The meaning of autonomy in nursing practice

Area of Science:

• Nursing Science
• Healthcare Management
• Professional Ethics

Background:

• Professional autonomy is defined as the authority to make decisions and act based on professional knowledge.
• Understanding autonomy is vital for nursing profession development amidst rapid healthcare changes and evolving specialist roles.

Purpose of the Study:

• To explore the meaning of nurses' experiences of autonomy in their work situations.
• To clarify the core elements of nursing practice in the context of expanding specialist roles.

Main Methods:

• Qualitative study employing a hermeneutic approach inspired by Gadamer's philosophy.
• Data collected through in-depth and focus group interviews with eleven Norwegian nurses (2-3 years post-graduation experience) in 2006.
• Analysis and interpretation of transcribed interview texts.

Main Results:

• Nurses' experiences of autonomy were described through four themes: 'to have a holistic view', 'to know the patient', 'to know that you know', and 'to dare'.
• Knowledge and confidence were identified as the core components of autonomy in nursing practice.
• Autonomous practice is linked to the authority in total patient care and decision-making power.

Conclusions:

• Autonomy in nursing practice involves authority over patient care, decision-making power in patient and family relationships, and freedom in clinical judgments and actions.
• Achieving autonomous practice requires nurses to be competent and courageous in taking responsibility.
• The study highlights the challenges inherent in managing autonomous nursing practice.