1. Chaos and Complexity Science Chaos and Complexity Science Marilyn A. Ray RN PhD CTN-A Professor Emeritus, Florida Atlantic University, Boca Raton, Florida © Marilyn A. Ray, All Rights Reserved

2. CURRENT HEALTH CARE NURSING ENVIRONMENT Loss of Trust Loss of Trust Disillusionment with nursing practice Disillusionment with nursing practice Organizations driven by economic survival Organizations driven by economic survival Decrease in loyalty to organizations Decrease in loyalty to organizations Ray, M., Turkel, M. & Marino, F. (2002). The transformative process for nursing in workforce redevelopment. Nursing Administration Quarterly, 26(2), 1-14.

3. THE NEW EVIDENCE Transcultural Caring Dynamics Spiritual - Ethical Caring Physical Social- Cultural Economic Technological Educational Political Legal © Marilyn A. Ray, All Rights Reserved

4. Economic Caring Economic Resources Economic Resources Money Money Goods Goods Services Services Interpersonal Resources (Foa, 1971) Interpersonal Resources (Foa, 1971) Love (caring) Love (caring) Status (educational preparedness) Status (educational preparedness) Information (education) Information (education) Ray, M. (1987). Health care economics and human caring: Why the moral conflict must be resolved. Family & Community Health, 10(1), 35-43.

5. Classification System of Caring Interactive Philosophical Psychological Practical Spiritual- Ethical Caring Classification System of Caring Interactive Philosophical Psychological Practical Spiritual- Ethical Caring © Marilyn A. Ray, All Rights Reserved

7. QUANTUM PHILOSOPHY 1. 1. What are the limits of human knowledge? 2. 2. Is the physical world shaped in some sense by our perception of it? 3. 3. Quanta are electromagnetic radiation which comes in tiny bundles of energy. 4. 4. Uncertainty Principle: Unfolding of quantum events-undulating waves of possibilities. 5. 5. Knowledge of nature fundamentally limited: When we grasp one part, another part slips from our grasp. © Marilyn A. Ray, All Rights Reserved

8. QUANTUM PHILOSOPHY (CONT’D) 6. 6. Mystery of the wave/particle duality in physics. 7. 7. Quantum Phenomena are neither waves nor particles but are intrinsically undefined until the moment they are measured. 8. 8. Quantum state reflects not only what we know about the system but what is, in principle, knowable. 9. 9. Reality is defined by the questions we put to it (Einstein and Bohr). © Marilyn A. Ray, All Rights Reserved

9. CHAOS AND THE SCIENCE OF COMPLEXITY CHARACTERISTICS Non-Linear Dynamics: Shattered the traditional notions of causality. Non-Linear Dynamics: Shattered the traditional notions of causality. Classical Predictability Impossible: Deterministic history does not bring about predictable future Classical Predictability Impossible: Deterministic history does not bring about predictable future Randomness: No discernible regularity or repetitive pattern. Randomness: No discernible regularity or repetitive pattern. © Marilyn A. Ray, All Rights Reserved

10. CHAOS AND THE SCIENCE OF COMPLEXITY (cont’d) Behind the apparent randomness lies great beauty and structural symmetry Behind the apparent randomness lies great beauty and structural symmetry Knower and the known are one Knower and the known are one All objectivity is subjectivity: What is known, or the answer is shaped by the observer in the action of observation (the observer’s potential knowledge changes). All objectivity is subjectivity: What is known, or the answer is shaped by the observer in the action of observation (the observer’s potential knowledge changes). Choice: The Conductor of the Symphony (Davidson & Ray, 1991). Choice: The Conductor of the Symphony (Davidson & Ray, 1991). © Marilyn A. Ray, All Rights Reserved

11. The Holographic Theory of Bureaucratic Caring Spiritual- Ethical Caring Physical Social- Cultural Legal Technological Economic Educational Political © Marilyn A. Ray, All Rights Reserved

12. TRANSCULTURAL CARING Relationship between charity and right action---compassion and justice. Relationship between charity and right action---compassion and justice. Transcultural Caring as Critical Nursing Ethics: © Marilyn A. Ray, All Rights Reserved

13. Chaos Theory in Nursing Practice Ray, M. (1994). Complex caring dynamics: A unifying model of nursing inquiry. Theoretic and Applied Chaos in Nursing, 1(1). 23-32. (Referred to now as Complexity and Chaos in Nursing). Ray, M. (1994). Complex caring dynamics: A unifying model of nursing inquiry. Theoretic and Applied Chaos in Nursing, 1(1). 23-32. (Referred to now as Complexity and Chaos in Nursing).

14. ETHICAL ECONOMIC CARING Ray, M., et al., 1994. The edge of chaos: Caring and the bottom line. Nursing Management, 26(9), 48-50.

15. THE TIME IS NOW

16. Acknowledgements Florida Atlantic University, The Christine E. Lynn College of Nursing, Boca Raton, Florida Florida Atlantic University, The Christine E. Lynn College of Nursing, Boca Raton, Florida Graphics Enhanced By: Graphics Enhanced By: M. Christopher Saslo PhD VA Administration, WPB, FL VA Administration, WPB, FL © Marilyn A. Ray, All Rights Reserved

17. References Davidson, Ray, M.. & Turkel, M.. (2011). Nursing, caring, and complexity science: For human- environment well-being. New York: Springer Publishing Company.. Davidson, Ray, M.. & Turkel, M.. (2011). Nursing, caring, and complexity science: For human- environment well-being. New York: Springer Publishing Company.. Dawes, M., Davies, P., Gray, A., Mant, J., Seers, K., & Snowball, R. (1999). Evidence-based practice. Edinburgh: Churchill Livingstone. Dawes, M., Davies, P., Gray, A., Mant, J., Seers, K., & Snowball, R. (1999). Evidence-based practice. Edinburgh: Churchill Livingstone. Henry, J. & Henry, L. (2004). The soul of the caring nurse: Stories and Resources for Revitalizing Professional Passion. Washington, DC: American Nurses Publishing. Henry, J. & Henry, L. (2004). The soul of the caring nurse: Stories and Resources for Revitalizing Professional Passion. Washington, DC: American Nurses Publishing. Page, A. (Ed.). (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, DC: The National Academies Press. Page, A. (Ed.). (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, DC: The National Academies Press. Porter-O'Grady, T. & Malloch, K. (2003). Quantum leadership. Boston: Jones and Bartlett Publishers. Porter-O'Grady, T. & Malloch, K. (2003). Quantum leadership. Boston: Jones and Bartlett Publishers. Ray, M. (1994). Complex caring dynamics: A unifying model of nursing inquiry. Theoretic and Applied Chaos in Nursing, 1(1). 23-32. (Referred to now as Complexity and Chaos in Nursing). Ray, M. (1994). Complex caring dynamics: A unifying model of nursing inquiry. Theoretic and Applied Chaos in Nursing, 1(1). 23-32. (Referred to now as Complexity and Chaos in Nursing). Ray, M. (1998). Complexity and nursing science. Nursing Science Quarterly, 11(3), 91-93. Ray, M. (1998). Complexity and nursing science. Nursing Science Quarterly, 11(3), 91-93. Ray, M. (& Turkel, M. 2010). The theory of bureaucratic caring. In M. Parker (Ed.), Nursing theories, n ursing practice. Philadelphia: FA Davis Company. Ray, M. (& Turkel, M. 2010). The theory of bureaucratic caring. In M. Parker (Ed.), Nursing theories, n ursing practice. Philadelphia: FA Davis Company. Ray, M., Turkel, M. & Marino, F. (2002). The transformative process for nursing in workforce redevelopment. Nursing Administration Quarterly, 26(2), 1-14. Ray, M., Turkel, M. & Marino, F. (2002). The transformative process for nursing in workforce redevelopment. Nursing Administration Quarterly, 26(2), 1-14. Taylor, M. & Keighron, K. (2004). Healing is who we are...and who are we? Nursing Administration Quarterly, 28(4), 241-248. Taylor, M. & Keighron, K. (2004). Healing is who we are...and who are we? Nursing Administration Quarterly, 28(4), 241-248. Turkel, M. & Ray, M. (2000). Relational complexity: A theory of the nurse-patient relationship within an economic context. Nursing Science Quarterly, 13(4), 307-313. Turkel, M. & Ray, M. (2000). Relational complexity: A theory of the nurse-patient relationship within an economic context. Nursing Science Quarterly, 13(4), 307-313. Turkel, M.& Ray, M. (2001). Relational complexity: From Grounded Theory to instrument development and theoretical testing. Nursing Science Quarterly, 14(4), 281-287. Turkel, M.& Ray, M. (2001). Relational complexity: From Grounded Theory to instrument development and theoretical testing. Nursing Science Quarterly, 14(4), 281-287. Turkel, M. & Ray, M. (2004). Creating a caring practice environment through self-renewal. Nursing Administration Quarterly, 28(4), 249-254. Turkel, M. & Ray, M. (2004). Creating a caring practice environment through self-renewal. Nursing Administration Quarterly, 28(4), 249-254.