"I didn't know anything, but I learned over time": The process of nurses attaining autonomy in Intensive Care Units.

Abstract

Understand the social processes experienced by nursing professionals and the meanings underlying autonomy in adult Intensive Care Units in the city of Cartagena (Colombia). A qualitative study with a grounded theory approach was conducted. Fifteen semi-structured interviews were carried out with nursing professionals, and the analysis was based on the coding technique proposed by Strauss & Corbin. Of the respondents, fourteen were female and one was male, with ages ranging from 23 to 57 years. Experience in intensive care units ranged from 1 to 28 years, and none had postgraduate studies. After thematic analysis, the central category was obtained from four categories: adaptation process, applicability of autonomy exercise, building autonomous competence, and limitations to the exercise of autonomy. Nursing professionals achieve their autonomy through a social process, based on different stages of learning when facing the environment of the units. It is grounded in decision-making and the power to act freely. However, barriers continue to hinder it, including limitations imposed by institutions, protocol-based interventions, social status, and individual differences among professionals.