Uncertainty in nursing: the impact on practice and leadership

Nurses experience uncertainty in practice due to the fast paced, complex nature of the healthcare system. Uncertainty in nursing practice has a direct influence on patient care, as well as personal well-being of the nurse, and his or her engagement and retention in the workplace. This paper describes a project intended to help nurses identify and cope with uncertainty in practice on an adult medical inpatient unit at a major Midwestern healthcare facility. The project is illustrated through a conceptual model of coping with uncertainty as guided by Margaret Newman\u27s Theory of Health as Expanding Consciousness (HEC). The model identifies tools for coping with uncertainty through connecting with the environment, oneself and others. A quilting metaphor is introduced to help nurses visualize patterns of uncertainty in practice and use the coping tools to move toward confidence and competence in practice. The role of nursing leadership is identified as integral to the success of the project. Additional development of the project and research is suggested for further understanding of uncertainty experienced specifically in nursing practice and to document the impact that HEC theory guided coping tools have on decreasing uncertainty in nursing practice