Nursing practice involves engagement of nurses in clinical fields through deliberation and enactment. In the phase of deliberation, nurses observe, recognize, form ideas about and decide on clinical situations, and construct clinical pictures. Clinical pictures are critically connected to nursing enactments, thus it is important to discover how nurses arrive at clinical pictures. The purpose of this article is to describe how nurses construct meanings of clinical situations and arrive at specific clinical pictures. The results are from a clinical fieldwork study replicated in Korea, Norway, and the United States, with samples of nurses working in acute-care hospitals. Data were collected through participant observations and in-depth interviews. A general model of clinical construction was derived from the results, which specifies four dimensions (i.e., problem, progress, status, and particularism) as the bases for clinical picture evocations. Clinical pictures are constituted by nurses' elicitations ofmeanings of clinical situations on these dimensions.
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