How does autonomy impact the nursing practice?

LadyFree28, BSN, LPN, RN · Aug 13, 2013

Employers or physicians may want nurses to follow algorithms, but that is not acceptable.
Scripting is not OK.
Empathy is essential. We must strive for this. We must insist on performing a complete assessment based on our own observation of the patient and then analying and synthesizing objective and subjective data to formulate Nursing Care Plan.
If we observe a change in the patien's condition it is our responsibility to act. Actions include notifying the physician and following medical orders, when appropriate.
Please remember hospitals exist for the purpose of providing NURSING CARE.
Any other diagnosis and/or treatment can be provided without admitting a person to the hospital.
Nursing Homes name makes it clear they are for people who need nursing care.
How much time does any other health professional spend with patients in hospitals and nursing homes? (SNF etcetera)
Acute care LPNs/LVNs do require clinical supervision, but are responsible for reporting any change in the patient's condition to the RN.
As professionals RNs and LVN/LPNs have a license and a great deal of responsibility.
Because we have an obligation to advocate for our patients, we must have the authority to fulfill that responsibility.

^THIS...as well as your previous post is spot on. :yes:

I think autonomy is present in nursing practice; I think that a percentage of individuals rely on PERCEPTION in determining lack of or how much autonomy they have in their practice. And that may depend on a regional or facility culture.

I worked in a Rehab hospital as an LPN...my opinion on POC, changing meds, even selecting med when there were changes in my patients-acute changes-was considered, and was approved; same thing as a RN...if anything, healthcare is a collaborative model; nursing is a discipline in its right; where the clinician makes assessments, formulates a plan of care, while taking into account of other diagnostic data into the picture. I have never felt that I had low or no autonomy in my practice; I have always advocated for my patient, and advocated my practice and my position in the interdisciplinary team. I also understand that they may be instances where one can think they have no autonomy, however, I think that one has to look at ways to ensure autonomy, especially in terms for advocating for their patients, even if it means ensuring the patient's autonomy; that requires the clinician to be autonomous enough to stop other members of the healthcare team in trying to go forward with plan that is not going to have a favorable outcome for the pt.

nurseprnRN, BSN, RN · Aug 13, 2013

there is no autonomy in nursing. nursing is not a "profession". it is a service occupation, just like working at McDonalds. nursing schools like to teach that nursing is a profession, but in reality it is just complying with standard of care and practice, and doctor's orders.

Thus speaketh someone with breathtakingly inadequate understanding of the breadth and scope of registered nurse practice and its legal power.

OP if you really want a good and inexpensive resource to clarify RN autonomy, go to Amazon and get the ANA Scope and Standards of Nursing Practice (2010 is the most recent edition). All RNs are held to these standards and most state nurse practice acts are written from them.