Registered nurses’ perceptions and experiences of autonomy: a descriptive phenomenological study

Abstract

BackgroundProfessional autonomy is a key concept in understanding nurses’ roles in delivering patient care. Recent research exploring the role of autonomy in the nursing work environment indicated that English and American nurses had differing perceptions of autonomy. This qualitative study aimed to explore the understanding and experiences of autonomy of nurses working in England.MethodsA descriptive phenomenological analysis of data from 48 semi-structured interviews with registered nurses from two National Health Service (NHS) hospitals (purposive sample) was used to explore the concept of autonomy.ResultsSix themes were identified: working independently; working in a team; having professional skills and knowledge; involvement in autonomy; boundaries around autonomy; and developing autonomy requires support. A key finding was that nurses related autonomy to their clinical work and to the immediate work environment of their ward, rather than to a wider professional context. Nurses also perceived that autonomy could be turned off and on rather than comprising an integrated aspect of nursing.ConclusionsFindings suggest that nurses in England, as framed by the sample, had a local ward-focused view of autonomy in comparison to nurses in America, who were reported to relate autonomy to a wider involvement in hospital level committees. Findings further indicate that autonomy was practiced occasionally, rather than incorporated into practice. Findings highlight the need for nurses in England to adopt a broader perspective and actively contribute to writing hospital guidelines and policies that recognise the importance of autonomy to nurse training and practice.

‘Stolen Time’- Delivering Nursing at The Bottom of A Hierarchy: An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing For Patients With Community Acquired Pneumonia.

“…The many interruptions we observed from other HPs may well be an indication of this hierarchy, implying, as it did, a lack of respect for and acknowledgment of nursing and RNs' time and independent role and function. This nding is supported by previous research [33,[38][39][40][41] indicating that the hierarchy has an impact on evidence-based nursing practice and that RNs experience a lack of support from physicians as well as interdisciplinary awareness of the value and impact of evidence-based NC [41,42]. It is important to emphasise that this pattern found in our study did not appear to be based on conscious actions or foul intentions from other professionals; rather, it was a barrier embedded in the organisational culture by tradition, poor leadership, and lack of societal and professional acknowledgment of the value and impact of nursing.…”

De autonomia roubada ao fortalecimento da profissão: conexões entre Enfermagem Brasileira e Africana

“…A study carried out with nurses from England revealed that some nurses are able to exercise their autonomy through teamwork, in their daily practices sharing their knowledge and skills. Thus, nurses reported that the hierarchy of health systems, as well as policies and guidelines, are determinant for their performance in an autonomous manner, 19 which is essential for their motivation and satisfaction in the context of the work environment.…”

Pacientu drošības realizācija medicīnas koledžas studiju procesā klīniskajā praksē

“…Pētnieki norāda, ka praktizējošo māsu izlasē trūkst vienprātības par autonomijas jēdzienu. Tiek norādīts, ka nav noteiktas autonomijas definīcijas, un konstatēta autonomijas interpretācijas dažādība (Oshodi et al, 2019). Savukārt pētījumā " Patient Participation in Decision Making During Nursing Care in Greece -A Comparative Study" secināts, ka pacientu līdzdalība, lai arī mērena, bija acīm redzama slimnīcas apstākļos.…”