Creative Nursing: A Journal of Values, Issues, Experience, and Collaboration is a peer-reviewed professional journal, with an overarching theme for each year and a related theme for each of our quarterly issues. Creative Nursing 2017 has been a year of Questioning Authority.

Questioning Authority: What Does It Mean?

Our mission for the year was to examine, evaluate, and criticize the body of knowledge that informs our care. The principles that guided our journey were:

Humanize patient care. Let the people we care for decide how they want to be cared for. The unit of experience is the intervention with the individual. Use common sense – no matter what authority says, do what is right for the patient. Think like a nurse.

Know who and what constitutes authority: Self (conscience, judgment, critical thinking); peers; patients, families, and other caregivers; nurse educators and theorists; physicians and other health care professionals; health care organizations and their policies; regulators; third party payers; national and community leaders; social conventions; the media; evidence-based practice. The list goes on.

Standardization values compliance over creativity. At specific times, standardization and compliance are paramount, but of all the actions nurses take in their professional practice, those times are very few. The rest of the time, we need creative nursing: wide eyes, open ears, open minds, and a healthy skepticism, in order to reimagine the next health care system. Topics in this issue included deferring to expertise before authority, Dorothea Orem and self-care, teaching millennials and Generation Z, and whether virtual simulation and pre-op teaching actually work.

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Questioning Authority: What Does It Take?

“It is at the intersection of the self and the other that true reflective practice occurs,” says guest editor and Curry College nursing professor Susan A. LaRocco. In this issue, we talk about what it takes—the attributes (personal and system) required—to challenge assumptions.

It takes courage: Facing fears of retaliation or marginalization; finding strength in trial and error and in failing forward; having confidence in our Ways of Knowing.

How do we process what we dare? Through reflection: debriefing for meaningful learning.

What else does it take? Humility, authenticity, tolerance for disruption, leadership that creates a safe environment for questioning.

Other topics included helping teammates work together through “virtues in common;” healthier work environments for academics and certified nursing assistants; helping new nursing professors become excellent teachers; unintended consequences of some JCAHO mandates; how understanding triggers could help nurses influence health behaviors; and how the movement to establish nursing as a profession distinct from medicine succeeded in the face of paternalism and misogyny.

Questioning Authority: What Does It Look Like?

It crosses boundaries. It is interprofessional, interdisciplinary, and respectful of individuals’ unique personal resources and contributions.

It advocates courageously for patients and families.

It uses science and art to humanize care.

For this issue of Creative Nursing, we found role models, exemplars, and stories of responses to educational and societal silos, inspired uses of simulation and art to humanize care, creative ways to recruit and retain valuable individuals in the nursing profession, and the application of nursing expertise to correct a scientific and cultural wrong number. The most moving story is by Joanne Dunn, from a health care skills simulation lab at the University of Worcester in England. Her depiction of a simulation of a typical busy unit on a typical morning moves us to reject the assumption that simulation lab exercises can never truly replicate what it means to be a nurse.

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Questioning Authority: What is the Impact?

In this issue of Creative Nursing we explored the impact on both process and outcomes, for both patients and those who care for them, in all arenas. We highlight a nurse theorist (Margaret Newman) who went against prevailing views of what constitutes health and illness; a biomedical scientist who questions currently accepted treatment for patients with breast carcinoma in situ; and a nurse and former Minnesota state senator who found the legislature to be a practice setting in which challenging assumptions and demanding reliable, authoritative, scientific justification for existing or new law is the major function of the role.

We invite you to experience the wisdom of our thought leaders, and to consider making your own contributions to Creative Nursing. To learn more about the journal, visit www.springerpub.com/cn.

Marty Lewis-Hunstiger, BSN, RN, MA
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