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This book opens up ways for an enlightened transmission of knowledge and wisdom from one generation to another. Those who are ignorant of the past are condemned to repeat failures and ignore past enlightened practices and successes. By making transitions from one generation of nurses to another more explicit and thoughtful, these authors contribute to a more enlightened and progressive future. The ironic, wise statement “It is not change that is difficult … it is the transition” is a central message of this inspiring book. Once you can survey a change that has already occurred, the difficulty is usually behind you. How we cope with, plan for, and civilize transitions from positions can ensure a better future. This is especially true for transitions from professional leadership positions into retirement, where the retiring person holds years of institutional wisdom and tradition that are crucial for effective transitions within a complex practice such as healthcare. It is here that attention to transitions and transmission of lessons learned over time become so crucial for sustaining excellence and a better future.
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Even though we are in the midst of major and multiple stages of transition into what is diversely understood as an age of postmodernism(s), we are also still very much in the grips of the Enlightenment tradition. In the Enlightenment tradition, science is valued, and the past is viewed as something to be overturned or at least changed. Ironically, the Enlightenment tradition is known as the “anti-tradition tradition” (Shils, 1981). Shils points out that the Enlightenment tradition misunderstands the very notion of tradition. Anti-traditionalism is itself a tradition. For example, the Enlightenment tradition highly values progress made through rationality and empirical science. There is also a value for expressive individualism, where individuals must discover their own originality and talents and not be a passive recipient of society’s influences and dictates on their individuality. This makes it difficult within the Enlightenment tradition to plan for and develop practices of transmission of wisdom, insights, and experiential learning gained in any living tradition. Without planned transitions, institutional progress and regressions are overlooked.
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The Stanford Encyclopedia of Philosophy (Bristow, 2011) describes the later Enlightenment tradition, citing Kant as a leading figure:
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Kant defines “enlightenment” as humankind’s release from its self-incurred immaturity; “immaturity is the inability to use one’s own understanding without the guidance of another.” Enlightenment is the process of undertaking to think for oneself, to employ and rely on one’s own intellectual capacities in determining what to believe and how to act. Enlightenment philosophers from across the geographical and temporal spectrum tend to have a great deal of confidence in humanity’s intellectual powers, both to achieve systematic knowledge of nature and to serve as an authoritative guide in practical life. This confidence is generally paired with suspicion or hostility toward other forms or carriers of authority (such as tradition, superstition, prejudice, myth and miracles), insofar as these are seen to compete with the authority of reason. (para. 3)
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Even to the postmodern ear, this self-reliance, suspicion of “truths from the past” experience is easily devalued. Most professionals recognize the extremity of Enlightenment’s individualistic view that one does not need past wisdom, or even history, to avoid the mistakes of the past or to sustain progress that has been hard-won. Self-reliance is necessary but not sufficient for growth and progress at the individual or institutional level. This book thoughtfully engages the topic of passing on insights, wisdom, and institutional history and culture.
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Those who are formally retiring from an organization have much to offer, especially if their offerings are tempered with a recognition of excellent practices and an accurate memory of past failures and wrong turns that have since been corrected. No organization can progress if all past learning—successful and failed experiments—is forgotten. The authors of this book thoughtfully examine the responsibilities of both giving and receiving front-line wisdom and mistakes of the past. Learning organizations will do well to thoughtfully consider the major transition occurring as baby boomers retire and carry with them the memory of significant improvement in quality and safety, as well as expensive mistakes. In the past, for example, nurses experienced almost unlimited responsibility but had limited authority within healthcare organizations. Nurses were among the few predominantly female professions that were not clamoring for more responsibility during the equal rights phase of feminism. Nurses need to include the lessons and victories gained by equal rights feminists. And equally important is the later wave of feminism that recognized the knowledge and wisdom embedded in caring practices, such as nursing, social work, teaching, and more. To continue with an oppositional version of feminism that mimicked the male strategies of leadership and “powers over” would continue to reinforce strategies of patriarchy and authoritarianism, while all but ignoring authoritative and empowering leadership and power-use needed by all disciplines organized to care for and nurture others.
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The reader has much to look forward to in reading the reflections on lessons learned and institutional knowledge passed on, as well as impediments to progressive improved care for patient populations and society in general. The art of listening and receiving the wisdom embedded in practice is aptly discussed by Jennifer Mensik and Jennifer Schomburg. Effective transitions require more than reflections on the past, as this book carefully points out: A focus on the future and needed new visions must also be considered. Learning from past successes and failure is essential to transforming the future of healthcare. This book makes many insightful contributions toward improving nursing and healthcare delivery. It deserves to be read by all nurses, particularly those in positions of leadership.
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–Patricia Benner, PhD, RN, FAAN
Professor Emerita in the Department of Social and Behavioral Sciences at the University of California, San Francisco
Former Senior Scholar at the Carnegie Foundation for the Advancement of Teaching