title: Changing our lens: seeing the chaos of professional practice as complexity.
abstract: OBJECTIVE
  The purpose of this evidence-based management practice project was to analyse dimensions of the Getting my Work Done issue, the only one of seven issues of highest concern for which 907 nurse interviewees were unable to identify effective strategies, formulate a 'best management practice', integrate the practice into clinical settings and evaluate results. METHOD/PROCESS: The evidence-based management practice process was used to identify the major impediment to Getting Work Done-assignment to multiple patients with simultaneous complex needs. Best management practice consisted of class presentation of a clinical-management problem scenario to 144 residents in nine Magnet hospitals, a private action commitment, class discussion and terminal action commitments.
  
  
  RESULTS
  Responses indicated that this 'best management practice' was effective in helping newly licensed registered nurses manage and handle multiple patients with simultaneous complex needs. A major avenue of resolution was perception of professional practice responsibilities as a series of complex, interrelated, adaptive systems. CONCLUSIONS/IMPLICATIONS FOR NURSING MANAGEMENT: Perception and use of the principles of complexity science assists newly licensed registered nurses in mastering management dilemmas that inhibit professional practice. In many participating hospitals, plans are underway to expand this best practice to include input and perception exchange among experienced nurses, managers and physicians.
authors.affiliation: Health Science Research Associates, Apache Junction, AZ 85119, USA. mcairzona@juno.com
authors.forename: Marlene
authors.initials: M
authors.lastname: Kramer
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Brewer
authors.forename: Diana
authors.initials: D
authors.lastname: Halfer
authors.forename: Pat
authors.initials: P
authors.lastname: Maguire
authors.forename: Summer
authors.initials: S
authors.lastname: Beausoleil
authors.forename: Kristin
authors.initials: K
authors.lastname: Claman
authors.forename: Maura
authors.initials: M
authors.lastname: Macphee
authors.forename: Judy Boychuk
authors.initials: JB
authors.lastname: Duchscher
mesh_terms: D006801:Humans; D009718:Nurse Administrators; D009732:Nursing Care / Q000458:organization & administration / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000592:standards*; D019982:Organizational Case Studies; D013597:Systems Analysis