Complexity Theory as Applied to Nursing

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Complexity Theory as Applied to Nursing, 2005

Abstract

Many conventional ideas about the world we live in have been shaken to their foundations by the emerging concepts of chaos and complexity. Insights are now being gained from the application of complexity theory into phenomena varying in scale from the natural sciences such as biology to the concept of caring in the nurse-patient relationship. These new scientific ideas have significant implications for the theory and practice of nursing. This paper will cover four key concepts from complexity theory that will be introduced as relevance to nursing. These include: unpredictable dynamic systems; the whole is greater than the sum of its parts; fuzzy and permeable boundaries; and, the centrality of paradox in all of life.

Introduction

Many conventional ideas about the world we live in have been shaken to their foundations by the emerging concepts of chaos and complexity. These new scientific theories are being applied with startling results in the social and natural sciences, particularly in the biological field. Insights are now being gained from the application of complexity theory into phenomena varying in scale from ventricular fibrillation to the spread of epidemics to the concept of caring in the nurse-patient relationship. Nursing therefore needs to be aware of these new scientific ideas as they have significant implications for the theory and practice of nursing. Chaos and complexity theory encompasses a large field. However, in this paper four key ideas will be introduced which are of relevance to nursing: 1.Dynamic systems behave in an apparently unpredictable and chaotic fashion, making predictions of future behavior impossible unless the rules governing chaotic systems are understood. Health can be argued to be a dynamic system. 2.The whole is greater than the sum of the parts; therefore reductionism is severely limited in its use as a tool in health care. 3.Boundaries between dynamic systems are naturally fragmented and fuzzy, consequently trying to draw sharp lines between nursing and medicine, for example, is fruitless. 4.Paradox is part of life and health care is no exception, both at the micro and macro levels; therefore it is important for nurses and other health care professionals to understand paradox and its central nature in all matters. Dynamic Systems and Chaos

One of the earliest and most accessible works which popularized chaos theory came from Gleick (1988) (Stacey, Douglas, & Shaw, 2002). He points out that science had in the past assumed that the real world progressed in a predictable way, governed by laws and mathematical formulae which allowed accurate predictions to be made. The growth in computer power enabled scientists to push their equations further as more elaborate calculations became possible. This led to the discovery by some scientists that, although they thought they understood some types of systems, when they tried to run them forward and predict future behavior, very strange things happened. Predicting the weather with any accuracy beyond a few days, for example, defied the most powerful computers, despite a solid understanding of the laws governing the behavior of the atmosphere. It became apparent that in certain systems what happens next is heavily dependent on what happened last. These systems are very sensitive to feedback and even the slightest variation can become magnified to produce major disturbances. This is known as sensitive dependence upon initial conditions or the ‘butterfly effect' – so called because it has been said that a butterfly flapping its wings in the tropics can cause disturbances in air flow which become magnified so many times over by sensitive feedback mechanisms, that the result several weeks later is a tropical hurricane! This notion is central to chaos theory (Stacey, Douglas, & Shaw, 2002). Such systems are known as dynamic systems and are distinct from linear systems which...
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