Research Paper on Nursing: Autonomy for Professional Practice & Improved Patient Care

Introduction

Nursing is an area of healthcare that involves the establishment of standards, setting up goals, monitoring practice, and measurement of outcomes. The associated standards satisfy the goals of recognized concepts and are meant to improve the professional practice of nurse practitioners. According to Walker and Avant (2011), one of such nursing concepts is autonomy, which refers to the individual decision and the freedom of assessment and provision of actions for better delivery of patient care. The freedom can be granted to either a patient on the care provider depending on a situation. This paper provides an analysis of autonomy, covering the scope, antecedents, and consequences, theoretical perspectives, and significance of the concept to nursing.

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Definition

Criteria

Specific conditions must be met before considering a situation and the associated decision under autonomy. For one, the individual has must have relevant internal capacity adequate to guarantee self-government and they should be free from any external constraint. According to Charles (2017), either the patient or the nurse involved should have the capacity of making relevant decisions, has adequate information about the decision and undertakes the exercise voluntarily. It, therefore, follows that the application of the autonomy in the nursing context is not limited to any group of stakeholders involved in a practice.

Normally, a patient should be able to make decisions without any form of influence from the healthcare provider. A care provider can only serve as a facilitator of decision making by enabling them to work with ethical provisions that will meet the safety requirements of the patient. Healthcare providers achieve this requirement by educating patients while restricting them from deciding on their behalf. The concept of autonomy is also practicable by a health professional; they could be presented with a challenging situation accompanied by the dilemma and in which they are expected to make informed decisions. In this situation, they should have the freedom to make choices they believe provides the best solution to the problem in question.

Uses

Autonomy is used to promote a greater level of happiness during the healthcare delivery. Autonomy involves making independent decisions with limited influence from other parties. Any human being develops a feeling of happiness when they are allowed to decide by themselves rather than being in an environment where they are liable to manipulations by external forces. Nurses are in a position of being sufficiently productive when they exercise their freedom. The concept loosens the unnecessary fixed ways and bases of making choices; this promotes creativity and the best outcomes manifest out of the decisions they make.

The concept of autonomy enables the opportunity to balance between professional knowledge and ethical requirements. Autonomous decision making solves the problems presented by the culture of working within the bounds of professional practice. As much as a profession should be the influence in any practice that a nurse accomplishes, situations vary and may require different approaches. In such situations, the healthcare practitioners, concerning autonomy, should make decisions out of the provisions and implications of both ethics and professional principles (Charles, 2017). Patents also benefit from this because their decisions are not influenced strictly by any predetermined principle but by considering the situation at hand.

Attributes

Autonomy has attributes, which refers to the characteristics of every autonomous decision making. One of the attributes is the complexity of a situation whose solutions are not obvious and requires informed decision making. There must be a complex situation and which has a given individual as the center of interest. Being a difficult situation, decision-making requires the ability to observe, conceptualize and analyses the complex problem; whether clinical or non-clinical as long as it is related to health. The other aspect of the attribute is the expected implication of the decision made. The implications are predetermined; however, the exercise still upholds the freedom that must characterize decision making.

Another identifying feature, and which is the most important, is the focus on the patient. Any exercise considered to be autonomous must be patient-centered especially when the decision to be made will have a direct impact on them. This also applies when the direct nursing practice professionalism is not required (Oshodi et al., 2019). While other factors are considered too, any step in healthcare should be expected to make positive outcomes on the side of the patients. On this note, even if the healthcare practitioner has the opportunity to make a decision the implication should suggest safety to the patient in question.

Antecedents and Consequences

Antecedents

Antecedents of autonomy include self-respect and the need for personal independence. These factors precede the concept of autonomy in that while human beings embrace practicing them, a guaranteeing approach is required to make it possible. In the context of nursing, both the patient and the care provider respect themselves hence would like to fight for caring for their interests. As a result, autonomy emerges whereby they are presented with the opportunity to make judgments individually with adequate freedom ( Oshodi et al., 2019). As a result, they will be able to favor their feelings which they had already determined. Taking care of the self-respect through autonomy ensured that personal independence has also played a determining role.

Consequences

While autonomy is used to promote desirable outcomes in nursing practice, other consequences may that quality of care is compromised. It is possible to have autonomy as the overarching goal in health care, which is a very risky practice. In such cases, health professionals tend to develop inappropriate conceptions regarding the ability of patients. Charles (2017) felt that the care providers believe that patients have sufficient potential to be self-managing and active. Besides, it may affect the relationship between patients and the professionals; when a patient has the feeling that they should determine their fate in a healthcare setting, the professionals may lose the interest of giving their best in the process.

Theoretical Perspectives

Feminist Perspective of Autonomy

The feminist perspective uses the concept of autonomy for a better study of gender perspectives. The use of the theory seeks to rehabilitate the notion whereby feminists argue that it is important to articulate the conditions of the autonomous choice for understanding gender issues; this includes oppression and the other related concepts like objectification. It, therefore, follows that the challenges facing the feminist theorists can be solved by re-conceptualizing autonomy from feminist perspectives. Every individual involved or affected by gender issues should be allowed to make effective decisions regarding how to address the problems.

Self-determination Theory

Self-determination theory suggests that every human being requires the perception that they have sufficient choices out of which they can determine what to do without the intervention of another person. Dell, Verhoeven, Christman, and Garrick (2017) argued that this theory applicable in the top-down approaches of management whereby leaders hardly involve the personnel who are below them in the hierarchy. The theory is however criticized as it does not recognize the difference imposition of activities and setting up the vision, hence associated with failures. Nevertheless, the perspective insists on self-determination of what one should accomplish.

Significance of the Concept to Nursing

Suggestion for Preferred Treatment Approach

An example of the significance of autonomy in the healthcare setting is the freedom granted to the patients to determine the approaches that the care providers should use in attending to their health issues. This is the case in contemporary society in which respect for individual independence is enhanced especially in healthcare organizations. This improves from the previous approaches to healthcare delivery in which doctors and other practitioners would decide everything on behalf of the patients which would be rather an effective way of dealing with patients. However, the freedom of choice as supported by autonomy in nursing (Dell et al., 2017). A specific example is whereby a patient is allowed to research and present the best way through which the healthcare practitioners can handle their health condition. While the does not mean that the professional knowledge of the practitioners is undermined, the patient may have more significant control over how they should be treated. The practitioners are involved in the treatment which is already determined following the consultation done with the patent.

Conclusion

Autonomy is widely applicable in the healthcare setting with the patient being the central focus regarding decision making. While there are rules in every healthcare organization, an individual is normally granted the opportunity to determine their fate with which care providers should comply. There are consequences of autonomy with both negative and positive implications of its application. The use of the concept can also be explained further by studying theoretical perspectives which reveal other areas in which it can be applied.

References

Charles, S. (2017). Attunement and Involvement: How Expert Nurses Support Patient Autonomy. IJFAB: International Journal Of Feminist Approaches To Bioethics, 10(1), 175-193. DOI: 10.3138/ijfab.10.1.175

Dell, E., Verhoeven, Y., Christman, J., & Garrick, R. (2017). Using Self-Determination Theory to build communities of support to aid in the retention of women in engineering. European Journal Of Engineering Education, 43(3), 344-359. DOI: 10.1080/03043797.2017.1410522

Oshodi, T., Bruneau, B., Crockett, R., Kinchington, F., Nayar, S., & West, E. (2019). Registered nurses' perceptions and experiences of autonomy: a descriptive phenomenological study. BMC Nursing, 18(1). DOI: 10.1186/s12912-019-0378-3

Walker, L. A. & Avant, K.C. (2011). Strategies for theory construction in nursing (5th ed.). Upper Saddle River, NJ: Pearson.