From rituals to reason: creating an environment that allows nurses to nurse

From rituals to reason is a description of the journey that one unit is taking to overturn traditional nursing culture and create an environment that will enable nurses to care for people. In our experience the reality of day-to-day nursing practice does not always correspond to the nursing rhetoric of individualised holistic nursing care for each person. We identified that traditional nursing culture, with a focus on task orientation, rigid hierarchical structures and resultant disempowerment of staff, is an impediment to delivery of patient-centered care. We introduced changes to management structures, care delivery models and staff behaviours with the aim of overturning this traditional nursing culture. Changing clinical practice to focus on client outcomes and provide a relaxed and patient-centered environment was easier to achieve than staff empowerment and their full involvement in decision making and innovation.