Decision making of psychiatric nurses in Finland, Northern Ireland, and the United States

Lauri, Sirkka; Salanterä, Sanna; Gilje, Fredricka; Klose, P.

doi:10.1016/s8755-7223(99)80052-0

Cited by 17 publications

(13 citation statements)

References 15 publications

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“…It is more difficult to define the expert nurse, and controversy exists as to whether the number of years in practice should be used to determine skill level. Although 5 years of experience has been used to define the expert nurse (Benner & Tanner, 1987;Fonteyn, 1991a;Lauri, Salantera, Gilje, & Klose, 1999;Parker et al, 1999;Sims & Fought, 1989), nurses may enter and exit practice on a part-time basis to accommodate their family, graduate education, and personal responsibilities. Simon (1989) used 10 years of work experience as the criterion for expertise.…”

Section: Purposementioning

confidence: 99%

Clinical Reasoning in Experienced Nurses

et al. 2003

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As an essential component of nursing practice, clinical reasoning is used to assimilate information, analyze data, and make decisions regarding patient care. Little is known about the reasoning strategies of experienced nurses who are not yet experts. This qualitative descriptive study explored the cognitive strategies used by experienced nurses as they considered assessment findings of assigned patients. To date, few studies of nurses' clinical reasoning have been conducted in a practice setting during actual patient care. A small group research design was employed using the think-aloud (TA) method with protocol analysis. A total of 15 experienced nurses were asked to "think aloud" about patient assessment findings. Data were audiotaped, transcribed, and analyzed using the three steps of protocol analysis. The results suggest that experienced nurses used a conceptual language to reason about assessment findings and used heuristics to reason more quickly and efficiently.

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Section: Purposementioning

confidence: 99%

Clinical Reasoning in Experienced Nurses

et al. 2003

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“…Their study showed that nurses' use of CDM differed according to field of practice and country [20–23]. In relation to different stages of the decision making process, Lauri and Salanterä [2] claimed that pure intuitive decision making did not weight on any of the 4 stages.…”

Section: Introductionmentioning

confidence: 99%

Clinical Decision Making of Nurses Working in Hospital Settings

Bjørk

Hamilton²

2011

Nursing Research and Practice

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This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

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“…As noted earlier in this paper, Lauri et al (1997Lauri et al ( , 1999 concluded that nurses' decision making is multidimensional. However, the theoretical perspectives that view decision making as a rational, step-by-step process (Gilje & Klose, 2000), an information process, or even the less linear intuitive interpretive model (Benner & Tanner, 1987) imply uni-directionality.…”

Section: Discussionmentioning

confidence: 53%

“…In contrast to a step-by-step process, intuition is a holistic understanding of the situation influenced by previous experiences (Benner & Tanner, 1987;Marsden, 1998). As with pain management research, most decision-making research has been conducted in acute care settings with medical and surgical patients; only recently have researchers examined how psychiatric nurses make decisions (Gilje & Klose, 2000;Lauri, Salanterä, Bild, Chalmer, Duffy, & Kim, 1997;Lauri, Salanterä, Gilje, & Klose, 1999) but these studies have been done in community rather than acute care settings. These authors argue that decision-making is contextual (Gilje & Klose, 2000;Lauri et al, 1997;Lauri et al, 1999;Lauri & Salanterä, 2002) and concur that the nurse's intuition and self-confidence are vital to decision-making (Gilje & Klose, 2000).…”

Section: Introductionmentioning

confidence: 99%

“…These authors argue that decision-making is contextual (Gilje & Klose, 2000;Lauri et al, 1997;Lauri et al, 1999;Lauri & Salanterä, 2002) and concur that the nurse's intuition and self-confidence are vital to decision-making (Gilje & Klose, 2000). Lauri et al (1999) concluded that the "decision-making process of psychiatric nurses is multidimensional and broad" (p. 279). In other words, no one model applies consistently across the diversity of situations faced by psychiatric nurses.…”

Section: Introductionmentioning

confidence: 99%

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Psychiatric Patients: How Can We Decide if You Are in Pain?

Dewar

Osborne

Mullett

et al. 2009

Issues in Mental Health Nursing

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How do psychiatric nurses make decisions about pain management for hospitalized psychiatric patients? This is the question addressed by this research. Using an exploratory, naturalistic interview approach, 20 nurses and managers in varied settings described their decision making when providing pain relief. Analysis of these narratives indicates that decision making about pain, in this unique context, is influenced by a number of intrapersonal and interpersonal factors such as the patients' needs, history, and diagnosis; nurses' beliefs about pain tolerance and drug addiction; collegial pressure; and unit safety. For example, diagnosis and patient history impact pain relief negatively, while the responsibility to maintain a safe environment imposes pressure to administer medication. Although, in a psychiatric unit, the nurse-patient relationship is essential to the healing process, nurses often face a dilemma as to whether the pain medication will contribute to healing or exacerbate the patient's issues. In psychiatric wards, the means of recovery are far less clear, tangible, and immediate than in other clinical settings. Recommendations are made for better preparing and supporting nurses to work effectively in these practice settings where pain relief is confounded by addiction and psychiatric diagnoses.

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Decision making of psychiatric nurses in Finland, Northern Ireland, and the United States

Cited by 17 publications

References 15 publications

Clinical Reasoning in Experienced Nurses

Clinical Reasoning in Experienced Nurses

Clinical Decision Making of Nurses Working in Hospital Settings

Psychiatric Patients: How Can We Decide if You Are in Pain?

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