Having a sense of autonomy or being able to make decisions that align with your own goals and priorities, is fundamental for all. For those working in the nursing profession, having a strong sense of autonomy can be especially important, empowering nurses to make independent decisions regarding the care of their patients. Not only can nurse autonomy positively affect patient outcomes, but it can also impact nurse job satisfaction and the overall function of the healthcare system.
So, what exactly is autonomy in nursing and why does it matter? With a better understanding of its impact in the field, nurses can work toward more independent and confident decision-making in their own careers.
What Is Autonomy in Nursing?
Specifically, autonomy in nursing refers to the empowerment of nurses to make independent decisions about how to care for their patients within the overall scope of their practice. There are a few key components of autonomy in nursing, including clinical judgment, decision-making, and a sense of professional responsibility.
Clinical Autonomy
When it comes to the autonomy of nurses, clinical judgment or autonomy refers to a nurse’s ability to assess, diagnose, plan, and care for patients independently based on their own medical knowledge, skills, and professional experience.
A nurse may exercise their clinical autonomy, for example, when deciding to give a patient who is in pain a pro re nata (PRN) medication. In some cases, nurses may exercise their own clinical judgment when initiating treatments and evaluating patient responses as well.
Professional Autonomy
In addition to clinical autonomy, nurses strive to maintain a sense of professional autonomy. This type of autonomy encompasses a nurse’s ability to make essential decisions about their own practice or facility where they work. That includes being able to participate and have a voice in the development of policies, advocating for patients and their needs, and pursuing opportunities for professional development as they arise.
Historical Perspectives on Nursing Autonomy
While nurses typically enjoy a fair amount of autonomy in their work today, this hasn’t always been the case. In fact, nurses have historically struggled to gain a sense of autonomy, respect, and independence in their work. Over time, many milestones and even societal norms have shaped the development of autonomy of nurses.
Early Nursing Practice
In the earlier days of the profession, nurses were often viewed as being subordinate to physicians. The medical hierarchy played a huge role here, allowing doctors and physicians to make the majority of the decisions that directly affected a patient and their care. During this time, the role of the nurse was to follow a physician’s orders regarding patient care plans and not to question those decisions or think independently.
The Rise of Professional Nursing
Throughout time, as nursing began to emerge as a more widely recognized profession around the mid-1800s, nurses really began to find their own voices and confidence. During this time, the healthcare field saw the emergence of professional nursing organizations, as well as the development of formal nursing education programs. This played a crucial role in demonstrating that nurses were capable of making clinical decisions and applying their own knowledge in the field, which began to drastically advance nursing autonomy.
Modern Nursing Practice
Today, nurses have more autonomy than ever in the workplace. In modern healthcare settings, nurses are taking on more responsibilities and leadership roles than ever before, making their own decisions and even carrying out their own treatment plans. Because nurses often spend more one-on-one time with patients than any other healthcare provider, it makes sense in the modern healthcare field that nurses should have more discernment and input when it comes to patient care decisions.
Examples of Autonomy in Nursing
Autonomy is demonstrated in various aspects of nursing practice, from clinical decision making to patient advocacy and more. In trying to understand what autonomy looks like in action, it can be helpful to look at some examples that occur regularly in the real world.
Clinical Decision-Making
Every day, nurses exercise their autonomy in their clinical decision-making, where they can apply their own expertise and medical knowledge to make independent decisions about patient care.
A prime example of this is a nurse performing interventions, such as CPR, on a patient suffering from a medical emergency. In such a situation, there is very little time to react, so nurses must be prepared to step in and initiate care to potentially save a patient’s life. Meanwhile, nurses may also exercise clinical decision-making when adjusting treatment plans and even administering “as-needed” medications.
Patient Advocacy
In several ways, nurses also play an essential role as patient advocates. Because nurses spend so much direct time with patients, they get to know them well and can advocate for their needs and preferences to other healthcare staff. This sense of autonomy and patient advocacy helps to ensure that patients receive the best possible care while being fully informed about their treatment options.
Leadership and Management
Nurses who have a lot of experience often work their way into leadership and even management roles over time. These roles, such as charge nurse and nurse manager, require them to apply even more autonomy to crucial decisions about staffing, the allocation of resources, and initiatives for quality improvement.
Research and Evidence-Based Practice
Another vital way in which nurses are demonstrating their autonomy in the healthcare field is by contributing new knowledge and applying it to clinical practice. Several nurses go on to conduct their own research and evidence-based practice as part of their studies or their work in the field, which can contribute to the overall advancement of the profession.
Why Autonomy in Nursing Matters
Autonomy in nursing is more important than ever, especially with nurses being relied upon to take on so many roles and provide much of the direct care to patients. When nurses are autonomous, they are better able to provide patients with optimized care. Meanwhile, nurses with a greater sense of autonomy can enjoy a higher level of job satisfaction when they’re trusted to make independent decisions and exercise professional judgment.
Improved Patient Outcomes
When nurses are trusted to apply their own medical knowledge and experience to their work, patient outcomes can actually be improved. This is because autonomous nurses are more likely to deliver timely interventions and more personalized care that can lead to better treatment and improved patient satisfaction overall.
Increased Job Satisfaction and Retention
Meanwhile, nurses who are trusted to make their own decisions and apply their own judgment in their work tend to have higher rates of job satisfaction. This may be because increased autonomy can be associated with reduced burnout and increased engagement, which can increase job satisfaction while improving retention rates for healthcare facilities.
Enhanced Professionalism and Collaboration
In a number of ways, autonomy also fosters a sense of professionalism among nurses while adding credibility and value to the profession. When nurses have autonomy, they may feel encouraged to collaborate with other healthcare professionals and contribute to a more cohesive, effective healthcare system.
Innovation and Adaptation to Change
Last but not least, autonomous nurses are more likely to identify areas of the field that need improvement. From there, they can apply their own autonomy and experience to develop and implement innovative solutions that enhance patient care and streamline processes. All of this can contribute to advancements and the field and improvement of patient care.
Challenges to Nursing Autonomy
Although the autonomy of nurses is more prevalent today than ever before, there are still some inherent challenges and barriers that can hinder autonomy among nurses. Some examples of common obstacles here include hierarchical power structures in healthcare, regulatory restrictions, lack of resources, and overall resistance from other healthcare professionals.
Overcoming Barriers to Autonomy
The good news is that despite these inherent barriers to nurse autonomy, there are some steps that nurses and other healthcare professionals can take to overcome common challenges to nursing autonomy. First, advocating for policy changes that provide nurses with more decision-making power can make a huge difference. Meanwhile, investing in more nursing education and leadership development can equip nurses with the knowledge and skills they need to make confident decisions. Additionally, staying up to date on clinical guidelines and best practices, as well as continuing their education, is essential for nurses to remain competent and informed in their decision-making.
In many cases, promoting and supporting interprofessional collaboration can also help nurses increase their autonomy. When they work alongside other healthcare professionals to conduct research and make contributions to the field, this can help them grow their influence, credibility, and decision-making power.
Which Nursing Professionals Have the Most Autonomy?
Today, all nurses have some sense of autonomy in their work regardless of their level of education or experience. However, the nurses who tend to have the most autonomous decision-making power and the most independent practice are those with more advanced degrees and training, such as BSNs and MSNs.
This is especially true for nurses in leadership or management positions, such as charge nurses and nurse managers. These nursing professionals may have a great deal of oversight and autonomy over entire shifts or departments, making important decisions on everything from patient care to staffing, scheduling, and conflict management.
Advance Your Nursing Education at Nevada State University
Being a truly autonomous nurse means having the ability and authority to make decisions based on your own medical knowledge and experience for the well-being of your patients. With a high level of autonomy at work, nurses can enjoy the respect and job satisfaction that they desire while building a stronger professional relationship with other medical professionals and improving patient outcomes.
Looking to further your knowledge in the nursing field and take your career to the next level? It may be time to pursue your BSN. At Nevada State University, we’re proud to offer an RN to BSN online program through our School of Nursing. Students who graduate from our RN to BSN program are prepared to meet the needs and challenges of today’s healthcare system with the utmost trust and autonomy, so get in touch to learn more about this program or start your application process today.