Shifting the Nursing Paradigm

Towards Partnership

Teddie Potter PhD, RN

Clinical Associate Professor, School of Nursing

Coordinator DNP in Health Innovation and Leadership

Objectives

• Define Riane Eisler’s Cultural Transformation Theory• Describe the common characteristics of dominator and

partnership systems• List the financial and emotional benefits of a partnership

culture• Analyze your work environment for its placement on the

dominator/partnership continuum• Discuss effective ways to shift nursing research, education,

and practice towards partnership

“Nurses should be full partners with physicians and other health care professionals in redesigning health care in the United States.” -Institute of Medicine (2010)

Inter-professional Education• Collaboration

• Respectful communication• Reflection

• Application of knowledge and skills• Experience of inter-professional teams

http://www.ipe.umn.edu/what/index.htm

What is a paradigm?• A worldview• The “lens” through which

one sees life• A filter for incoming data

We only are conscious of the things that nicely fit into our paradigm.

• Our paradigm determines the way we interpret our sensory experiences.

• “A paradigm is the entire constellation of beliefs, values, techniques, and so on shared by the members of a given community.”

-Thomas Kuhn-

The Chalice and the Blade: Our History, our Future

• Riane Eisler

• The Chalice and the Blade (1987) examines over thirty thousand years of patterns through Western history

Cultural Transformation Theory:• “What we think of as natural and inevitable-

destructive personal and social patterns such as domestic violence, chronic warfare, racial and religious prejudice, the domination of women by men – are not natural or inevitable at all.” -Riane Eisler

• We can therefore consciously choose the paradigm we live by

Cultural Transformation Theory Human history has been a struggle between two conflicting paradigms

The Domination Paradigm• Rigid hierarchies: those on

top control those below them

• Obedience to orders without questioning is encouraged

• Control is maintained by guilt, fear, and force

• Males over females (patriarchy)

• Those who are different are to be conquered, controlled, or destroyed

The Partnership Paradigm

• Mutually respectful and caring relations

• No need to maintain rigid rankings of control so no abuse or violence

• Conflict is an opportunity to learn and be creative

• Equal value for both genders, fluid gender roles

• Power is used to empower rather than disempower

The Dominator Paradigm and the Health care System

• Rigid hierarchies between professions

• Emphasis placed on defeating and controlling the opponent (disease)

• Health care provider is “above” the patient in the hierarchy

• Nature is not seen as an ally but rather the cause of disease therefore something to be controlled or conquered

• APRNs face limitations on their practice

• Other examples? Stories?

Organizational Benefits of Partnership• Employees feel valued and empowered to contribute and

participate

• Conflict can be used creatively to explore alternatives and challenge the status quo

• Creativity is nurtured through safety for risk-taking, less fear of making mistakes, and permission to be inquisitive and explore

• Communication is free to flow in all directions

• The workplace is family friendly creating a synergistic sense of community

• Synergistic belonging extends to the planet, creating the social and environmental consciousness needed for long range planning, sustainability, and success.

-Riane Eisler, The Power of Partnership (2002)

LEADERSHIP AND THE USE OF POWER

Dominator Paradigm

Leadership is based on power over. The leader gives orders to subordinates and these orders must be unquestioningly obeyed.

Partnership Paradigm

Leadership gives power to (The leader nurtures and supports productivity and creativity) AND/OR uses power with (The leader encourages and participates in teamwork) employees.

HIERARCHIES IN THE PARTNERSHIP PARADIGM

In a hierarchy of actualization, leaders and managers facilitate, inspire, and empower rather than control.

-Riane Eisler, The Real Wealth of Nations: Creating a Caring Economics (2008)

Leading Towards Partnership–based Healthcare Systems

• Employees are seen as partners in setting and reaching goals and objectives

• Every employee’s unique abilities are fostered • Employees are treated with empathy and caring • Employee’s voices are heard and their ideas are respected • Emotional needs are understood and addressed • Cooperative work and individual responsibility are combined • Employees are encouraged to think for themselves and trust

their observations and experiences • Emphasis in placed on caring and ethical behaviors

AWAKENING THE FULL POTENTIAL OF NURSING THROUGH

PARTNERSHIP