Intuition and the development of expertise in surgical ward and intensive care nurses.

摘要

AIM: The aim of this study was to explore and identify nurses' clinical expertise in surgical ward and intensive care settings in England. One of the objectives of the study and the focus of this paper was the exploration of these nurses' understanding and use of intuition in the context of their practice. BACKGROUND: Since 1980 many studies have investigated qualified nurses' use of intuition within aspects of their practice. However, it was Benner's (1982, 1984) seminal work that firmly established the relationship between intuition and expert clinical practice. Since that time a possible relationship between intuitive components of decision-making and nonexpert nurses' practice has remained relatively unexplored until recently. METHODS: This constructivist qualitative study incorporated observation and interview to explore 61 qualified nurses' expertise through their assessment of patients following major surgery. FINDINGS: Specific findings highlighted refinement in nurses' use of intuitive and analytical elements of decision-making across the four identified levels of expertise. The most fluent and effective use of intuitive and analytical components of decision-making was found in the expert group. CONCLUDING REMARKS: These results are discussed in relation to current understanding of the components of expert decision-making in nursing practice. Both intuitive and analytical elements should be recognized in any model that seeks to depict the true nature of nurses' decision-making as they develop clinical expertise.