From Partnership to Innovation

Abstract

In Creative Nursing 2012, our overarching theme of Partnerships in Practice led us from an exploration of the frontiers of a new paradigm in professional relationships; through ways to educate nurses in understanding, creating, and navigating these relationships; to living the relationships as we bring the art and science of nursing to those we serve. This issue focuses on the structures that support and enhance partnerships in practice: shared governance, primary nursing, and unitbased councils (those that foster evidence-based practice and those that design effective, humane policies to address the realities of providing care at all hours). Our guest editor, Tim Porter-O'Grady, literally wrote the book on shared governance 25 years ago. In this issue, he presents his own new paradigm in "Reframing Knowledge Work: Shared Governance in the Postdigital Age." Then, in an example of the synergy that earns our journal its title, Adelphi University nursing professor Patricia Donohue-Porter advocates for an immersive culture of shared governance within nursing-a culture nourished by elements of classical scholarship such as scholarly inquiry, conscious reflection, persistent critique, and intellectual creation, and characterized by scholarly virtues described by philosophers and nursing theorists. Equally passionate advocacy for the role of primary nursing in giving "practical, functional life to the relationship of professional trust between registered nurses and their patients" is provided by health care consultant Shirley Ruch, who issues a call for "clarity, empowerment, and accountability." When our editorial board chose Sharing Governance as our final issue on partnerships, we wished to create a link with democracy because we see shared governance as the ultimate democratic process and want to emphasize its relevance to the wider society. Nursing professor Lori Steffen reviews Healing the Heart of Democracy: The Courage to Create a Politics Worthy of the Human Spirit by Parker Palmer. And "This I Believe About Nursing in a Changing World," an essay by nursing scholar, ethicist, and thought leader Katharine Densford, is as relevant today as it was when written in 1964. The scholarly impulse that makes nurses professionals rather than technicians moves us to partner in interdisciplinary groups to enhance the care we provide through studying best practices and implementing and evaluating quality improvement initiatives. We present two articles in the "Outcomes" section that offer exciting vistas of what can be achieved when unit-based councils are empowered to act to their full capacity. Julie Ann Sakowski and colleagues from Sutter Health in California describe a 5-year project to promote evidence-based practice through unit councils. The significant gains in quality of care that they are able to report are truly inspiring. And consultant Susan Wessel presents outcomes from several organizations throughout the country after the formation of unit practice councils to implement Relationship-Based Care. These organizations report advances in a myriad of variables, both clinical (e.g., ventilator-associated pneumonias and central line-associated bloodstream infections) and operational (e.g., patients' willingness to recommend and nurse satisfaction). Employing unit-based councils to manage staffing and scheduling is advocated by ChrysMarie Suby of the Labor Management Institute. These issues may seem far afield from the scholarly pursuit of a culture of shared governance, but they are vital to nurses striving to provide excellent care to patients while remaining healthy themselves. When schedules are restructured so that nurses are no longer working seven 12-hour shifts in a row, the impacts on patient safety and caregiver health cannot be overestimated. In our ongoing feature on Nursing Salons, Sheryl Ramstad, an attorney and judge who is beginning a new career in nursing, gives the history of salons going back to 17th-century France, "Coming from the legal profession, which is steeped in rich traditions like the Inns of Court and the Socratic method, I appreciated the historical underpinnings and attended to increase my knowledge of my new profession. …