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Exploring the Concept and Use of Positive Deviance in Nursing

Gary, Jodie C. PhD, RN

AJN, American Journal of Nursing: August 2013 - Volume 113 - Issue 8 - p 26–34
doi: 10.1097/01.NAJ.0000432960.95762.5f
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Overview: Positive deviance involves an intentional act of breaking the rules in order to serve the greater good. For nurses, the rightness or wrongness of such actions will be judged by other people who are in charge of rules enforcement; but the decision to engage in positive deviance lies solely with the nurse. There is no uniform or consistent definition of positive deviance. This article uses the Walker and Avant method of concept analysis to explore and identify the essence of the term positive deviance in the nursing practice environment, provide a better understanding of the concept, and clarify its meaning for the nursing profession. In turn this led to an operational definition: positive deviance is intentional and honorable behavior that departs or differs from an established norm; contains elements of innovation, creativity, adaptability, or a combination thereof; and involves risk for the nurse. The concept of positive deviance is useful, offering nurses a basis for decision making when the normal, expected actions collide with the nurse's view of the right thing to do.

This concept analysis aims to increase our understanding of positive deviance within the context of professional nursing practice.

Jodie C. Gary is an assistant professor in the College of Nursing, Texas A&M Health Science Center, Bryan, TX. Contact author: gary@tamhsc.edu. The author and planners have disclosed no potential conflicts of interest, financial or otherwise.

© 2013 Lippincott Williams & Wilkins. All rights reserved.