Nurses' work conditions: The role of clinical reasoning uncertainty at the post-anesthesia recovery room

• Autor(a) principal: Cunha, Lara Daniela Matos
• Data de Publicação: 2023
• Outros Autores: Santos, Márcia Noélia Pestana dos, Lomba, Maria de Lurdes Lopes de Freitas, Santos, Margarida Reis
• Tipo de documento: Outros
• Idioma: eng
• Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Texto Completo: http://web.esenfc.pt/?url=6E9K7gC5
• topic: Patients safety; Clinical Reasoning; Post-anaesthesia Nursing; Uncertainty; Work Conditions

Background - There is a paucity of research on healthcare providers' experiences of navigating uncertainty, especially nurses. This phenomenon deserves attention as nurses deal with uncertainty in order to attend to the safe delivery of care. Providing adequate working conditions appears to be closely linked to patient safety, since patient outcomes are associated with the contextual characteristics of nursing care. Objectives - To explore the experiences of uncertainty in clinical reasoning of nurses in the recovery room. Methodology - A phenomenological descriptive design, following Colaizzi's analysis was conducted. In-depth interviews were conducted with 14 nurses from a post-anesthesia recovery room. The interviews were digitally audio-recorded and transcribed verbatim. Two researchers conducted data analysis independently and followed seven phases: (re)reading the transcripts, extracting significant statements, formulating meanings from significant statements, aggregating formulated meanings into themes, developing a description of the phenomenon's essential structure, generation of fundamental structure of the phenomenon, validation of the findings through participant feedback. The process employed MAXQDA Analytics Pro 2022 software. Results/Discussion - One theme and five sub-themes emerged from the data analysis: theme 'Uncertainty Experiences in Nurses' Clinical Reasoning' and the sub-themes communication, work ethic, incivility, (in)security and risk, and occupational stress. Participants identified conflict management through effective communication, work ethics related to doing the best for the patient, promoting civility for a safe work environment, and preventing occupational stress as influencing nurses' physical and mental health. Identifying potential areas for improvement and encouraging change results in employalty, higher job satisfaction, and stronger working relationships. Conclusions - Nurses' clinical reasoning uncertainty are largely focused on patient safety. By exploring the phenomenon, it will be possible to identify potential improvements in nurses' practices that minimize the impact of uncertainty and can identify ecocentric changes in work conditions that may improve clinical reasoning accuracy. Post-anesthesia recovery room nurses perceived that working conditions mediate uncertainty in clinical reasoning.