the clinical decisions of practitioners. Moreover, practitioners are being asked to make use of the practice-based research that arises as a result.
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