Intuition in clinical decision-making by the nurse in ICU

Abstract

This research article follows on a previous article where the results of a concept analysis of intuition were reported. The purpose of this article is to debate the role of intuition in clinical decision-making by the nurse in ICU. Clinical decision-making has been noted by many critical care nurses and nurse researchers as one of the most critical elements of critical care nursing. Minute by minute, the critical care nurse is bombarded with a vast array of data that is, in part, derived from numerous monitoring devices employed in modern ICUs. Although interpretation of the data begins with an understanding of the physiology or pathophysiology being monitored, the ultimate application of the monitoring of this data depends on the ability of the critical care nurse to make clinical decisions. Clinical decision-making refers to a reasoning process that the critical care nurse employs in order to care for the critically ill patient. The purpose of clinical decision-making in ICU is to promote the health of the critically ill patient through more complete and effective problem solving. Based on experience and observation of decision-making in ICU, it was observed that nurses in critical care units make clinical decisions, some of which they can justify, and others that they cannot justify. The latter type of clinical decision-making is sometimes referred to by nurses in critical care units as "gut-feeling" or intuition. Furthermore, it appears from this observation that clinical decision-making based on intuition is effective and contributes to better and more complete problem solving in critical care units. Therefore, the following question arises: What is the role of intuition in clinical decision-making by the nurse in ICU? >From the debate on the role of intuition in clinical decision-making in ICU, the conclusion is drawn that in order to facilitate better and more complete problem solving in ICU, both clinical decision-making based on the nursing process and intuition are necessary.



Health SA Gesondheid Vol.6(2) 2001: 18-32