The pattern of personal knowing in nurse clinical decision making

The struggle to teach clinical decision making effectively continues despite recent efforts aimed at improvement. In recognizing that a complex activity like clinical decision making entails multiple patterns of knowing, qualitative research methodology was used to gain a practice-based understanding of clinical decision making. The result is a description of the pattern of personal knowledge in nurse clinical decision making. Nurse informants label the pattern of personal knowledge as knowing, and describe their success in making clinical decisions as highly dependent upon the quality of interpersonal relationships with patients, peer nursing staff, and physicians. The dynamic of interpersonal relationships and the difficulties in establishing them are identified as important influencing factors in nurses' clinical decision making.