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To learn: The power of reflection

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      Kenneth White, PhD, AGACNP, ACHPN, FACHE, FAAN
      Reflection can take many forms—writing, journaling, taking a long walk, daydreaming, talking with friends or colleagues—and it can provide us with insights that bring clarity and wisdom. It can spur a new direction or lead to a resolution for change. Reflection can also bring forth a wide range of emotions. Unlike the other kind of reflection— where light, sound, heat, or an image is sent back and not absorbed— our reflections often bring with them strongly felt sentiments. As the American Academy of Nursing (Academy) launches this first year of a three-year, 50th Anniversary commemoration, our theme for 2022 is reflection. As a collective body, we should take this opportunity to look inward and consider our organization's progress and impact over the past five decades.
      I served as Chair of the Academy's 50th Anniversary Task Force when it was established in 2020 under the Presidency of Dr. Eileen Sullivan-Marx. This thoughtful and productive group, which included Fellows Dr. Joanne Disch, Dr. Julie Fairman, Mr. Ramon Lavandero, Dr. Paula Milone-Nuzzo, and Ms. Barbara Nichols, made recommendations to the Board of Directors in June of 2020 to guide the planning process for the commemoration. The Task Force launched its work by creating the following purpose statement:
      The American Academy of Nursing's fiftieth anniversary:
      • Interprets and preserves the Academy's journey to influence policy that improves health worldwide;
      • Celebrates individuals and organizations whose contributions have made the Academy a source of influence; and
      • Positions the Academy for future impact towards a more diverse, inclusive, and equitable Fellowship that collaborates widely within and outside the organization to advance policies that reduce disparities and champion health equity.
      The recommendations that followed took full account of the current global pandemic and were mindful of fiscal considerations and yet, were still bold. The Task Force strongly believed that the Academy's golden anniversary should be more than a celebration; it advanced a central recommendation to create a 50th Anniversary Committee to allow for a deeper dive into our organization's history, as well as a rigorous assessment of its impact. As the new President of the Academy, I launched this committee in January; I am delighted to have Dr. Joanne Disch serve as Chair, and to have a wide cross section of Academy Fellows join the Committee, including Dr. Catherine Alicia Georges, Dr. Anne Gross, Dr. Colleen Leners, Ms. Barbara Nichols, Dr. Winifred Quinn—an Honorary Fellow, Dr. Franklin Shaffer, Dr. Lin Zhan, Dr. Sandra Lewenson, and Board Liaison, Dr. Linda Scott, President-Elect. Their collective history, expertise, experience in leadership roles within the Academy, and commitment to the organization's mission and vision will help shape not only our anniversary reflection and celebration but also the future of the Academy.

      Going Beyond Knowledge to Learning

      This period of reflection offers a chance for us to bring different ways of thinking about history into our understanding of the Academy's past, present, and future. For example, I go back to my earlier work using chaos theory (now known as complexity science) as a framework for comprehending nonlinear dynamics in complex adaptive systems—and nursing, as an art, a science, a practice, and a profession, is exactly that: a complex, adaptive system. About 20 years ago,
      • McDaniel R.
      • Driebe D.
      Complexity Science and Health Care Management.
      offered the notion that there is value in remembering, and then forgetting, history. The decisions and actions that span the course of an organization's history are often context- and time-dependent; they were made with whatever information was available at the moment, in real-time, just as is true of the decisions we make today, individually and as an organization. It is the power of reflection in real-time that is essential. McDaniel and Driebe suggest that history informs capabilities, and we gain these capabilities from listening; the goal is to create an environment where people and their insights are brought forth and valued. We should embrace history as a capability to learn, rather than to simply know. To make this point resonate, those authors cite
      • Berwick D.M.
      The double edge of knowledge [editorial].
      : “Sometimes learning requires courage. It can be difficult for experts, especially, to admit candidly that they could be better at what they do if only they knew more. To become a learner is to become vulnerable.”
      The most critical quality we must cultivate during this year of reflection is vulnerability. We need to be aware of and learn from the actions taken by the Academy that made our organization great as well as those that, in retrospect, could have been more effective. While hindsight may be 20:20, clear vision only matters if we learn from it. As President and with the Board of Directors, I will actively work to create a space for Fellows and stakeholders to consider how they are connected to the Academy's history, moments in which they felt seen, and when circumstances should have been more inclusive. Some Fellows have been witnesses to the actions of our organization for many years; others are new to our collective history. Complexity science tells us this will not be a linear path.
      The ultimate outcome of the Academy's golden anniversary should be a focus on our future— how we will further enhance our individual and collective connections to and engagement with an organization that means different things to each of us, and how we will, as a whole, find commonality. Many of us will fondly remember the moment we were inducted to the Academy or how our sponsors made us feel when they took the step to say, “I believe in you.” Others may reflect on the policy actions taken by the Academy and how their body of work contributed to positions and decisions that influenced health policy. Some of us will look to the future seeking change within our organization. No doubt your colleagues will share the emotions—pride, concern, excitement, purpose—that emerge in your reflections. This year of reflection will enable us to renew the Academy in ways that encourage nurses who have made exceptional contributions to advance health and health equity to apply for membership. It is a future where the American Academy of Nursing continues to be called on for our collective expertise to inform health policy.
      I close with this quotation from the British author and novelist Arnold Bennett: “There can be no knowledge without emotion. We may be aware of a truth, yet until we have felt its force, it is not ours. To the cognition of the brain must be added the experience of the soul.” Powerfully stated, we will not truly know until we have felt its force, and we will not change if we have not learned. Emotion, knowledge, and learning are inextricably linked and will be our path forward in the Academy's year of reflection.

      References

        • Berwick D.M.
        The double edge of knowledge [editorial].
        Journal of the American Medical Association. 1991; 266 (https://jamanetwork.com/journals/jama/article-abstract/391123): 841-842
        • McDaniel R.
        • Driebe D.
        Complexity Science and Health Care Management.
        in: Blair J. Fottler M. Savage G. Advances in Health Care Management. Elsevier Science Ltd, 2000: 11-36 (https://www.emerald.com/insight/content/doi/10.1016/S1474-8231(01)02021-3/full/html)