Promoting Clinical Practice Knowledge in an Age of Taxonomies and Protocols

Authors

  • Lee SmithBattle R.N., DNSc,

    1. Lee SmithBattle is an Associate Professor, St. Louis University, St. Louis, Missouri, and Margaret Diekemper is an Associate Professor, Maryville University, St. Louis, Missouri.
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  • Margaret Diekemper R.N., M.S.N., C.S.

    1. Lee SmithBattle is an Associate Professor, St. Louis University, St. Louis, Missouri, and Margaret Diekemper is an Associate Professor, Maryville University, St. Louis, Missouri.
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Address correspondence to Lee SmithBattle, 3525 Caroline Street, St. Louis, MO 63104.

Abstract

The proliferation of classification schemes, practice guidelines, and critical pathways expresses our modern faith in theoretical reasoning and scientific evidence. This mode of knowing is almost universally championed for providing the evidence that will guide and advance nursing practice. The nature and complexity of clinical expertise, however, are misconstrued with the quest to standardize nursing practice. After distinguishing between theoretical and clinical reasoning, several narratives from two interpretive studies of public health nursing practice will illustrate how clinical practice resists theoretical understanding and must be more fully articulated if clinical and ethical reasoning is to be preserved and strengthened.

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