Clinical decision-making processes in perioperative nursing.

The purpose of this phenomenological study was to reveal the processes of clinical decision making by expert perioperative nurses. Six nurses with a minimum of five years experience who considered themselves to be experts in OR nursing were asked to describe perioperative situations in which they had made a difference in patient outcomes. In every situation described, an intricate pattern of concern was present and associated with further assessments. The pattern was labeled Seeing the big picture: Engendered through caring. This study provides initial documentation to support how RNs make critical contributions to the quality of perioperative patient care.