Nurses are expected to access, appraise, and incorporate research evidence into their professional judgment and clinical decision making.What is the limitation for nurses decision making about their patients? Can they decide without permission of doctors? When and where?
Hi, thanks for introducing this question. The topic is one that has relevance across a wide field, but also which varies depending on the location and local setting. A number of factors influence and inform the ability and scope of nursing decision making. These include the legal and legislative boundaries set by national nursing organisations, expectations associated with professional bodies as well as societal, professional and institutional expectations. In some countries, it may be considered reasonable that nurses make autonomous, independent decisions, when based on evidence and backed up with clearly articulated rationale and logic; this may be linked to role specifications and advanced learning such as the Nurse Practitioner registration. Other countries may have more limited expectations of the nursing role and the opportunity to move outside existing medical hierarchy is more constrained. Sometimes the limitations are imposed from within the nursing profession itself, and are linked to fears of legal implications associated with potential error; in other cases the fear is associated with the implications of failing to act to the extent possible - of needing to provide any possible care in limited circumstances and with limited resources resulting in nurses working beyond their capacity or scope. In other words, I am suggesting that this is such a broad question, that it is very difficult to offer any definitive answer without some further parameters! You might find it helpful to look at some of the writing and discussion around the role, scope of practice and development of advance practice roles which tends to incorporate discussion of factors such as opportunity to move towards greater autonomy and independence of practice, which typically includes consideration of indolence of practice from medical domination. I have attached some articles below that might be of interest:
Recognize their capabilities and limitations and perform only the nursing functions that fall within their scope of practice and for which they possess the required knowledge, skills and judgement.
http://www.clpna.com/wp-content/uploads/2013/02/doc_CCPNR_CLPNA_Code_of_Ethics.pdf
It's seems Krishnan that the information you posted relates to the (at least here in the US) nurses with the lowest level of academic training. I personally have been a CNA, LPN, Associate prepared RN, Bachelor prepared RN and am now in graduate school.
In my experience, the broadness of practice is also influenced by the specific specialty in which the nurse practices. So Nader, I think that this question needs to be fine tuned as it covers a myriad of levels when it comes to formal training, years of experience and specialty.
@ Nader
Personally I dont believe or agree, but that's a clear limit specified by Canadian Council
Dear all,
I think if the boarder of doctors' and nurses' duties is determined, many problems will be solved!
The problem is that the role of nursing in health system is not well defined.
A lack of informed shared decision-making rationales on the issue among patients, nurses, and stakeholders limit nurses' right (and desirable) decision making about their patients:
Article Challenging Rules, Creating Values: Park's Sweet Spot Theory...
Article Thinking 'Outside the Box'
The ability of nurses to make effective decisions is critical to their contribution to patient outcomes.
The most significant personal characteristics impacting nurses' clinical decision-making are competence and self-confidence.
External variables such as organizational structure, access to supportive resources, and nursing education may have a positive or negative impact on nurses' decisions.
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