Preface

Evidence is all the rage in nursing these days, and the evidence-based practice (EBP) movement seems well-nigh unstoppable. Anyway, who would want to stop progress toward clinical care based on proven best practices? Many years ago, the nurse-scientist Dr. Norma Matheny reminded us how difficult it is to get any intervention/activity out of nursing practice once nurses are used to performing the activity. Nurses seem to be trapped in “we've always done it this way” kind of thinking, even when new knowledge shows a practice to be obsolete (or, worse, dangerous). Then, there is the equally daunting challenge of getting new ideas or procedures into clinical practice. This is often so slow that Rogers [1] wrote an entire book about how innovations “diffuse” into practice. Even EBP itself diffuses slowly. Few practicing registered nurses (RNs) coming into my classes have a good understanding of evidence. That is unfortunate, because better understanding of the EBP movement would help us to use data wisely. I wonder, however, whether slow EBP diffusion is anywhere near as big a problem as is the troublingly limited understanding of some EBP “early adopters.” Last spring, when discussing Watson's view of the essence of nursing as human caring, a student remarked that because she practiced on the basis of evidence only, she had no need to consider human connections—just the evidence and just the outcomes (measurable, of course), no more and no less. Well, she certainly had gotten some of the point of EBP, but had she missed the core of EBP, and of nursing itself?