Nursing decision making in critical care areas.

Abstract

This exploratory study sought to identify factors that critical care nurses consider relevant in making rapid patient care decisions; to explore the decision making of these nurses in crisis situations; and to identify critical patient care situations where rapid nursing decisions are made. The convenience sample consisted of 50 nurses in critical care settings. A semi-structured interview with a critical care case study was utilized to examine the nurses' decision making. Open ended responses were transformed into fixed categories for tabulation. The findings suggested that: 1 knowledge and experience were the most important factors influencing rapid decision making; 2 although the nurses identified the appropriate decisions in a given crisis situation they had difficulty providing a theoretical rationale for their decisions; 3 the given case study and the 50 crisis situations identified by the subjects indicated that many nursing decisions for critically ill patients were carried out prior to physician assistance. A demographic data questionnaire that examined age, nursing experience, formal education and continuing education of the subjects determined that the majority of the nurses were under 30 years old, had either less than 1 year experience or 7-9 years in critical care, were graduates of a 2-year diploma programme, and took continuing education courses at the community college level.