Designing Relationalities for Nursing Work Futures

Atula Jadhav, Deborah Forster, Stein Wetzer, Eva Verhoef, and David Abbink

Towards a systemic mindset shift through transdisciplinary research and innovation

In this exhibit, we illustrate an example of transdisciplinary research and innovation (TD R&I) as performed at FRAIM—a Dutch transdisciplinary research and innovation centre. FRAIM’s aspired impact is shaping meaningful, just and viable work futures—with and for workers—in various key sectors in the Netherlands (such as care, energy transition, logistics, repair & maintenance).

We showcase our work in the care sector,  where FRAIM has partnered with Convergence (a multi-university consortium) in the 2-year NURTURE project. The project aims to innovate technology-mediated nursing work in hospitals. FRAIM’s broadest long-term aspiration, to shape the future of work, will take more than two years, but will critically depend on bringing about a systemic mindset shift away from current approaches to innovation that emphasise top-down tech-push processes aimed at short-term measurable gains in productivity. Achieving such a shift requires a unique integration between research and innovation practices. This integration of a plurality in ways of knowing is at the heart of FRAIM’s transdisciplinary research & innovation (TD R&I) approach.

Transdisciplinary collaboration (TDC) literature (e.g., NECTR, 2025) acknowledges the challenge of enacting systemic mindset shifts, as it depends on the kind of embodied and experiential learning that allows the emergence of new insights across a plurality of perspectives (also known as epistemic intelligence, Bijl-Brouwer, 2022). We aim for these experiences to engage and reverberate through a whole system. Once such shared sense-making and knowledge co-creation is performed and experienced by a whole system, it can be leveraged to repeat and sustain the kind of impact (mindset shift) we aspire to.

Strategically, TD R&I practice is best understood in terms of designing relationalities to address the complexities (Pendegrast et al., 2025) of significant societal challenges, such as an ageing workforce, labour shortages, and patterns of human migration. We design (1) systems relations to address the complexity of the systems that come together in such projects, (2) social relations to address the participatory complexity, (3) temporal relations to address the process complexity and (4) knowledge relations to address the epistemological complexity of the plurality of perspectives that are the engine for TD R&I.

We examine these relational dynamics as they occur while working for one year towards the first whole system milestone event in the nursing TD R&I process. Process-wise, this milestone event represents the transition from a joint discovery phase to a joint definition (building on the generic Double Diamond approach to design (Design Council, 2025). We map five major activities of TD R&I up to this point (after onboarding): Shadowing & Observation; Interviews; Employee Journey Mapping; Opportunity Identification; Impact vs. Effort Evaluation session. The significance of this milestone cannot be overstated. It is performative and experiential, shared with the widest participation of stakeholders, and is choreographed to counterbalance the asymmetric power relations more typical in sessions with managers, technology experts and workers. We establish a worker-first sensibility from the outset and leverage trust-building, so as to enact a wider conversation about innovation opportunities where the voice of nurses is primary.

Even though only partially through the full TD R&I cycle, we find the arcs of impact buildup important to share, alongside the challenges faced in navigating these dynamic relational complexities. In the NURTURE project, we underestimated the time and resources required to reach this milestone. Nevertheless, the impact on the system is shaping up to be as intended. Not only were the shared sense-making and joint decisions during the Impact vs. Effort evaluation successful, but we are also seeing tangible signs of a systemic mindset shift—commitment in terms of resources and personnel.

KEYWORDS: transdisciplinarity, research and innovation, nursing work futures, future of work, complex relational dynamics