When Protocols Are Not Enough

Abstract

The pressing need for health care reform in this century has contributed to an increasing interest in educating health care providers who can deliver cost-effective, high-quality care. Demand for primary care nurse practitioners has risen significantly, and nursing education has responded by increasing the numbers and graduates of nurse practitioner programs. Although this century brings new opportunities for expanded nursing roles, it also presents challenges for nurse practitioners to sustain a holistic perspective while providing quality care. The purpose of this interpretive phenomenological study was to discover, describe, and analyze the stories of 10 novice nurse practitioners who used intuition in clinical decision making. The authors maintained a critical social consciousness and postmodern perspective to analyze and describe the shared meanings and common practices of participants. This article discusses the six themes and constitutive process that emerged from the data and addresses implications for nurse practitioner education and practice.

The Use of Intuition in Homeopathic Clinical Decision Making: An Interpretative Phenomenological Study

“…Our findings confirm that despite differences in clinical practice, homeopaths show considerable similarities to other medical practitioners in their description and use of intuition in practice. They were aware of experiencing intuition and the rapid nature of the experience [41, 42]; they found it difficult to express what intuition is (e.g., [6, 16]); but had an understanding of its origins during clinical practice, perceiving it to be a cognitive process reliant on their clinical knowledge and experience [43–45]; but also related to their inherent personal intuitiveness [46]. In addition, they were also cognizant of the types of intuition they used; intuitions helping them to deepen their understanding of their patient (perceptive intuition [46]) and enhance their relationship with their patients, as well as those helping their prescribing decisions (both perceptive but also idea generating intuitions).…”

Use of intuition by critical care nurses: a phenomenological study

“…Rigor was achieved using several strategies included in the trustworthiness criteria described by Schwandt et al 7 , 26 To enhance credibility, the researchers conducted member checks with participants after the first-level analysis and again at several points during data analysis. Final member checking occurred as participants were asked to review the findings, comment on the accuracy of interpretations, and confirm descriptions.…”

“…Intuition has been defined as a feeling of knowing that something terrible is happening, 6 an immediate unconscious perception, 7 direct understanding of truths, independence of the analytical process, 8 a nonlinear process of knowing through physical awareness, “emotional awareness” and “making connection between them”, 9 and an irrational unconscious type of knowing. It has also been described as a “gut feeling” and with some negative connotations, such as “having a very bad feeling”, “feeling uncomfortable”, “feeling there was something terribly wrong”, “something missing”, or there was “something they had not done”.…”

“…It has also been described as a “gut feeling” and with some negative connotations, such as “having a very bad feeling”, “feeling uncomfortable”, “feeling there was something terribly wrong”, “something missing”, or there was “something they had not done”. 7 , 10 …”

Teaching diagnostic reasoning: Transitioning from a live to a distance accessible online classroom in an Adult Acute Care Nurse Practitioner Program

“…Kosowski and Roberts [5] investigated intuitive decision making among novice nurse practitioners and found that intuition frequently triggered a more analytical approach in their sample.…”