Occupational ideology and clinical decision-making in British nursing

As the first phase of a study to assess the usefulness of the nursing process model of nursing practice, a survey was carried out in one health district to ascertain the predominant occupational ideology of clinical nurses, their perception of decision-making about individual patient care in everyday work, and their view of whether they ought to exercise a decision-making role with respect to 23 aspects of patient care. Two hundred ideology scale questionnaires were processed, together with perceived and normative decisions inventories. Subjects were representative of six nursing fields, i.e. general nursing, geriatric nursing, psychiatric nursing, mental handicap nursing, health visiting and district nursing. The main findings were that nurses predominantly espouse a professional ideology, they perceive decision-making to be part of their everyday work and contend that they ought to be able to make decisions in 22 out of the 23 areas of patient care included in the inventories. Differences in ideology between the groups and between men and women are identified and discussed, and some areas of role conflict highlighted. The professional ideology was found to correlate significantly with decision-making and a significant correlation was established between paramedicine and bureaucracy.