Evidence-based care in nursing: reforms versus research, rhetoric versus reality

The new evidence-based health care culture, together with nurses' demands for enhanced professional status, has embedded within its strategy the imperative to develop a corpus of nursing-specific research. These apparently compatible aims were intended to meet the need for enhanced professional status while at the same time enabling clinical nursing practice to be justified on scientific grounds. While the dual reform agendas brought with them the resistance that always accompanies radical amendments to the status quo, they also seem to have created an unanticipated reciprocal antagonism which has impeded the development of nursing research. The policy changes that were necessary to meet the prerequisites for professional status have had a detrimental effect on the potential for generating an adequate body of nursing research. This second paper discusses some of the key reforms to nursing that have been implemented over the last decade and their impact on nursing's progress towards creating its own esoteric research knowledge base that could inform clinical care. It is suggested that policy and research may be diametrically opposed, and that nursing, if it is committed to professionalization, may have to reconsider its allegiance to the scientific research culture in favor of achieving some of the other objectives on its agenda.