Professional Autonomy Of Nurses Research Articles

First Level of Health Care: The Autonomous Role of Nurses

Introduction: Although nursing autonomy is advancing with national legislation towards a competency-based approach, a positivist vision centered on biomedical aspects persists, limiting comprehensive care. Despite training and experience, role conflicts and oppression by the medical team persist, impeding freedom of decision and leading to job dissatisfaction.Objective: To analyze the professional autonomy of nurses in type A, B and C health centers at the first level of care in Health District 09D04 - Febres Cordero.Method: Qualitative, descriptive, and dialectical approach, based on the perceptions of nursing professionals about their autonomy in Health District 09D04.Results: The perception of autonomy in the first level of health care is limited, under pressure and subject to demanding schedules. There are restrictions imposed by parameters and regulations, although benefits such as quality care and educational responsibility are recognized. Legal limitations, lack of support and restrictions affecting nurses' autonomy are also identified.Conclusions: To empower nurses, a series of measures are required at both the practical and educational levels. These include the implementation of laws that support their autonomy, ongoing training, the promotion of a favorable work environment, and the strengthening of their educational background with a focus on leadership and solution-finding skills.

First Level of Health Care: The Autonomous Role of Nurses

Introduction: although nursing autonomy is advancing with national legislation towards a competency-based approach, a positivist vision centered on biomedical aspects persists, limiting comprehensive care. Despite training and experience, role conflicts and oppression by the medical team persist, impeding freedom of decision and leading to job dissatisfaction.Objective: to analyze the professional autonomy of nurses in type A, B and C health centers at the first level of care in Health District 09D04 - Febres Cordero.Method: qualitative, descriptive, and dialectical approach, based on the perceptions of nursing professionals about their autonomy in Health District 09D04.Results: the perception of autonomy in the first level of health care is limited, under pressure and subject to demanding schedules. There are restrictions imposed by parameters and regulations, although benefits such as quality care and educational responsibility are recognized. Legal limitations, lack of support and restrictions affecting nurses' autonomy are also identified.Conclusions: to empower nurses, a series of measures are required at both the practical and educational levels. These include the implementation of laws that support their autonomy, ongoing training, the promotion of a favorable work environment, and the strengthening of their educational background with a focus on leadership and solution-finding skills

The Impact of the COVID-19 Pandemic on the Professional Autonomy of Anesthesiological Nurses and Trust in the Therapeutic Team of Intensive Therapy Units-Polish Multicentre Study.

Introduction: The COVID-19 pandemic as well as the rate of spread of this particular pathogen around the world have caused the number of patients requiring medical attention and intensive care to exceed the capacity of even the best organized health care systems. This resulted in the need to hire employees who had not previously worked in intensive care units. Experience and knowledge have become particularly important in the context of mutual trust in the ICU team. At the same time, it could affect the level of professional autonomy of nurses, understood as the freedom to perform work based on knowledge, skills and competence without the need to submit to other medical professions. The pandemic status has required that nurses are always involved in their work by participating in training. Faced with the dangers of COVID-19, there is no doubt that by the end of the pandemic, both nursing and healthcare will be better equipped to face future challenges. Methods: The study lasted from July to September 2021. The data collection procedure started with the consent of the heads of the institutions where the data was collected. The study was conducted using the Dempster Practice Behavior Scale (DPBS), which examines work autonomy. The survey using the proprietary questionnaire was conducted among 225 nurses working in eleven ICUs in five voivodeships in Poland. Results: The autonomy of nurses during the COVID-19 pandemic was assessed at a high level. Younger respondents rated autonomy as being higher. Almost half of the respondents assessed the level of professional independence as high, including 52% of nurses, and significantly less, including 34% of doctors. A group of 47% of respondents assessed that trust had decreased and 28% said that trust had improved slightly. Conclusions: Professional independence allows you to perform work independently on others, taking responsibility for decisions and actions. The COVID-19 pandemic, through the influx of new staff members into treatment teams, had an impact on both nursing autonomy and the level of trust in a team, as shown in this study.

Professional Autonomy of Nurses: A Qualitative Meta-Synthesis Study.

Background:Autonomy is the main element of professional practice in nursing. However, despite the many studies conducted on nursing autonomy, this concept is not fully understood and a comprehensive explanation of this concept in nursing is necessary. Meta-synthesis offers a way to increase the understanding of this concept using existing research findings. Thus, the present study aimed to explain the concept of professional nursing autonomy.Materials and Methods:This qualitative meta-synthesis was conducted based on a modified version of Noblit and Hare's meta-ethnography approach and qualitative studies on the concept of nursing autonomy published in databases such as PubMed, Scopus, Web of Science, Cochrane, SID, IranMedex, Magiran, and ScienceDirect in the past 15 years (2003–2018).Results:Thirteen articles that reported the experiences of nurses regarding professional autonomy were included in the research. Based on the meta-synthesis of findings, the final interpretation of the professional autonomy of clinical nurses was presented in the three themes of professional competence, professional decision making, and professional interactions.Conclusions:According to the results, the concept of professional autonomy is a developmental achievement based on patient-based professional competence along with self-reliance to provide the best care plan for the promotion of patients' health through the professional decision making and professional interactions with other professional team members.

Ways of understanding nursing in psychiatric inpatient care - A phenomenographic study.

AimThe aim was to describe the ways that nursing staff in psychiatric inpatient care understand nursing.BackgroundNursing in psychiatric care is marginalized with ambiguous role definitions and imperceptible activities. Nurse managers' capabilities to establish a direction and shared vision are crucial to motivate nursing staff to take part in practice development. However, before establishing a shared vision it is important to identify the different ways nursing can be understood.MethodsSixteen individual semi‐structured interviews with nursing staff members were analysed using a phenomenographic approach.ResultsFive ways of understanding nursing were identified. These understandings were interrelated based on the way that the patient, nursing interventions and the goal of nursing were understood.ConclusionThe diversity of identified understandings illuminates the challenges of creating a shared vision of roles, values and goals for nursing.Implications for Nursing ManagementAwareness of staff members' different understandings of nursing can help nurse managers to establish a shared vision. To be useful, a shared vision has to be implemented together with clear role definitions, professional autonomy of nurses and support for professional development. Implementation of such measures serves as a foundation to make nursing visible and thereby enhance the quality of patient care.

Nurses’ lived experiences of professional autonomy in Iran

ObjectivesNurses' autonomy is a complex and multi-dimensional concept that has often been overlooked. Although many studies have addressed patients' autonomy, there has been no assessment of nurses' experience of professional autonomy. The present study aimed to assess nurses’ lived experiences of professional autonomy in Shiraz, Iran. MethodsThe present qualitative study was conducted in Shiraz (Iran) from January 2016 to February 2018. The target population was selected among nursing professionals employed by various hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The experiences of the participants were assessed through 14 in-depth semi-structured interviews. The response of the participants was analyzed using Van Manen's 6-step approach for interpretive phenomenology. ResultsBased on the analysis of the interviews, 4 themes, 11 categories, and 13 sub-categories were extracted. The themes were: Advocacy for patients and nurses, independence in the workplace, Involvement in professional decision-making, and Professional accountability. ConclusionDue to the intense interaction between nurses and patients, a better quality of care will be achieved if the professional autonomy of nurses is ensured. Healthcare authorities and hospital managers should provide the framework and permit the nurses to practically exercise full independence in the workplace.

Nurse–Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses

ABSTRACTBackground and aimsPoor collaboration between the physicians and the nurses may interfere with nursing performance in patient care. This study aimed to determine the nurse–physician collaboration and professional autonomy of intensive care nurses.Subjects and methodsThis descriptive correlational study was performed on 126 nurses working in the intensive care units (ICUs) of Ardabil, Iran. The data were collected using the Jefferson scale of attitudes toward physician–nurse collaboration’ (JSAPNC) and the Dempster Practice Behavior Scale (DPBS). The results were analyzed using descriptive statistics (mean, standard deviation, and frequency) and inferential statistics (t-test, ANOVA, and Pearson).ResultsThe mean score of the nurse–physician collaboration was found to be 47.83 ± 3.9, which indicates good collaboration between physicians and nurses in the ICUs. The results showed that 73% of the nurses reported a moderate autonomy and 27% of them considered their autonomy to be high. There was no significant relationship between the nurse–physician collaboration and the professional autonomy of the nurses (p >0.05).ConclusionThe nurses who participated in this study had a positive attitude toward collaboration with the physicians and a moderate level of professional autonomy. Interventions may be required to further enhance the level of nurse–physician collaboration and the professional autonomy of nurses.How to cite this articleAghamohammadi D, Dadkhah B, et al. Nurse-Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses. Indian J Crit Care Med 2019;23(4):178-181.

Comparing the attitude of doctors and nurses toward factor of collaborative relationships.

Background and Objectives:Effective relationship and collaboration between doctors and nurses is considered the main factor in achieving positive medical results, which is the most important goal of the healthcare system. This study aims to compare attitude of doctors and nurses toward factors associated with doctor-nurse collaboration, including shared education and teamwork, caring as opposed to curing, physician's dominance, and nurses’ autonomy.Methods:In this cross sectional, descriptive-comparative study, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration was used to assess doctor–nurse collaboration in four domains, including shared education and teamwork, caring as opposed to curing, physician's dominance, and nurses’ autonomy. To this end, descriptive (mean, standard deviation) and inferential statistics including independent t test, Chi-square, and variance analysis were used.Results:According to the results obtained, compared to doctors, nurses showed a more positive attitude toward shared education and teamwork, caring as opposed to curing, and physicians’ dominance, but there was no significant difference between the two groups in nurses’ autonomy.Conclusion:With regard to doctor-nurse collaboration, it is essential that doctors and nurses be acculturated in the course of their academic education. Moreover, policies to change pattern of professional relationships from hierarchical to complementary can be effective in enhancing professional autonomy of nurses and reducing impaired professional interactions.

Evaluation of professional autonomy and the association with individual factors among nurses in the Southeast of Iran

Background and Purpose: Professional autonomy in nursing is defined as working in a self-determined environment and making decisions based on professional judgment. This study aimed to evaluate professional autonomy and its association with individual factors in nurses employed at teaching hospitals affiliated to Kerman University of Medical Sciences in the southeast of Iran in 2013. Methods: This was a descriptive analytical study, and required data were collected by quota sampling using self-administered questionnaires, which were completed by 385 nurses at four teaching hospitals in Kerman, Iran. Data analysis was performed using inferential (ANOVA) and descriptive statistics (mean and frequency) in SPSS V.18. Results: In this study, a significant correlation was observed between professional autonomy and age (P>0.001), gender (P=0.04), work experience (P>0.03), education level (P>0.02) and attitude of nurses. Moreover, a positive correlation was found between the mean scores of professional autonomy and nursing experience (r=0.559). Conclusion: According to the results of this study, general attitude of nurses towards professional autonomy was relatively positive. In addition, professional autonomy was observed to increase with higher education level and job satisfaction. Hierarchical team decisionmaking may restrict professional autonomy in nurses. Therefore, it is recommended that nursing skills and professional autonomy of nurses be improved through appropriate methods.

Intent to stay in the nursing profession and associated factors among nurses working in Amhara Regional State Referral Hospitals, Ethiopia.

BackgroundNurses are essential to the health care delivery system especially to meet the health related millennium development goals. However, despite the significant shortage of nurses in Ethiopia, research in the country regarding nurses’ intent to stay in their profession is lacking. This study assessed intent to stay in the nursing profession and associated factors among nurses working in referral hospitals, Amhara Regional State, Ethiopia.MethodsInstitution-based cross-sectional study was conducted among 389 nurses from April 8 to May 5, 2013. Stratified random sampling technique was used to select the study participants from five referral hospitals. Data were collected using pretested and structured self-administered questionnaires. Descriptive statistics were conducted to summarize the sample characteristics. Backward stepwise logistic regression model was fitted and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors.ResultsThe proportion of nurses who reported intent to stay in the nursing profession was 39.8%. Age 40 to 49 (AOR [95% CI] 4.5 [1.6-12.8]), being married (AOR [95% CI] 2.0 [1.0-3.8]), having a bachelor degree in nursing (AOR [95% CI] 2.2 [1.2-4.1]), satisfaction with: autonomy and professional opportunities (AOR [95% CI] 2.6 [1.2-5.9]), scheduling (AOR [95% CI] 3.4 [1.6-7.5]), and pay and benefits (AOR [95% CI] 8.8 [4.5-17.1]); high continuance commitment (AOR [95% CI] 2.4 [1.3-4.8]) and high normative commitment (AOR [95% CI] 3.7 [1.9-7.2]) were the significant predictors of intent to stay in the nursing profession.ConclusionsIntent to stay in the nursing profession was low among nurses working in Amhara Regional State referral hospitals. Interventions aimed at increasing the professional autonomy of nurses and revising the current salary and other duty payments are vital.

Factors contributing to professional autonomy of nurses working in special nursing home for the elderly

Factors contributing to professional autonomy of nurses working in special nursing home for the elderly

An evaluation of nurses’ professional autonomy in Turkey

The development of a profession's autonomy closely relates to that profession's level of autonomy in performing its specific role. For the nursing profession, this key role is nursing care. This study was undertaken to evaluate the professional autonomy of nurses in care provision, from an ethical perspective. A mixed methods approach is employed in this research, which makes use of both quantitative and qualitative methods. The quantitative dimension of this research covers sociodemographic aspects and makes use of the Sociotropy-Autonomy Scale. The qualitative dimension of the research relates to the factors that affect professional autonomy in nursing care. The sample consisted of 30 nurses working in the orthopedics, neurology, or intensive care units of three hospitals. Before conducting this research, we received permission from the ethical committee, as well as written permits from all the institutions in which the research was carried out. Informed consent was obtained from all participants. According to the findings of this study, only 6.7% of the nurses surveyed stated that nurses had professional autonomy; they also stated that professional autonomy in nursing was mostly restricted by the need to be "dependent upon the physician in nursing implementations" and that autonomy in nursing care was mostly limited by a "high number of patients per nurse." This study determined that delays in resolving problems with regard to professional autonomy in nursing care in Turkey could be creating many of the professional and ethical problems that nurses face there. It is recommended that: individuals choose the nursing profession conscientiously; nurses need to be given professional awareness; their professional organizations need to be strengthened; and plans need to be made to increase research and to accumulate both knowledge and expertise.

Professional autonomy of nurses in hospital settings – a review of the literature

Autonomy is regarded as an essential element of professional status. Especially nurse managers have an important role in searching for ways to empower nurses and to provide conditions that promote autonomous practice. This article provides an overview of the empirical research literature on the professional autonomy of nurses in hospital settings. The aim is to clarify the concept and to give information on how the autonomy of nurses has been studied through the decades. The definitions of autonomy and the results of empirical research are reviewed. Further, the article offers a description of the methodologies used in the studies of the autonomy of nurses over the years: data collection methods, samples and research contexts. The review focuses on empirical articles published between 1966 and December 2009 retrieved from the CINAHL and MEDLINE databases. The studies were classified based on a content analysis. This review draws attention to the complexity of the concept of autonomy and its various definitions. Moreover, the data for studies have been collected primarily by questionnaires; the sampling methods have been nonrandomized and the samples varying. It would be necessary to study autonomy in different countries using the same instrument.