Guest Contributor: Leah Korkis
Director of Clinical Education and Nursing Excellence,
University of Southern California

I grew up kayaking with my Dad off the shores of Kailua, Oahu. I remember with each stroke of my paddle the shifting winds blowing through my hair, the rhythmic lapping of waves, and the mysterious expanse stretching beneath and beyond. The ocean held mystery, life, and meaning. It was not something to conquer but to learn from—to listen to, to move with. My Dad taught me how to read the water, navigate based on the changing elements, and how to use the paddle effectively. In hindsight, those teachings offered not just technique but practice of dialectical pluralism; that is, embracing the surrounding complexities by considering multiple perspectives, reconciling contradictions, and viewing reality as a dynamic process. This wisdom now echoes through my understanding of nursing as a developmental journey that blends how we know (epistemology) and who we are becoming (ontology) in our practice.

Nursing theory has profoundly shaped my understanding. Maria W. O’Rourke’s emphasis on the professional role positioned nursing as a distinct identity, rather than a collection of functions or titles. Informed by the Metaparadigm and Patterns of Knowing, framed my understanding of nursing as a professional discipline. Daniel Pesut’s writings inspired me to see nursing as a future-facing discipline grounded in vision, foresight, and deep change. Margaret Newman’s work awakened me to the idea of uncovering meaning through an evolving pattern of consciousness. Barbara Dossey’s Integral Nursing framework added a holistic, integrative lens that brings it all together.

A Metaphor for Practice
Through my understanding of these theories, my early experiences on the water come full circle. They provided a metaphor for nursing as an intentional, developmental journey. In this metaphor:

• The current represents our shared obligations and professional characteristics articulated in our Scope and Standards of Practice, Code of Ethics, Social Policy Statement, and state-specific Nursing Practice Act. These are not abstract ideals; they are living documents that articulate the forces that shape our collective direction. They orient our shared purpose and differentiate us from other healthcare professionals. When we align with them, we are not merely following rules—we are recognizing and participating in the deep pattern of what it means to be a nurse.
• The paddle represents our behaviors, competencies, and technical skill—what others observe. It reflects our ability to perform procedures, communicate clearly, document accurately, and coordinate care. It is necessary, but not sufficient. Competence must be paired with conscious decision-making—action guided by insight, empathy, and clinical reasoning.
• The wind is our collective momentum. It is the push of historical progress, the momentum of history through nursing thought, advocacy, and leadership. It is the breath of Nightingale, Henderson, Orem, Roy, Benner, Watson, and many others. Knowledge evolves and pushes us forward; other times, it struggles—calling for new clarity and leadership. To navigate it well, we must cohere with the lineage, even as we evolve it.
• The waves are the external forces that challenge our consciousness—policy shifts, emerging technologies, and evolving patient populations. Some waves lift us with innovation and progress; other times, they crash over us with burden and disruption. Regardless, these waves do not merely batter us. They invite transformation. They force us to rise and to evolve our meaning-making structures and expand our perspectives (Fiandt et. al., 2003). We must grow in our ability to meet them with evidence, insight, and presence.
• And finally, there is the depth. The vast ocean that lies beneath all titles, all tasks, all knowledge. It reflects the learner’s evolving constructions of meaning, shaped by personal values, beliefs, and lived experiences. Just as the ocean holds diverse, dynamic ecosystems, beneath the surface lies our insight into human experience, our understanding of suffering, adaptation, and health. This is the realm of wisdom, compassion, and an ever-deepening awareness of what it means to serve (Pesut, 2001a; 2001b; 2002).

Within this metaphor, each intentional action—a moment of listening, a student mentored, a system improved, a contribution to nursology, a community served—sends ripples into the water. At first, these ripples may seem small, however, over time they may transform relationships, organizations, and even the profession itself. To be and become a nurse, then, is to honor the currents, understand the wind, respect the waves, and to extend further out into the depths (Meleis et. al., 2000). This is not a passive drifting but a developmental unfolding. While every nursing career journey is unique, no path is inherently better or worse (Parse, 1998). Developmental theorists like Kegan and Cook-Greuter teach us that adults grow not just by acquiring knowledge, but also by transforming how they know—expanding their meaning-making, deepening their perspective, and expanding their consciousness. Likewise, our professional potential unfolds through deliberate engagement with self, with others, and with the evolving profession we serve.

Picture yourself in the kayak, in the sea of nursing. How are you currently responding to the currents, winds, waves, and depths? Where in your practice are you paddling with intention, and where might you be drifting? What ripples are you creating through your presence, choices, and contributions? What might it look like for you to deepen your awareness and seek out development in one of these areas? You are not alone on this journey. But the way you chart your course matters. The profession, the people you serve, and the nurse you are becoming, all depend on how you show up in the ocean of nursing.

References

American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Silver Spring, MD: American Nurses Publishing.

American Nurses Association (ANA). (2021). Nursing: Scope and Standards of Practice. Silver Spring, MD: American Nurses Publishing.

American Nurses Association. (2025). Code of ethics for nurses. Silver Spring, MD: American Nurses Publishing.

Benner, P. (1984). From novice to expert. Menlo Park, 84(1480), 10-1097.

Carper, B.A. (1978) Fundamental Patterns of Knowing in Nursing. Advances in Nursing Science, 1, 13-24. http://dx.doi.org/10.1097/00012272-197810000-00004

Chinn, P. L., & Kramer, M. K. (2013). Integrated theory & knowledge development in nursing- E-Book. Elsevier Health Sciences.

Cook-Greuter, S. R. (2002). A detailed description of the development of nine action logics adapted from ego development theory for the Leadership Development Framework.https://www.researchgate.net/publication/350500645_

Fawcett, J. (1984). The metaparadigm of nursing: present status and future refinement. Image: The Journal of Nursing Scholarship, 16(3), 84-87.

Fiandt, K., Forman, J., Megel, M. E., Pakieser, R. A., & Burge, S. (2003). Integral nursing: An emerging framework for engaging in the evolution of the profession. Nursing Outlook, 51(3), 130–137. https://doi.org/10.1016S0029-6554(03)00080-0

Henderson, V., & Nite, G. (1978). Principles and practice of nursing (Vol. 78, No. 9, p. 1574). LWW.

Inayat, S., & McCaffrey, G. (2023). Dialectical pluralism for nursing knowledge development. Creative Nursing, 30(1), 12–20. https://doi.org/10.1177/10784535231213843

Kegan, R. (1982). The evolving self: Problem and process in human development. Harvard University Press.

Meleis, A. I., Sawyer, L. M., Im, E. O., Messias, D. K. H., & Schumacher, K. (2000). Experiencing transitions: An emerging middle-range theory. Advances in Nursing Science, 23(1), 12–28.

Newman, M. A. (1994). Health as expanding consciousness (2nd ed.). National League for Nursing Press.

Orem, Dorothea E. (1997). Views of Human Beings Specific to Nursing. Nursing Science Quarterly, 10.1, 26–31.

O’Rourke, M. O. (2021). A situation-specific theory about professional role identity formation as related to role clarity and nurse work engagement. In Situation specific theories: Development, utilization, and evaluation in nursing (pp. 211–230). https://doi.org/10.1007/978-3-030-63223-6_15

Roy, C. (1997). Future of the Roy Model: Challenge to Redefine Adaptation. Nursing Science Quarterly, 10(1), 42-48. doi:10.1177/089431849701000113

Parse, R. R. (1998). The human becoming school of thought: A perspective for nurses and other
health professionals. SAGE.

Pesut, D. J. (2001a). Assumptions that hold us. Nursing Outlook, 49(5), 210. https://doi.org/10.1067/mno.2001.119933

Pesut, D. J. (2001b). Deep change. Nursing Outlook, 49(3), 118. https://doi.org/10.1067/mno.2001.116158

Pesut, D. J. (2002). Awakening social capital. Nursing Outlook, 50(1), 3. https://doi.org/10.1067/mno.2002.122216

Watson, J. (2012). Human caring science. Jones & Bartlett Publishers.

About Leah Korkis

Leah Korkis is an accomplished nursing leader with a Master of Science in Nursing as a Clinical Nurse Specialist from Mount Saint Mary’s University and a distinguished Bachelor of Science in Nursing from Bradley University. Leah serves as the Director of Clinical Education and Nursing Excellence within Keck Medicine of USC, where she drives initiatives such as the ANCC accredited Practice Transition Accreditation Program (PTAP), professional and clinical development, professional governance, research, and nursing practice enhancement efforts. Leah is also a part-time faculty member at Mount Saint Mary’s University, teaching in both the administrative and clinical nurse specialist specialty tracks at the master’s level.