Jodie C. Gary's "Exploring the Concept and Use of Positive Deviance in Nursing" (August) was very interesting and informative. I was surprised by the amount of literature dedicated to the subject.

When I first saw the title, I thought that the use of the term "positive deviance" was merely a clever way to catch readers' attention. Needless to say, my mind was changed a few pages into the article.

It brought to mind several instances of my own positive deviance, and I agree that there's presently no easy way for institutions to gain wisdom from the contributions to patient care that positive deviance makes.

Maureen Shawn Kennedy provides an example of her own positive deviance in the Editorial, "Nurses: Patient Advocates, Positive Deviants?" but it seemed to me more of an example of what nurses often do-follow protocol for the benefit of the patient. In the scenario she describes, the surgical resident sought to ignore the specific instructions provided by the burn unit to which the patient would soon be transferred. The nurses' clever subterfuge was a nice way to avoid ruffling feathers while ensuring that the patient received the requested and most appropriate treatment.

Richard Flynn, PhD, RN

Seminole, FL