Managing polarities in complex systems

Broome, Marion E.

doi:10.1016/j.outlook.2007.10.001

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Volume 55, Issue 6 , Pages 269-270, November 2007

Managing polarities in complex systems

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Marion E. Broome, PhD, RN, FAAN

I usually don’t write an editorial that reflects on a specific article or articles in an issue. There are several reasons for this—not the least of which is that so many of the papers we publish discuss important contemporary issues—too many to choose just one. However, 2 papers in the previous issue by Chaffee & McNeill¹ on nursing as an adaptive complex system, and Scott & Cleary’s² on polarities in nursing struck a cord with me. Certainly in my role as dean, the notion of a large nursing school as a complex system came as no big surprise. It seems like 80% of my time, whether in the role of dean, editor, faculty member or colleague is spent managing polarities that continually manifest themselves within education, the health care system and the university environment. Some days I do a good job of balancing these. And some days I don’t. As I read the 2 papers, I found it challenging to identify what I thought the polarities were in the complex systems in which I operate. I also reflected about the role of nurse leaders in those systems—most specifically nursing education. That is, those leaders who must proactively negotiate current polarities and chart the “way forward” in order to maximize the discipline’s and profession’s contributions.

Polarities are defined as “interdependent opposites which function best when both are present to balance with each other.”³ In our nursing world I believe there are a number of professional polarities that have existed for at least 2 decades but which have outgrown their original balance. Most of the polarities are fostered by those who continue to strive to maintain clear boundaries that can no longer be sustained in an environment of scarce resources—scarcity in terms of people, time, energy, and funding. In large, complex schools of nursing that are expected to meet varied missions, one specific polarity is the graduate/undergraduate labels that inhibit faculty contributions to both research and teaching. I would argue that this imbalance is fed by some of the traditional behaviors that were very adaptive in past years, but which now set up silos which restrict individual view of what could and should be.

The graduate/undergraduate faculty role and accompanying curricular polarities has evolved slowly over the last 20 years, as schools of nursing required the doctorate for tenure-track faculty. Many developed clinical-ranked tracks for master’s-prepared faculty who almost exclusively taught in the undergraduate program. For some reason, the majority of us who chose to attain a doctoral degree also chose, after completion, to not teach in the undergraduate programs. Faculty who chose not to engage in doctoral study 20 years ago then found their place teaching only at the undergraduate level. Some of the diversion of doctoral-prepared faculty was attributable to the expanding research enterprise in nursing and the recognition that nurse scientists could make a unique and sustainable contribution to health science. Some was also attributable to the ever-expanding graduate program options and roles. In some cases these may have been created to sustain the sheer numbers of doctoral-prepared faculty who needed a graduate program in which to teach. At that time many believed that individuals could be rewarded for “doing what they do best,” that clinical faculty were more connected to clinical practice and, thus, better prepared to teach undergraduate students. And, importantly, there were enough “contributors” to the overall mission of the organization to allow for the development of silos and rigid boundaries around roles and responsibilities. Finally, 25 years ago the average age of faculty was in early forties—we all had plenty of time to make our contributions where and when we wanted.

However, the past decade has brought increasing complexity to this world of nursing education, one in which the old “rules of order” and rewards structures no longer fit, and certainly are not supportive of a complex adaptive system. As research funding becomes more and more competitive, as we struggle to simply replace those who are retiring, and as graduate students increasingly attend school on a part-time basis, the system is strained beyond its capacity to flex. Undergraduate students bring experiences and expectations that challenge all faculty and the system strains to regain balance. As ever-escalating tuition and fees are capped and legislators consistently reduce appropriations to support education, as health systems place restrictions on student numbers and faculty involvement, as research funding becomes scarcer and linked with multidisciplinary teams and translational requirements, even the phrase “complex adaptive system” does not quite capture the unprecedented demands placed on nursing faculty and administrators.

Chaffee and McNeill offer some interesting advice about polarities and complex adaptive systems. They tell us old dogs must learn new tricks, we must break down silos, expect unpredictability, and lead differently. “New tricks” are easy to talk about and difficult to learn. And, in some cases, the mental models are neither there from which to learn nor available to guide, such as in clinical education. It is just recently that clinical education models have been studied.⁴ Hopefully, we will use the data to construct new models that are not only innovative and effective, but also much more cost efficient. Chaffee and McNeill also state leaders must continue to push for decentralization and empower faculty and staff throughout the complex organization. This, too, is easier said than done. True empowerment demands reciprocal relationships in which accountability is shared equally and not just at the leadership level. This will require leaders to be transformative (versus autocratic) and make visible their intent, their visions, and their constraints. Using consistent communication and “walking the talk,” and sharing data about financing of education could help faculty and staff in the organization to understand why we must change how we “do our work.” One can’t possibly be empowered without revealing all the facts. Anything less presumes those we expect to be innovative and responsible for managing polarities at their own level, as well as negotiating a complex system, can do so in a vacuum. Of course the transparent leader is vulnerable—but doing no less will also keep leaders in their own silos and keep the community wisdom (and hope) from building what could be a better future for all in a complex adaptive system.

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