Maryam AllahBakhshian1, Nasrollah Alimohammadi2, Fariba Taleghani1, Ahmadreza Yazdan Nik1, Saeed Abbasi3, Leila Gholizadeh4. 1. Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. 2. Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: alimohammadi@nm.mui.ac.ir. 3. Department of Anesthesiology and Critical Care Medicine, Critical care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 4. Faculty of Health, University of Technology Sydney, Sydney, Australia.
Abstract
BACKGROUND: The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. PURPOSE: The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. METHODS: In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using content analysis. DISCUSSION: Data analysis led to identification of two main themes and five subthemes: (a) the profession-related barriers with two associated subthemes of "lack of capacity to exercise autonomy" and "lack of strong professional bodies"; (b) organizational barriers with the associated subthemes of "role ambiguity," "a directive rather than supportive workplace," and "lack of motivation." CONCLUSION: ICU nurses in Iran may face many challenges in gaining professional autonomy. The identified inter- and intraprofessional barriers to the exercise of autonomy need to be addressed to promote critical thinking, job satisfaction, and motivation of ICU nurses, which can in turn lead to improved patient outcomes.
BACKGROUND: The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. PURPOSE: The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. METHODS: In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using content analysis. DISCUSSION: Data analysis led to identification of two main themes and five subthemes: (a) the profession-related barriers with two associated subthemes of "lack of capacity to exercise autonomy" and "lack of strong professional bodies"; (b) organizational barriers with the associated subthemes of "role ambiguity," "a directive rather than supportive workplace," and "lack of motivation." CONCLUSION: ICU nurses in Iran may face many challenges in gaining professional autonomy. The identified inter- and intraprofessional barriers to the exercise of autonomy need to be addressed to promote critical thinking, job satisfaction, and motivation of ICU nurses, which can in turn lead to improved patient outcomes.
Authors: Titilayo Olufunke Oshodi; Benjamin Bruneau; Rachel Crockett; Francia Kinchington; Shoba Nayar; Elizabeth West Journal: BMC Nurs Date: 2019-11-01