Practice Change and Bricolage in Nursing

Abstract

This paper aimed to define and describe the concepts of practice change and bricolage in nursing. The ontology, epistemology and axiology of practice change in nursing will be clarified as it relates to the experiences of the nurse and patients. This paper proposes that the most significant changes in a nurse-nursed relationship are the self-initiated incremental changes that result in improved patient care, arising from a need to cope with difficult situations, adjust and make sense of the experiences that they were having. It is also within this context that the case is argued for considering that changes in nursing practice involve bricolage activity. Bricolage is the construction or creation of a work from a diverse range of things that happen to be available, or a work created by such a process (Gobbi, 2005). The idea of using patient's environment and available resources which are at hand is the main goal in the bricolage activity (Reed and Shearer, 2011). This stance, which is derived from the work of Levi-Strauss, conceives elements of nursing practice as an embodied, bricolage practice where nurses draw on the 'shards and fragments' of the situation-at-hand to resolve the needs of the individual patient for whom they care. This conceptualization of practice change in nursing could be analyzed with a particular emphasis on its implication for nursing epistemology, pedagogy and praxis.