Professional autonomy in nursing: An integrative review

Abstract

Aim To summarize knowledge of professional autonomy in nursing. Background Professional autonomy is associated with experienced meaningfulness of the work. This refers to participation in decision‐making and the ability to influence working practices. Evaluation In an integrative review, relevant studies were retrieved from four databases. Quality was systematically evaluated using critical appraisal tools. PRISMA guidelines were followed. Inductive content analysis was used to analyse current knowledge of the focal subject. Key issues The search identified 27 relevant studies published between 2000 and 2019. Elements describing nurses’ professional autonomy were independence in decision‐making and ability to utilize one's own competence. Themes relating to nurses’ professional autonomy were shared leadership, professional skills, inter‐ and intra‐professional collaboration and healthy work environment. Conclusion Understanding the multidimensional nature of professional autonomy is essential to create attractive work environments. It is important to enable nurses to participate in decision‐making and develop nursing through shared leadership to enhance the recruitment and retention of a skilled workforce. Implications for Nursing Management The findings have anticipated utility for supporting nursing practice and nurse leaders’ understanding of approaches to foster nurses’ professional autonomy.

Impact of Nurse–Physician Collaboration, Moral Distress, and Professional Autonomy on Job Satisfaction among Nurses Acting as Physician Assistants

“…In our findings, professional autonomy may significantly predict job satisfaction among nurses acting as PAs, consistent with comprehensive literature reviews in a range of contexts, such as with nurses in different care settings [ 52 , 53 ] and PAs worldwide [ 44 , 54 ]. It can be supported by self-determination theory (SDT), which identifies three basic psychological needs—autonomy, competency, and relatedness—as determinants of satisfaction [ 55 ].…”

“…Indeed, the outcomes of professional autonomy motivate nurses to apply their knowledge and skills and foster professionalism; thus, in literature reviews [ 53 , 59 ], it has been found to enhance job satisfaction, commitment, retention of nurses, and clinical outcomes for patients. Conversely, Mastekaasa [ 60 ] reported no relationship between autonomy and job satisfaction among physicians, nurses, teachers, and social workers in Norway.…”

Nurses' critical reflections of working in unit practice councils—A qualitative interview study

“…Nurses are highly educated professionals with professional autonomy and accountability to secure the safety and health of their patients (Porter-O'Grady, 2019;Pursio et al, 2020). Without effective distributional decision-making structures throughout the organisation, nurses are left in the role of employees with no ownership of their work and no accountability, forcing them to forget their professional role (Hess, 2011;Porter-O'Grady, 2019).…”

“…Without effective distributional decision-making structures throughout the organisation, nurses are left in the role of employees with no ownership of their work and no accountability, forcing them to forget their professional role (Hess, 2011;Porter-O'Grady, 2019). There are certain legal restrictions relating to nurses' professional autonomy (Pursio et al, 2020), and shared decision-making is particularly challenging when applied to issues generally controlled by management such as resources, recruitment of personnel and budgets (Scherb et al, 2011).…”

Predicting nurses' occupational commitment and turnover intention: The role of autonomous motivation and supervisor and coworker behaviours

“…Organizational efforts to strengthen nurses' autonomous motivation, through supportive supervisor and coworker behaviors, should prove to be a beneficial strategy for contributing to a well-rooted workforce in the profession. Among the possible means to facilitate such efforts, healthcare managers, including supervisors in departments or units, could promote a culture of support, for example by encouraging equity in the application of policies and relying on shared leadership (Pursio et al, 2021). The finding that supportive coworker behaviors would be particularly important to facilitate nurses' autonomous motivation adds to the relevance of bringing particular attention to shared leadership in which team members with particular knowledge, skills or abilities assume greater leadership in some areas of their work.…”