Clinical decision-making described by Swedish prehospital emergency care nurse students – An exploratory study

2016 ◽  
Vol 27 ◽  
pp. 46-50 ◽  
Author(s):  
Tomas Nilsson ◽  
Veronica Lindström
2020 ◽  
Vol 10 (3) ◽  
pp. 57-62
Author(s):  
Carolyn Lees ◽  
Trudy Hutchison ◽  
Alison White ◽  
Robyn Lotto

Background: Paramedics have witnessed a huge shift in their role as providers of prehospital emergency care, although little is known about how student paramedics manage the competing demands they face in practice. Aim: To explore how student paramedics experience the changing healthcare landscape. Method: Semi-structured, focus groups and thematic content analysis was adopted. A purposive sample of student paramedics at different stages of their diploma preparatory training were invited to participate in focus group interviews. Findings: Participants considered that other services and the public perceived the purpose of emergency paramedics as largely a traditional one, as a service to transport patients to hospital. This appears to influence how they manage complex clinical situations. Student paramedics' clinical decision-making is frequently influenced by the emotional environments in which they work, combined with difficult communication with patients and a lack of support from the various professional groups involved in patient care. Conclusion: This study has highlighted the complexity of situations that student paramedics find themselves in while making decisions, which has important implications for paramedic educators and those supporting them in practice.


2014 ◽  
Vol 35 (3) ◽  
pp. 55-60 ◽  
Author(s):  
Maria da Graça Oliveira Crossetti ◽  
Greicy Kelly Gouveia Dias Bittencourt ◽  
Ana Amélia Antunes Lima ◽  
Marta Georgina Oliveira de Góes ◽  
Gislaine Saurin

The objective of this study was to analyze the structural elements of critical thinking (CT) of nurses in the clinical decision-making process. This exploratory, qualitative study was conducted with 20 emergency care nurses in three hospitals in southern Brazil. Data were collected from April to June 2009, and a validated clinical case was applied from which nurses listed health problems, prescribed care and listed the structural elements of CT. Content analysis resulted in categories used to determine priority structural elements of CT, namely theoretical foundations and practical relationship to clinical decision making; technical and scientific knowledge and clinical experience, thought processes and clinical decision making: clinical reasoning and basis for clinical judgments of nurses: patient assessment and ethics. It was concluded that thinking critically is a skill that enables implementation of a secure and effective nursing care process.


2015 ◽  
Vol 24 (3) ◽  
pp. 268-278 ◽  
Author(s):  
Anna Abelsson ◽  
Lillemor Lindwall

Background: Ethics and dignity in prehospital emergency care are important due to vulnerability and suffering. Patients can lose control of their body and encounter unfamiliar faces in an emergency situation. Objective: To describe what specialist ambulance nurse students experienced as preserved and humiliated dignity in prehospital emergency care. Research design: The study had a qualitative approach. Method: Data were collected by Flanagan’s critical incident technique. The participants were 26 specialist ambulance nurse students who described two critical incidents of preserved and humiliated dignity, from prehospital emergency care. Data consist of 52 critical incidents and were analyzed with interpretive content analysis. Ethical considerations: The study followed the ethical principles in accordance with the Declaration of Helsinki. Findings: The result showed how human dignity in prehospital emergency care can be preserved by the ambulance nurse being there for the patient. The ambulance nurses meet the patient in the patient’s world and make professional decisions. The ambulance nurse respects the patient’s will and protects the patient’s body from the gaze of others. Humiliated dignity was described through the ambulance nurse abandoning the patient and by healthcare professionals failing, disrespecting, and ignoring the patient. Discussion: It is a unique situation when a nurse meets a patient face to face in a critical life or death moment. The discussion describes courage and the ethical vision to see another human. Conclusion: Dignity was preserved when the ambulance nurse showed respect and protected the patient in prehospital emergency care. The ambulance nurse students’ ethical obligation results in the courage to see when a patient’s dignity is in jeopardy of being humiliated. Humiliated dignity occurs when patients are ignored and left unprotected. This ethical dilemma affects the ambulance nurse students badly due to the fact that the morals and attitudes of ambulance nurses are reflected in their actions toward the patient.


Sign in / Sign up

Export Citation Format

Share Document