is true, and assuming that individuals will only change their practice if they believe
there to be benefit in doing so, then not only is it necessary for individual practitioners
to be disposed to change their practice but it is also necessary for them to form and/or
revise their (related to practice) beliefs on the basis of evidence and/or argument. This is
to say that if nurses are to base their practice on evidence then they must be
dispositionally open-minded. It follows that those nurses who are not dispositionally
open-minded (that is do not have the virtue of open-mindedness) are failing in some
way.
Walsh and Ford (1989) provide many examples of nursing practices where rituals
continue despite a wealth of (research) evidence that demonstrates the lack of an
evidence base for those practices and offers recommendations for evidence based
practice. This contributes to, and perhaps is even explanatory of, the 'practice-theory'
gap. Students of nursing often complain of the discrepancy between what they are
taught in the classroom and what they see practiced in the clinical areas. Manual
handling provides a telling example.
It was once the case that nurses were required to lift patients. During the 1970s an early
attempt to utilise evidence as a basis for practice led to a move to adopt lifting
techniques using the principles of ergonomics and correct positioning to minimise the
potential for harm to patients and/or staff. The impetus for introducing the idea of ‘safe
lifting’ came from a recognition of the high numbers of nurses lost to the profession as a
result of back injury. Despite the best efforts of health authorities in providing training
in safe lifting there was a marked reluctance by clinical nurses to change the traditional
approach of lifting (particularly the 'underarm' lift) despite widespread acceptance of
evidence demonstrating the potential hazards to both patients and staff.
Some of the techniques designed to avoid harm were adopted during the 1980s only to
be subsequently discredited by new evidence. In addition, European directives have lead
to the introduction of restrictions on permissible lifting loads which has effectively
outlawed the lifting of adult patients. Hence, the term manual handling rather than
lifting. There are a number of devices designed to make easy and effortless the manual
handling of patients, many of which are inexpensive, readily available, and relatively
simple to use: yet resistance to the use of these devices is apparent to any who work in
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