Decision making within a community provider organization.
OBJECTIVE
To explore community nurses' experiences of decision making within the community provider organization.


BACKGROUND
Recent changes in health care with an increasing number of patients being cared for outside of institutions can put considerable pressure on the nurse with respect to decision making.


METHODS
In-depth interviews were performed with 6 registered nurses in two communities. The interviews were analysed by means of phenomenological hermeneutics.


RESULTS
The community nurses' experiences of decision making were interpreted as spiders or octopuses, consultants and troubleshooters. The subthemes were; networking and structuring, responsibility, availability and knowledge, assessment power, information selection, avoiding rules and bypassing managers. In accordance with hermeneutical phenomenology, the findings were discussed and explained with reference to Ofstad's philosophy of freedom to make decisions.


CONCLUSIONS
In their decision making, community nurses are committed to finding administrative solutions that satisfy patient needs.
Department of Nursing, Health and Culture, University West, Trollhättan. ingela.berggren@hv.se
Ingela
I
Berggren
Eric
E
Carlstrom
D001291:Attitude of Health Personnel; D003152:Community Health Nursing / Q000458:organization & administration*; D003220:Conflict, Psychological; D003659:Decision Making, Organizational; D006040:Goals; D006801:Humans; D007400:Interprofessional Relations; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology; D015279:Organizational Culture; D016134:Organizational Policy; D010344:Patient Advocacy; D010687:Philosophy, Nursing; D011209:Power, Psychological; D017009:Professional Autonomy; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013548:Sweden