Oral Presentation The 26th International Nursing Philosophy Conference 2023

Exploring the Ecosystem of Nursing Complexity (#74)

Tracey L Clancy 1
  1. University of Calgary, Calgary, ALBERTA, Canada

Nurses often use the word "complex" to describe nursing and yet are challenged to articulate clearly what complexity means. European nursing has aligned with the UK Medical Council definition of a complex intervention – defined as an activity that contains several component parts with the potential for interaction between them which, when applied to the target population, produces a range of possible and variable outcomes. From this definition we can surmise that complexity means that which is made up of component parts interacting in unpredictable ways that influence the delivery of and outcomes of health-related interventions for populations. The component parts that make up complexity include objective elements such as medications and technology used in the delivery of the health intervention. Sasso et al. (2017) suggests that the specific component parts of complexity in/for nursing include activities such as monitoring patients, educating patients and their families, preparing discharge plans, providing psychosocial support to patients who are seriously ill and their family members, and advocating for their patients. These defined 'component parts of complexity' in nursing are associated by Sasso et al, with the nursing outcomes of priorities of care, required care, and missed nursing care. In this typical example of the literature on nursing complexity, it has been operationalized as explicitly determinate and quantifiable tasks, such as monitoring patients. I will argue in this presentation that this orientation, presenting the component parts of complexity in nursing as a series of tasks, does not constitute the true nature of nursing complexity, which involves how we mobilize knowledge to inform decision making in practice. I will discuss how process philosophy gets us to a more accurate understanding of the complexity that is nursing complexity.  


  1. Richards, D. A., & Borglin, G. (2011). Complex interventions and nursing: looking through a new lens at nursing research. International journal of nursing studies, 48(5), 531-533. https://doi.org/10.1016/j.ijnurstu.2011.02.013
  2. Sasso, L., Bagnasco, A., Aleo, G., Catania, G., Dasso, N., Zanini, M. P., & Watson, R. (2017). Incorporating nursing complexity in reimbursement coding systems: the potential impact on missed care. 929-932. http://dx.doi.org/10.1136/bmjqs-2017-006622