Changing Nursing and Nursing Change: a dialectical analysis of an action research project

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Abstract
This paper focuses on an action research project, which aimed to develop the roles of nurses working in a specialist out‐patient department. There is a dearth of literature in this field of nursing. Complex issues (historical, cultural, personal and political) surrounding the process and outcome of change are discussed. Current analyses often highlight specific aspects of the complexities of the process of change (see, for example, Titchen & Binnie, 1992). In this paper, the present debate is expanded by developing practical and theoretical arguments which draw on the work of hermeneutic philosophers and critical theorists, including Gadamer (1975) and Winter (1989). Accordingly, non‐correspondences or contradictions within the research setting are identified, and 13 key factors which hindered/helped change are discussed. Drawing on a general body of literature, the analysis is widened to take into account change in other areas of nursing and education. It is argued that as nurses and researchers we live and cope with many tensions or contradictions that are dynamic and evolving. However, some of these tensions need to be addressed and settled, if only partly, for major changes in practice to occur.