Factors influencing decision making during patient care : nursing students' perceptions

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Wiens, V. I.
University of Lethbridge. Faculty of Education
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Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 1991
During their clinical practicum, nursing students are involved in making decisions about the care for their patient or group of patients. The purpose of this study was to ascertain nursing students' perceptions of the variety and magnitude of factors that influence them as they are making decisions about patient care. For the study a nonexperimental approach utlizing a cross-sectional descriptive design was used. Thirty-three second year and thirty-one third year nursing students from a diploma nursing school responded to a questionnaire designed to reflect perceived domains of influence in thier clinical decision making. A subset of 18 subjects were interviewed. Some of the major findings include: 1) More second year than third year students perceived stress as a factor affecting their clinical decision making. Third year students most often mentioned the instructor-student relationship as a source of stress. Second year students most often referred to their workload and fatigue as contributing to their stress. 2) More third year than second year students preceived decision making theory and the nursing process to be an influencing factor in decision making. 3) Previous life and health-related work experience was indicated to be an influencing factor in clinical decision making more often by second year students than by third year students. 4) When asked to choose and rank five from a list of sixteen influencing factors in clinical decision making, the combined group chose the following in order; knowledge of patients and their condition, level of self confidence, knowledge of nursing proces, relationship with instructor, previous nursing experience, and previous life experience. 5) In the interviews the two most frequently mentioned guiding forces in decision making were: (a)what they (the student) or someone close to them would want and (b)patient preference. The study encourages nursing instructors to be cognizant of the variety of forces impacting student decision making in the clinical setting. It also suggests that students who are encouraged to incorporate their personal reality in an atmosphere that provides some latitude in decision making will be more likely to assume decision-making responsibility.
viii, 96 leaves ; 28 cm.
Nursing -- Decision making , Nursing -- Practice -- Decision making , Nursing students -- Decision making , Dissertations, Academic