Clinical wisdom among proficient nurses.
This article examines clinical wisdom, which has emerged from a broader study about nurse managers' influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses' experience and clinical practice by giving voice to the nurses themselves, and to look for differences in their practice. This was a qualitative study based on semistructured interviews followed by analysis founded on Gadamerian hermeneutics. The article describes how proficient nurses experience their practice. Proficient practice constitutes clinical wisdom based on responsibility, thinking and ethical discernment, and a drive for action. The study showed that poor working conditions cause proficient nurses to regress to non-proficient performance. Further studies are recommended to allow deeper searching into the area of working conditions and their relationship to lack of nurse proficiency.
Uhrenfeldt
Lisbeth
L
Aarhus University, Institute of Public Health, Department of Nursing Science, Høegh-Guldbergsgade 6A, Building 1633, DK-8000 Aarhus C, Denmark. lu@nursingscience.au.dk
Hall
Elisabeth O C
EO
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D032882:Comprehension; D003299:Cooperative Behavior; D003718:Denmark; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D007600:Judgment; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D009736:Nursing Process / Q000941:ethics / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000523:psychology; D010344:Patient Advocacy / Q000941:ethics; D036301:Qualitative Research; D020377:Self Efficacy; D012941:Social Responsibility; D011795:Surveys and Questionnaires; D013850:Thinking