Exploring nurses clinical decision making experience in Rwanda Military Hospital

Abstract

Introduction Globally, nurses are the biggest number acting at the front line of patient care in health service institutions, their daily activities are taking place in the ongoing evolution of research and technology. This requires nurses to be competent decision makers in order to be able to respond to the patients‟ needs. However, nurses worldwide are limited in participation in decision making about patient care and those who participated claimed more than they currently do. Aim The aim of this study is to explore the lived experience of nurses‟ clinical decision making at Rwanda Military Hospital. Methods This study used a qualitative phenomenological approach. A phenomenological design was used to seek a deeper and fuller understanding of the lived experiences of the nurses‟ clinical decision making (CDM) on daily activities. An interview guide with open-ended questions was used to collect data and the data were analyzed according to four stages of Giorgi‟s phenomenological methodology. A total of ten participants allowed saturation and trustworthiness were ensured in this study. Findings The findings of the study are presented and discussed according to the three main themes that emerged during the data analysis: (1) Role ambiguity (2) Informal power of nurses to promote patient care (3) disempowering nature of policies. Sub themes of each of these themes have been presented and discussed; deep insight into the experience of the participants in clinical decision making was elaborated. Conclusion and Recommendations This study concluded that nurses are experiencing more frustration and facing barriers in clinical decision making. However, they were using their knowledge and experience in team work to apply CDM in patient care regardless of the policy that hindered their practice. It was recommended that NCNM and health institutions review the policy and the scope of practice to include CDM aspect for nurses.