Perception and Deception in Nurses’ Clinical and Work-Related Professional Autonomy: Case Study for a Hospital in Romania

Abstract

The continuous expansion of the nursing scope of practice, the undeniable growth of the nurses’ role in the healthcare crisis, the shortage of labor, especially in rural areas and marginalized urban csommunities, and last but not least, the lack of literature on Romanian nursing autonomy are some of the background factors in this study. This study’s purpose is to assess nurses’ perceptions of their medical care independence. The main hypothesis is that more advanced levels of education generate a greater inclination toward autonomous interventions. The quantitative research is based on a survey using a self-designed questionnaire as a tool (based on a nurse-focused structure and process indicators following the Donabedian model) applied in a Romanian clinical hospital. Based on a literature review, three composite indicators were developed and tested for reliability using the Cronbach alpha coefficient. These indicators reflect autonomy from three perspectives: clinical practice independence, autonomy in relation to work, and autonomy through digitalization. This scientific approach revealed a major impact of the regulatory framework on nurses’ perceptions of their autonomy, below the expectations of use, and the acceptance of digital technologies among nurses. Finally, it was observed that college graduate nurses perceive lower levels of independence than post-secondary ones.