(Hek et al. 2002), the tendency for nurses to seek ‘hard’ scientific (rather than ‘soft’
qualitative) evidence for practice is unsurprising. From this perspective the legitimacy
test rests on a majority view of what counts as evidence and makes the use of evidence
from sources perceived as outside of the mainstream or on the margins of professional
respectability problematic. A nurse who uses evidence from sources outside of the
normal boundaries of this legitimacy test will need to argue the case for its acceptance.
The risks (and effort) involved in drawing from sources with uncertain legitimacy may
serve to act as a barrier to open-mindedness. For if it is at the cost of risking accusations
of unprofessional conduct, then it is difficult to imagine why a nurse would want to
choose evidence from anywhere other than ‘respectable’ or ‘sanctioned’ sources. This is
to say that if the only evidence perceived as legitimate is narrowly conceived as that
which results from ‘scientific’ research then the nurse who uses evidence from sources
that do not meet this gold standard will risk censure.
While the closed-minded nurse is unlikely to challenge the boundaries of putative
legitimacy, both the open-minded and the credulous nurse may find the restrictions
imposed by this hierarchy of evidence difficult. Yet this similarity between the
credulous and the open-minded nurse is superficial for while the former will struggle to
assess the provenance of information, the latter will endeavour to adopt a critical stance.
Thus the open-minded nurse will guard against spurious evidence and/or disingenuous
argument. Further, and unlike the credulous nurse, the motivation of the open-minded
nurse in seeking to extend the range of evidence for practice will be primarily for the
benefit of patients. For these reasons, closed-mindedness seems likely to operate as a
force militating against change. Hence, obstacles to becoming dispositionally open-
minded are external as well as internal and it looks as though learning to be open-
minded requires a certain degree of courage in the face of such forces. Nevertheless, and
in spite of these difficulties it still seems that a nurse must strive to become a
dispositionally open-minded practitioner if she or he is serious in aiming to enable the
flourishing of more-than-ordinarily vulnerable persons.
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