would hold that through a series of social interactions (occurring both at educational institutions and in institutions where the nurse works), the nurse's ability to reason develops through a series of stage.
This development is said to occur in four stages. Any given nurse may progress through all four stages or remain throughout his/her career at any given stages; in other words, progress through the four stages is not guaranteed. Each of these stages, along with an application to the professional status of an RN, is presented and discussed below.
Stage 1 - Dualism. At this stage the nurse thinks in absolutes and is unable to deal with multiple points of view. Imagine a professional nurse at this stage of thinking working in an inpatient acute care setting for AIDS patients; the nurse in such a setting must work collaboratively with the attending physician, consultants, a primary care team, ancillary therapists and a variety of other hospital personnel such as lab, pharmacy and infection-control people. The demands placed on the RN in this situation can vary depending upon which particular personnel she is current interacting with; moreover, different members of the team can differ in their assessments of the ability and capabilities of the RN.
If the nurse is at the dualistic stage of thinking, the likelihood is strong that she will come into conflict with one or more of these people because this kind of thinker is unable to deal with the ambiguity associated with such a setting. Nor can this type of thinker tolerate differing points or view or make the kind of independent judgements called for in such a setting.
Stage 2 - Multiplicity. The nurse at this stage of thinking is able to examine different perspectives, although she is not at the point at which she can evaluate them. If this nurse were in the acute care setting just delineated she would remain in conflict with others; however, the conflict level ...