Reflections on Nursing Care Outcomes

This issue of Advances in Nursing Science (ANS) reflects to me the vital role that this journal has taken in the realm of nursing's scholarly literature. The work that is reported here goes far beyond the limited, albeit important, task of demonstrating what can be expected to evolve when nurses are involved in patient care. The articles in this issue do address expected and demonstrated outcomes of nursing care, but they also present, examine, question, and critique the models or mental images associated with the aims we seek, and the worth or value of what we aim to accomplish as nurses. Most important, several of the articles in this issue contain rich images of outcomes that are fully grounded in the deepest values and ideals of nursing care.

Over the years, ANS has consistently challenged the dominant models that drive the healthcare industry, presented work that demonstrates alternatives, and work that is clearly grounded in nursing values. The dominant medical model yields many important outcomes, and the methods of traditional science provide compelling evidence that can shape and improve nursing practice, and many nurses practice and conduct research that is grounded in these dominant models. But if as a discipline we were to be limited to what comes from practice and research grounded in dominant models, we would lose the vitality and richness that persist in nursing. The richness of which I speak-deep human connections, finding meaning in illness, nourishment of the mind/body/spirit-is not readily accessible to the traditional methods of science, nor are the outcomes associated with these healing experiences simple or easy to comprehend, much less articulate.

We live in an age where the most meaningful and elusive experiences of human existence are often glossed over or ignored, but they remain ever present and even more ardently sought. It is possible to simply take the position that the realm of science and the goal of producing demonstrable outcomes is not the appropriate "place" to address meanings, to explore values and dynamics grounded in human care and caring, and that these concerns lie within the realms of religion or philosophy. I believe that we do not have the luxury of sweeping these concerns into other realms, and that it is possible to continue to reach for ways to bridge the traditional gaps between the empirical and the artistic, that which is seen and measured and that which is deeply comprehended by the human spirit.

The future of nursing as a discipline is still in the making, and nursing as many of us have known it will evolve into other forms. But the values of caring that have shaped nursing care will persist in some form because this is at the heart of human desire. As research has shown, people do want medicines that cure, surgical interventions that fix what is going wrong, and competent nursing care that contributes to these important outcomes, but they also want, even yearn for, the kind of nursing care that comforts on many levels, that makes sure everyone involved is on the same page, nurses who understand their deepest concerns, who appreciate what they are going through, and who help interpret the complexity of their care and the system in which it is happening. As the contents of this issue of ANS demonstrate, we can reach for these important goals, and we can create the circumstances in which to achieve outcomes that come from the best and the fullest forms of nursing care.

Peggy L. Chinn PhD, RN, FAAN

Editor