Much of what nurses know is visible at the bedside.
We recognize patterns. We interpret changes in a person’s condition. We identify human responses, make clinical judgments, choose nursing actions, evaluate what changes, and continually adjust care.
But what happens to that knowledge after the moment of care has passed?
Too often, much of it becomes difficult to retrieve, analyze, compare, or learn from.
That question has shaped a great deal of my work, and it will be at the center of my keynote presentation at the 2027 International Nursing Knowledge Conference, taking place 9–11 June 2027 in Pamplona, Spain.
My presentation, Seeing Nursing Clearly: Transforming Nursing Knowledge into Visible Impact, will explore what becomes possible when nursing knowledge is not only used in practice, but also represented in ways that allow us to see it, study it, share it, and build upon it.
From a clinical question to a much larger one
My interest in this area began during my master’s studies with Dr. Marjory Gordon.
She encouraged me to consider which nursing diagnoses might apply to the area in which I was working: neonatal intensive care.
It was a relatively simple question, but it opened the door to something much larger.
If we can identify and describe the clinical judgments nurses are making, can we also examine the quality of those judgments? Can we evaluate whether particular nursing actions lead to the outcomes we intend? Can we identify patterns across patients, units, organizations, or populations? And can what we learn from practice point us toward the questions that nursing research should investigate next?
Those questions stayed with me as I moved into healthcare leadership and quality improvement.
There, I encountered another challenge.
When the record cannot show us what nursing knows
Electronic health records contain enormous amounts of information, yet retrieving meaningful nursing data has often been surprisingly difficult.
Nurses may assess a patient, recognize a pattern, arrive at a clinical judgment, intervene, and evaluate the response. But if those elements are not captured in a structured and connected way, we lose much of our ability to examine the relationship between them.
That has implications far beyond documentation.
If nursing knowledge is difficult to retrieve, it becomes harder to investigate which nursing interventions contribute to particular outcomes. It becomes harder to identify gaps in practice. It becomes harder to build evidence from clinical care. And it becomes harder to demonstrate, using data, the distinct contribution nurses make to outcomes for individuals, families, and communities.
In other words, what we cannot adequately represent becomes much harder to study.
And what we cannot study becomes much harder to improve.
Creating a continuous exchange between research and practice
This is why I see standardized nursing classifications as much more than terminology.
At their best, they provide a way to represent nursing knowledge and clinical judgment consistently enough that information can move.
Research can inform practice.
Practice can generate data.
That data can reveal patterns, questions, and gaps.
Those questions can drive further research.
And new knowledge can then return to practice.
That continuous exchange is essential if nursing is to develop its knowledge base at the pace our patients, health systems, and profession require.
It also creates an opportunity to connect what happens in individual encounters with something larger: a body of nursing knowledge that can be examined, refined, tested, taught, and improved over time.
We also need to change how we teach nurses to reason
For me, this conversation is not only about information systems.
It is also about education.
When I became an educator, I became increasingly concerned that we sometimes expect students to develop diagnostic reasoning almost intuitively.
Yet diagnostic reasoning is not intuitive simply because someone has learned a collection of facts.
Students need repeated opportunities to assess, recognize patterns, consider possible explanations, distinguish between competing hypotheses, make clinical judgments, select appropriate nursing actions, and evaluate whether those actions produced the intended result.
Those habits of reasoning need to be developed deliberately and reinforced throughout nursing education.
When we make the structure of nursing knowledge clearer, we can also make the process of reasoning with that knowledge clearer.
That has implications not only for students, but for practicing nurses, educators, researchers, informaticians, and leaders.
What could nursing become if we could see it more clearly?
That is the question I hope we will explore together in Pamplona.
What could we learn if nursing knowledge were more visible within electronic health records?
What questions could researchers answer?
What could educators teach more intentionally?
What could nurses demonstrate about their contribution to outcomes?
And what new knowledge might emerge if information generated through everyday nursing practice could more easily inform future research?
I don’t see this as simply a technical problem.
It is a knowledge problem, an education problem, a research problem, and ultimately a patient-care problem.
It is also an opportunity.
The 2027 International Nursing Knowledge Conference, with the theme “Expanding, Bridging, and Unifying Knowledge,” will bring nurses together to examine questions like these from across research, education, clinical practice, informatics, and other areas of the profession.
I hope you will join us in Pamplona from 9–11 June 2027.
Bring Your Work to the Conversation
The conference is not only an opportunity to hear from keynote speakers and colleagues from around the world. It is an opportunity to contribute your own work to the future of nursing knowledge.
If your research, scholarship, educational innovation, clinical work, or other work is helping us understand, develop, connect, apply, or advance nursing knowledge, we want to hear from you.
Abstract submissions are open now and close on 30 September 2026.
Submit your abstract and join the international nursing community in Pamplona as we explore how nursing knowledge can be expanded, bridged, unified, and put to work for better care.
Because the future of nursing knowledge will not be shaped by one person, one classification, one institution, or one field of practice.
It will be shaped by nurses who are willing to ask better questions, share what they are learning, challenge what we think we know, and build the knowledge our profession needs next.
I look forward to continuing that conversation with you in Pamplona.
About the Author
Dr. T. Heather Herdman, RN, PhD, FNI, FAAN, is Chief Executive Officer of the International Nursing Knowledge Association (INKA), formerly NANDA ® International (NANDA-I). She is a former President of the Association and has held leadership roles across its diagnosis development and review work.
Her work focuses on clinical reasoning and decision-making within a holistic nursing framework of care, with particular expertise in nursing diagnosis, standardized nursing language, and the connection between assessment, diagnosis, nursing action, and outcomes. She has lectured internationally on clinical reasoning and the clinical validation of nursing diagnoses and is one of the co-leads of the Clinical Reasoning Framework within NANDA® 360.
Since 2009, Dr. Herdman has served as editor or co-editor of NANDA International Nursing Diagnoses: Definitions and Classification, currently in its 14th edition. Her clinical background includes neonatal intensive care, high-risk antenatal care, and labor and delivery, and she has also worked in healthcare quality, home health, hospice, and nursing education.
A member of the founding class of NANDA-I Fellows and recipient of the NANDA-I Mentor Award, Dr. Herdman is also a Fellow of the American Academy of Nursing.
Comments (0)
Leave a comment