Nurses play one of the most important roles in care delivery within several healthcare organizations. They serve as the pillar that connects the other healthcare professionals, ensuring that optimal care is delivered to patients as necessary.
As a result of constant interactions with patients, they can provide direct care and advocate for the specific needs of their patients to improve the overall care situation. In addition, their knowledge and expertise also come in handy when making critical administrative decisions.
However, if there’s one impediment that registered nurses experience in the day-to-day carrying out of their responsibilities, it’s that they lack autonomy. Despite their knowledge, expertise, experience, and work ethic, they often cannot make decisions without answering to authority, including in emergencies.
Thus, there’s a crucial need for nurses to exercise autonomy in the work that they do. Not only can it save more lives, but it’ll also improve their productivity and job satisfaction levels. When nurses can make decisions without unnecessary constraints, it’ll transform the work system, and in the end, it’ll truly benefit the care delivery within healthcare organizations.
Here, we will look into the intricacies of nursing autonomy – what it means, how it works, and the level of impact that it has on the overall quality of patient life. Understanding how it works will lead to better patient outcomes, increased job satisfaction, and a general care delivery system transformation.
What does nursing autonomy mean?
Nursing autonomy is, just as the name suggests, the liberty of registered nurses to make decisions relating to their patients, using their own knowledge, critical discretion, and expertise, rather than waiting on the approval of a physician or anyone else on the healthcare hierarchy. In essence, nursing autonomy hinges on the idea that nurses need to have control over their nursing practice with the liberty of making decisions as long as they fall within the scope of their training, expertise, and practice.
The most comprehensive definition of nursing autonomy can be deduced from the Magnet Recognition Program of the American Nurses Credentialing Center (ANCC) in 1990. This Magnet Recognition evolves around nursing excellence and the potential change that can happen when nurses are allowed to lead in the healthcare system.
There are 14 Forces of Magnetism that make up principles that will help reform nursing and healthcare, with the main objective being the transformation of patient, family, and community healthcare delivery.
The ninth Force of Magnetism revolves around the autonomy of nursing, and it is described as the:
Ability of the nurse to assess and perform nursing actions for patient care based on competence, professional expertise, and knowledge.
Nursing autonomy pushes for a chance for Registered Nurses to practice and exercise judgment independently as they provide patient care. Even the ANCC, that’s existed for over 30 years, has always recognized how important it is for nurses to have control over practice.
Over the years, research into the field of autonomy in nursing shows that there are two different types of autonomy in nursing:
Clinical autonomy refers to the clinical decision-making process regarding patient care, and it gives nurses the authority to make judgments about patient care.
Control in nursing practice, on the other hand, refers to the nurses’ influence over their practice setting, which cuts through policy-making, operations, organization, administration, and governance.
The second level pushes the idea that if there’s anything that will impact the nurses, they should have a say in it.
Having an opinion and influencing decisions that relate to patient care and the organization of practice is a huge feat for registered nurses. However, it also comes with a great deal of responsibility. For things to work out excellently, nurses need to pull in resources, knowledge, and experience so it doesn’t backfire and impede development potentials.
What exactly are the ways through which nurses can practice autonomy? The next section explains that appropriately.
Examples of autonomy in nursing
One of the job descriptions of registered nurses is that they collaborate with other members of the healthcare team, particularly the physicians. Physicians have a high level of autonomy in many ways, but this doesn’t take away the fact that nurses enjoy an existing level of autonomy.
For instance, as soon as they step into a patient’s room, registered nurses have enough knowledge and skills to assess patients’ signs and symptoms to determine if they require immediate help or should be acted on accordingly. This provides a level of undefined autonomy to the nurses, as they can decide on the spot after examining the patient if some oxygen is required or if the medication needs to be stopped.
Another example of autonomy that nurses have is patient education. They have the choice of informing patients about possible risks if certain things are done or not, the times and ways that certain medications should be taken, or the required type of exercise.
Other examples of the existing level of nursing autonomy include:
- The administration of PRN medications and checking of patient’s vitals.
- Making quick decisions during emergencies.
- Giving vaccinations and taking blood to send to pathology.
- Interpreting medical results for medical diagnostics.
- Providing in-home care and on-site support to the elderly.
- Managing healthcare equipment as necessary.
- Delegating aide to assist with ambulation.
Regarding control over practice, autonomy can also reflect participation in decision-making, gaining more control over work conditions and daily duties, and presenting ideas for general organizational practice.
These examples show how far nursing autonomy goes to impact healthcare delivery. Sometimes, leaving decisions to the nurse’s knowledge, assessment, and skills can make the difference in saving a life or not.
Benefits of nursing autonomy
Nursing autonomy has a number of benefits for all the parties involved. For the nurses themselves, it can greatly improve their performance levels; for the healthcare organizations, it can promote a positive work environment; and with the patients, there’s a higher level of patient outcomes. Here are some of the benefits of nursing autonomy outlined:
Improves overall quality of patient life
This is by far the most important benefit of nursing autonomy. The patient outcome is the most important end goal for every healthcare organization. Nursing autonomy helps in improving the welfare of patients as nurses can administer the appropriate medical treatment as required, even without approval from higher personnel.
A good level of autonomy can provide a great nurse-patient relationship which, in the end, will play an important role in ensuring that the patients can have their needs met appropriately. A recent study shows that hospitals that give higher levels of autonomy to their nurses experienced reduced levels of mortality rates.
Healthcare organizations that capitalize on leaving certain decisions to the expertise and experience of their nurses will generally experience a higher and improved quality of life in their patients.
Enhances job performance and satisfaction
It’s not far-fetched to say that autonomy will improve the satisfaction nurses derive from their jobs and their performance levels. On one end, autonomy provides a level of empowerment professionals need to work on their jobs. When nurses are trusted to make certain decisions, it improves their confidence levels to keep getting better at their work.
Conversely, it will also affect the relationship and collaboration with other medical practitioners on the team. First, it improves job performance and reduces the level of stress and burnout that nurses experience. When nurses are also working amongst themselves, they will feel more thrilled to address the problems of those who don’t have the appropriate medical knowledge.
Nursing autonomy reduces the unnecessary back and forth with the daily administration of care to patients. Nurses are left to experience greater satisfaction in their roles, jobs, and, ultimately, in their careers. Increased job satisfaction can also mean that there’s a reduced level of turnover rates, better care, and enhanced patient results. Hence, entrusting nurses and giving them respect and decision-making ability will have a ripple effect throughout the organization.
Improves communication amongst inter-professional teams
Autonomy also helps improve communication between teams, and in turn, patients will receive optimal care as soon as required. For instance, the physician in charge of a patient will have faith in the fact that they can reach out to the nurse if a critical situation occurs, and they also know that the nurse can be trusted to handle the appropriate medical treatment when required.
Team communication plays an important role in the treatment of patients, as the medical professionals involved will be better positioned to handle patients’ needs and provide more holistic care.
How to improve your autonomy as a nurse
As much as nursing autonomy can benefit both the professionals and the patients, it’s important to note that the level of autonomy given to a nurse will depend on their education and skill set. A more experienced nurse is more likely to enjoy more autonomy than anyone else. Similarly, an improved level of competency will also lead to greater autonomy. If you’re looking for the best ways to get more autonomy as a nurse, here are four things you can do:
Advance your nursing education
As an unwritten rule, the higher the level of education a nurse has, the more expertise they acquire, and subsequently, the more autonomy they will have access to on their job. Nursing education also grooms future nurses by fortifying their professionalism and building them up for autonomy on their job. Nurses that are more intentional about acquiring more education and knowledge will have a better chance of independence during practice.
If you enroll in a nurse practitioner pathway program at an accredited university like Marymount University, you will likely learn how to have the most control over your practice.
Get more certifications
Aside from enrolling for advanced education at an accredited university, another way to build your resume and make yourself eligible for more autonomy is by acquiring knowledge through specialty certification. Certifications are a great idea because not only do they testify to your commitment to improvement and excellence, but they also help to demonstrate a higher level of professionalism that’s required in the nursing field. Nurses that take the initiative to earn certifications will benefit from improved autonomy.
Establish a stronger relationship with your patients
This is simply a situation of helping your patients so they can help you. Nurses that establish and maintain a good relationship with their patients will be in a better position to understand their unique situations and provide treatment and advocacy for them when needed. With time, it becomes much easier for autonomy to be given to such a professional.
Join professional nursing organizations
Professionals gain several benefits from joining professional organizations on different levels. One of these benefits is gaining access to people, resources, and tools that will come in handy. As a nurse, becoming a member of a nursing organization will help you partake in mentorship programs and gain access to nursing journal subscriptions and other things that will help you further build your professional skills and competencies. Thus, you’ll have a better chance of becoming a better nurse that experiences autonomy.
Nursing autonomy plays a vital role in promoting quality patient care. When nurses are granted the autonomy to make clinical decisions, they can provide individualized care that is tailored to the unique needs of each patient. This results in improved patient outcomes increased patient satisfaction and decreased healthcare costs. Nursing autonomy also promotes professional growth and job satisfaction for nurses, which ultimately translates to better retention rates and improved quality of care.
In addition to these benefits, nursing autonomy also contributes to the overall efficiency of healthcare systems. When nurses have the authority to make decisions, they can act quickly in response to changes in a patient’s condition, which can help prevent adverse events and reduce hospital readmissions.
Overall, nursing autonomy is essential for promoting high-quality patient care, improving healthcare outcomes, and ensuring the satisfaction of both patients and healthcare providers. As such, healthcare organizations should prioritize the development and implementation of policies that promote nursing autonomy, in order to fully realize these benefits.
Infographic Provided by Healthcare Consulting Company, Polaris Group