The Importance of Nursing Intuition

• Face vaccine cards are in circulation throughout the U.S. from not only civilians but those in the healthcare professions as well.

• Despite citizens having the right to bodily autonomy and being given the choice to receive a vaccination, it is evident that the production, distribution, and possession of fake vaccine cards is a continuously growing and dangerous problem that must be addressed.  

• Whether you are involved in the recruiting and interviewing process for new providers at your facility or working in triage, knowing the signs and understanding the consequences of fake vaccine cards is beneficial as we continue to navigate through this pandemic.  

As a nurse in any field or setting, the value of “a nurse’s intuition” is inevitable and must be present in order to provide the critical thinking skills that lead a nurse to know what to do and how to get it done.   

The process of nursing intuition is a tool that must be utilized when approaching a patient and addressing his/her medical and physical needs.  There are several ways of possessing instinctual knowledge, but the fundamental ones used the most among nurses include empirical, aesthetic, personal, emancipatory, and ethical knowledge.

Importance of Nursing Intuition

Nurses have the ability to implement nursing intuition while integrating both analytical and objective information in decision-making.  Nursing instinct or nursing intuition should never be used solely, but  in combination with knowledge and clinical skills involving patient care.   

Nursing practice consists of knowledge that is determined by various ways of viewing information after it has been organized, tested, and applied.   

Rationales for nursing practice consist of patterns, forms, and structures that determine the ways that nurses think about skills, treatments, communication, and interacting with their patients.  Understanding these patterns and ways of thinking is imperative for critical thinking to be implemented among nurses in various fields. 

Examples of Nursing Intuition in Patient Care

Nurses must of course follow protocols and abide by both subjective and objective symptoms when treating patients. However, often times nurses have an underlying sense that there is more going on with a patient than what is currently being presented.   

Example One

A 40 year old patient was admitted for shortness of breath and had a history of asthma since childhood.  Despite multiple breathing treatments and steroids being administered to the patient,  the nurse still felt a sense of uneasiness due to the patient’s sporadic moments of difficulty breathing.  The doctor was eager for discharge since the patient’s oxygen levels had improved, but the nurse noticed there were still periods of shortness of breath.  The nurse questioned the doctor if they could possibly do more testing as the nurse did not feel reassured about letting the patient go home with the shortness of breath that was still present.  An echocardiogram was ordered and the ejection fraction results ended up being 30% – normal is above 50%.  The nurse was able to save this patient from a possibly disastrous cardiac event occurring at home that may have otherwise went unnoticed if she ignored her nursing intuition.   

Example Two

A patient presents with stomach pain and pain management regime is implemented. The nurse assures the patient that the pain medication will more than likely be beneficial as long as the medication is taken as prescribed by the primary physician. However, the nurse experiences a feeling that the pain may be related to something besides what the lab results and tests are indication. The nurse is aware that even though baseline observations are normal up to this point, there is an underlying reason for the pain that has been fully identified.

Five Fundamental Ways of Nursing Intuition

Early examination of nursing literature led by Barbara Carper (1978) resulted in four fundamental ways of knowledge and a fifth fundamental way of knowledge was put in place by Chinn and Kramer (2008).   

Empirical

Empirical was considered the most familiar and respected pattern related to the science of nursing. With this type of knowing, there is an assumption that an objective reality exists and the truths can be understood based on objective truths.

Aesthetic

Aesthetic was considered the arte of nursing. It allows the nurse to move beyong the surface to connect with human experiences that are unique suchs as sickness, recovery, suffering, and death. This type of knowledge makes it possible to know what to do and how to be in the moment with patients. 

Personal

Personal was considered the knowledge or self and others in relationship to nursing care. The nurse focuses on the inner experience of being genuine and whole. It involves knowing one’s own self and also knowing one’s self in relation to others.

Emancipatory

This conceptualized a broad scope of knowledge that recognized “knowing” patients beyond the current boundaries. It allows the individual to be aware of and reflect upon the cultural, social, and political status and to formulate an understanding of why things came to be that way.

Action is implemented in ways that reduce or attempt to reduce injustice and inequality. The goal is to produce changes that are intended for the benefit of all.

Ethical

Ethical was considered the moral component of knowledge in nursing and focused on what ought to be done. The nurses focus on making moment-to-moment decisions about what needs to be done, what is right, and what is responsible. Ethical knowledge goes beyond the codes of conduct and directs nurses in a way that exhibits their morals, and priorities.

The Bottom Line

Nurses can definitely benefit from using a framework such as the ones presented by Carper (1978) and Chinn and Kramer (2008) which incorporates “ways of knowing” and also helps nurses to conceptualize and reflect critically upon important processes in each facility or setting. 

However, it can be a challenge to know and understand the complex roles of nurses across many clinical settings. It can also be a challenge to care for patients in a fully comprehensive manner.  It is important to realize that while these fundamentals are important and necessary, nursing intuition is equally important and should not be disregarded when focusing on patient care.

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