Abstract

Nurses are often encouraged to work to their fullest potential, including exercising clinical autonomy--a factor known to decrease morbidity and mortality. Nonetheless, nurses endure historical, societal, and professional barriers to be respected and independent. In the intensive care unit (ICU), critically ill, often unstable patients require nurses to respond quickly and adapt to each unique situation, which may mean migrating outside of formal rules, norms, and policies, or "rule-bending." However, as inherent subordinates of hospital administrators and physicians, rule-bending, no matter how well-intended, necessary, or benign, often cause nurses to function in a grey zone of vulnerability and risk.

I sought to explore how ICU nurses conceive of personal and professional risk when exercising clinical autonomy at the bedside.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 27996874; ProQuest document ID: 2442640277. The author still retains copyright.

Author Details

William Albert Randall, PhD

Sigma Membership

Non-member

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Grounded Theory

Research Approach

Qualitative Research

Keywords:

Clinical Autonomy, Quality of Care, Rule-Bending, Professional Challenges

Advisor

Ester Apesoa-Varano

Second Advisor

Jodie C. Gary

Third Advisor

Donald A. Palmer

Degree

PhD

Degree Grantor

University of California, Davis

Degree Year

2020

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2022-03-16

Full Text of Presentation

wf_yes

Dissertation

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