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Tradition is reflected in the way practice gets done. It is handed down, perhaps shifting slightly to prevailing ideas and directives. It constitutes ‘normal practice’ and, as such, is largely taken for granted. When tradition is dissected, it can be viewed as the assumptions and attitudes that govern everyday practice. Bohm (1996, p. 69) writes:

Normally, we don’t see that our assumptions are affecting the nature of our observations. But the assumptions affect the way we see things, the way we experience them, and consequently the things we want to do. In a way we are looking through our assumptions; the assumptions could be said to be an observer in a sense.

Practice is contextual set within particular organisational settings. Dawson (2015, p. 25) notes that ‘context refers to the grand societal narratives, those clusters of beliefs and cultural norms that give shape and meaning to the human cultures within which we live’.

Responding in more desirable ways to a situation is likely to disrupt normal practice and require a shift in cultural norms and assumptions and, as such, may be resisted by those who have an investment in maintaining normal practice and its status quo. You might say, ‘I believe in treating patients with dignity and compassion’ and believe your practice reflects that. However, on reflection you may acknowledge that your responses lack these qualities leading to uncaring behaviours what Jameton (1992) and Corey and Goren (1998) have labelled the ‘dark side of nursing’. So next morning you may set out to remedy this in your own practice and get criticised by other staff for getting too involved with your patients. The pressure is immediately put on you to conform to normal practice. You feel the creative tension and the difficulty in resolving it.