The Paradigm Model of VIP Ward Nurses' Decision Making

특실병동 간호사의 의사결정 경험에 관한 패러다임 모형

  • Received : 2009.07.21
  • Accepted : 2009.09.11
  • Published : 2009.11.30

Abstract

Purpose: The purpose of this research was to describe the decision making of nurses in a VIP ward. Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin (1998). The data were collected through an in-depth interview, which were audio-taped and transcribed. The data were collected from 10 nurses from July to November 2007. Results: The core category on VIP ward nurses' decision making was named as "adjusting with flexibility and deepened insight". The causal condition was established by 'the patients who wanted to be treated specially'. The contextual conditions included 'caring patients from various departments', 'differences depending on the nurses' clinical experience', and 'client-centered atmosphere in the VIP ward'. The intervening conditions included 'problem solving styles of nurses', 'attitudes of patients and family members', 'nurse-doctor relationships', and 'accessibility to information'. It was confirmed that nurses changed their action-interaction strategies depending on the intervening conditions, thus resulted in the nurses' role conflict and the need to expand their consciousness. Conclusion: The result of this study indicates that nurse's decision making depends on their experiences and the nature of social context in which nursing occurs.

Keywords

References

  1. 김동옥 (2001). 신규 간호사의 임상의사결정양식의 변화-중환자실 간호사를 중심으로. 서울대학교 대학원 박사학위논문.
  2. 김문실 (1996). 임상 실무에서의 의사결정. 대한간호, 35(5), 13-19.
  3. 김현경 (2002). 윤리적 딜레마 사례에 대한 간호사의 의사결정분석. 연세대학교 대학원 석사학위 논문.
  4. 박현정 (2006). 일 병원특실병동의 간호문화: 간호사와 환자 관계를 중심으로. 서울대학교 대학원 석사학위 논문.
  5. 이여진 (2001). 임상간호사의 의사결정에 따른 다변수간의 인과관계. 한양대학교 대학원 박사학위논문.
  6. 조미경, 정현숙 (1999). 일부 종합병원 일반간호사의 의사결정 참여와 전문성. 지역사회간호학회지, 10(2), 537-548.
  7. 천미희 (2005). 응급실 간호사의 의사결정 과정에 관한 연구. 경상대 대학원 석사학위 논문.
  8. 최희정 (1997). 환자간호에 대한 간호사의 의사결정과정 및 관련 요인에 관한 연구. 서울대학교 대학원 박사학위논문.
  9. 최희정 (1999). 환자간호에 대한 간호사의 의사결정 내용과 특성 및 의사결정 장애요인에 대한 분석. 대한간호학회지, 29(4), 880-891.
  10. 한성숙 (1992). 간호사들이 임상에서 경험하는 윤리적 딜레마의 실상과 의사결정에 관한 연구. 서울대학교 대학원 박사학위논문.
  11. Benner, P. (1984). From Novice to Expert: Power and Excellence in Nursing Practice. MenloPark, California: Addison Wesley Publishing Company.
  12. Field, P. A. (1987). The impact of nursing theory on the clinical decision making process. Journal of Advanced Nursing, 12, 563-571. https://doi.org/10.1111/j.1365-2648.1987.tb03046.x
  13. Hammond, K. R. (1966). Clinical inference in nursing. Nursing Research, 15(1), 27-37. https://doi.org/10.1097/00006199-196601510-00007
  14. Huges, K. K., & Young, W. B. (1990). The relationship between task complexity and decision-making consistency. Research in Nursing & Health, 13, 189-197. https://doi.org/10.1002/nur.4770130308
  15. Jenkins, H. M. (1985). Improving clinical decision making in nursing. Journal of Nursing Education, 24, 242-245.
  16. Orme, L., & Maggs, C. (1993). Decision-making in clinical practice: how do expert nurses, midwives and health visitors make decisions? Nurse Education Today, 13, 270-276. https://doi.org/10.1016/0260-6917(93)90052-4
  17. Pardue, S. F. (1987). Decision-making skills and critical thinking ability among associate degree, diploma, baccalaureate, and master's prepared nurses. Journal of Nursing Education, 26(9), 354-361.
  18. Radwin, L. E. (1998). Empirically generated attributes of experience in nursing. Journal of Advanced Nursing, 27(3), 590-595. https://doi.org/10.1046/j.1365-2648.1998.00548.x
  19. Rew, L. (2000). Acknowledging Intuition in Clinical Decision Making. Journal of Holistic Nursing, 18(2), 94-108. https://doi.org/10.1177/089801010001800202
  20. Sandelowski, M.(1986). The problem of rigor in Qualitative Research. Advanced in Nursing Science, 8(3), 27-37. https://doi.org/10.1097/00012272-198604000-00005
  21. Strauss, A., & Corbin, J. (1998). Basics of Qualitative Research. 2nd ed. Sage Publication.
  22. Weiss, S. (1985). The influence of discourse on collaboration among nurses, physicians and consumers. Research in Nursing and Health, 8(1), 49-59. https://doi.org/10.1002/nur.4770080110