Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based healthcare.

Annelise Norlyk, Anita Haahr, Pia Dreyer, Bente Martinsen Woythal

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Drawing on our previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper is to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence-based practice as seen from the point of view of nursing theory.
The paper highlights two conflicting courses of development. One is a course of standardisation founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative we argue that, in the current implementation of evidence-based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence-based medicine are being lost in the transformation into the current evidence-based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today’s evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’.

Key words: nursing practice, evidence-based practice, nursing theory, nursing theorists, ethics of care, hospital culture, patient participation, fast-track programme
TidsskriftNursing Inquiry
Udgave nummer3
Sider (fra-til)e12187
Antal sider7
StatusUdgivet - 2017


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