To be sure or not to be sure: concepts of uncertainty and risk in the construction of community nursing practice

Abstract

This paper focuses on one aspect of a research study exploring qualified and student nurses' constructed meaning of nursing in a community context. Uncertainty and risk were particularly important factors in the practice constructions reported by qualified nurses. However, this aspect of practice did not constitute a significant element of the clinical curriculum, and students displayed a limited appreciation of these concepts. The visibility and articulation of these aspects of practice may therefore need to be enhanced to develop a more accurate appreciation of practice in the community context, as well as refining the education agenda for this aspect of health care. Four types of uncertainty were identified in this research, namely uncertainty as a consequence of an unpredictable practice context, uncertainty created by the nurse–patient power balance, uncertainty created by exposure to diverse needs and finally, facing risk and dealing with uncertainty when alone. By drawing on a range of literature, the particular dimensions of risk and uncertainty experienced in community practice are differentiated. It is argued that as a core tenet of the practice experience it is timely and appropriate to review perceptions of risk and uncertainty. Acknowledging these as an accepted part of practice may not only facilitate the practitioner's ability to manage the experience but also allow learners to develop their appreciation and understanding of risk and uncertainty.