Barriers to Intensive Care Unit Nurses' Autonomy in Iran: A Qualitative Study Publisher Pubmed



Allahbakhshian M¹ ; Alimohammadi N¹ ; Taleghani F¹ ; Nik AY¹ ; Abbasi S² ; Gholizadeh L³ Show Affiliations
Source: Nursing Outlook Published:2017

Abstract

Background The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. Purpose The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. Methods In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using content analysis. Discussion Data analysis led to identification of two main themes and five subthemes: (a) the profession-related barriers with two associated subthemes of “lack of capacity to exercise autonomy” and “lack of strong professional bodies”; (b) organizational barriers with the associated subthemes of “role ambiguity,” “a directive rather than supportive workplace,” and “lack of motivation.” Conclusion ICU nurses in Iran may face many challenges in gaining professional autonomy. The identified inter- and intraprofessional barriers to the exercise of autonomy need to be addressed to promote critical thinking, job satisfaction, and motivation of ICU nurses, which can in turn lead to improved patient outcomes. © 2016 Elsevier Inc.