Journal of Korean Academy of Nursing Administration (간호행정학회지)

Korean Academy of Nursing Administration (한국간호행정학회)
권호 표지

Decision Making Experience of VIP Ward Nurses in the Clinical Practice Adjustment Process

특실병동 간호사의 실무적응과정에서의 의사결정 경험

  • 김춘미 (선문대학교 간호학과) ;
  • 김정수 (삼성서울병원 특실병동 간호파트) ;
  • 김덕희 (우석대학교 간호학과)
  • Published : 2009.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this research was to describe the decision making experience of VIP ward nurses in the clinical practice adjustment process. The research question was about "how nurses adjust their clinical practice to nursing situations and develop decision making process 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 was collected through in-depth interviews with 10 nurses from July to November, 2007. Results: The core category of nursing care decision making process was named as "adjusting with flexibility and deepened insight." The clinical practice adjustment process in nursing care decision making has progressed through four preceding interlocking phases: 1) dependent phase, 2) defensive phase, 3) independent phase, 4) integrative phase. These phases were classified by the level of nurses' dependency, proactivity, presupposition and integration. Conclusion: The result of this study indicated that nurse's decision making depended on their experiences and the nature of social context in which nursing occurs. Therefore, it is important to elaborate an effective training program for nurses to develop the phases of nursing care decision making.

Keywords

References

  1. Benner, P. (1984) From novice to expert: Excellence and power in clinical nusing practice. Menlo Park, CA.: Addison-Wesley Publishing Co.
  2. Bradby, M. (1990). Status passage into nursing: Another view of the process of socialization into nursing. J Advanced Nurs, 15. 1220-1225. https://doi.org/10.1111/j.1365-2648.1990.tb01715.x
  3. Chenitz, W., & Swanson, J. M. (1986). Qualitative research using grounded theory, from practice to grounded theory: qualitative research in nursing. Menlo Park, CA.:Addison- Wesley Publishing Co.
  4. Cho, M. K., & Jeong, H. S. (1999). Participation in decisionmaking and expertise of staff nurses. J Korean Comm Nurs, 10(2), 537-548.
  5. Choi, H. J. (1997). A study on nurse's decision making process and related factors for patient care. Unpublished Doctoral Dissertation, Seoul National University, Seoul.
  6. Choi, H. J. (1999). An analysis of nursing decision tasks, characteristics, and problems with decision making. J Korean Acad Nurs, 29(4), 880-891.
  7. Choi, W. H., & Kim, M. H. (2005). Analysis decision-making situations and alternatives for clinical nurses in a university hospital. J Korean Acad Nurs Admin, 10(4), 449-457.
  8. Coombs, M. (2003). Power and conflict in intensive care clinical decision making. Intensive and Critical Care Nurs. 19, 125-135. https://doi.org/10.1016/S0964-3397(03)00040-5
  9. Elaine, S., & Mary, C. (2002). Promoting critical thinking in nursing education:literature review. Intern J Nurs Practice, 8, 89-98. https://doi.org/10.1046/j.1440-172x.2002.00340.x
  10. Farnell, S., & Dawson, D. (2006). 'It's not like the wards'. Experiences of nurses new to critical care: A qualitative study. Intern J Nurs Studies, 43, 319-331. https://doi.org/10.1016/j.ijnurstu.2005.04.007
  11. Kim, B. S., Ryu, E. J., Kim, K. H., Chung, H. K., Song, M. S., & Choi, K. S. (1999). A study on the experience of nurses' socialization process in the hospital setting. J Korean Acad of Nurs, 29(2), 393-404.
  12. Kim, D. H. (2002). Understanding experience of nurse dealing with difficult patients. Unpublished doctoral dissertation, Seoul National University, Seoul.
  13. Kim, D. O. (2001). Models of nursing care decision making in novice critical care nurses: Changes through experience. Unpublished doctoral dissertation, Seoul National University, Seoul.
  14. Kosowski, M. M., & Roberts, V. W. (2003). Intuitive decision making by novice nurse practitioners. J Holistic Nurs, 21(1), 52-72. https://doi.org/10.1177/0898010102250275
  15. Lee, M. H., Jang, G. S., Kim, Y. S., Hong, Y. M., Kang, Y. S., Kong, B. H., Shin, M. J., & Ha, N. S. (2003). Nursing professional and nursing ethics. Seoul:Hyunmoonsa publishing.
  16. Lim, N. Y., & Yi, Y. J. (2004). Factors on decision-making participation related to clinical experience difference, J Korean Acad Nurs, 34(2), 270-277
  17. Mackintosh, C. (2007). Protecting the self: A descriptive qualitative exploration of how registered nurses cope with working in surgical areas. Intel J Nurs Studies, 44(6), 982-990. https://doi.org/10.1016/j.ijnurstu.2006.04.009
  18. Park, H. J. (2006). Ethnographic study on the V.I.P hospital ward: focusing on nurse-patient relationships. Unpublished master's thesis, Seoul National University, Seoul.
  19. Park, S. M., & Kwon, I. G. (2007). Factor influencing nurses' clinical decision making- focusing on critical thinking disposition-. J Korean Acad Nurs, 37(6), 863-871.
  20. Rew, L. (2000). Acknowledging intuition in clinical decision making. J Holistic Nurs, 18(2), 94-108. https://doi.org/10.1177/089801010001800202
  21. Sandelowski, M. (1986). The problem of rigor in qualitative research. Advance in Nursing Science, 8, 27-37.
  22. Sohn, H. M., Koh, M. H., Kim, C. M., & Moon, J. H. (2001). The clinical experiences of adaptation as a new nursing staff, J Korean Acad Nurs, 31(6), 988-997.
  23. Sung, M. H., & Eum, O. B. (2009) Relationship between critical thinking disposition, professional nursing competence and job satisfaction in clinical nurses. J Korean Acad Nurs Admin, 15(1), 26-36.
  24. Strauss, A., & Corbin, J. (1998). Basics of qualitative research (2nd ed.). Sage Publication.
  25. Tabak, N., Bar-Tal, Y., & Cohen-Mansfield, J. (1996) Clinical decision making of experienced and novice nurses. Western J Nurs Research, 18(5), 534 - 547. https://doi.org/10.1177/019394599601800505
  26. Thompson, C., & Dowding, D. (2001). Responding to uncertainty in nursing practice. Intern J Nurs Studies, 38, 609-615. https://doi.org/10.1016/S0020-7489(00)00103-6
  27. Yi, M. S., Lee, E. O., Choi, M. A., Kim, K. S., Ko, M. H., Kim, M. J., Kim, H. S., Son, J. T., Eom, M. R., Oh, S. E., Lee, K. S., Jang, E. H., Cho, G. J., & Choe, J. S. (2000). Expertise in ICU nursing: A qualitative approach. J Korean Acad Nurs, 30(5), 1230-1242.
  28. Yi, M. S., & Jezewski, M. A. (2000). Korean nurses' adjustment to hospitals in the United States of America. J Advanced Nurs, 32(3), 721-729. https://doi.org/10.1046/j.1365-2648.2000.01533.x
  29. Yi, Y. J. (2002). Causal relationship of the variables to decision-making of clinical nurses. Unpublished doctoral dissertation, the Hanyang University of Korea, Seoul.