Steps to Reaching Autonomy in Decision Making

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Making tough calls is a part of life no matter what career path one chooses. Every person is unique in the way that they react under pressure, some have a natural ability to stay calm and collected while others have to really concentrate in order to keep it together. While there are plenty of strategies that people can use, two of them are highlighted below. The first is situational awareness; a persons ability to evaluate the situation they are in and be able to comprehend what they see in order to make more appropriate decisions. Second is intuition, being able to trust your gut is extremely important, especially when a nurse is under pressure and has to think fast. The third piece is how these two forms of decision making allow a nurse to reach autonomy and how they are two of the main building blocks to taking nursing to the next level. Courage is ones capacity to take charge and be the leader when it is necessary, there will always be hard decisions to make but the great nurses understand the importance of trusting and using what they know.
Situational Awareness
The environment that nurses work in is constantly changing, which is why nurses have to be able to adapt to any situation they are put in. This is what situational awareness is all about. As quoted by Stubbings, Chaboyer & McMurray, “[Situational awareness] is the term for the level of awareness and the dynamic understanding that a practitioner has of a situation (2012, p. 1443). Situational awareness is the earliest step in decision making (Stubbings, Chaboyer & McMurray, 2012, p. 1444). If we are unable to comprehend the situation at hand and react based on our evaluation then we cannot expect to be able to make the proper decision.
According to Stubbings, Chaboyer & McMurray, there are three levels of situational awareness, first is the perception of the situation. This is centred around what the nurse initially sees. Second is comprehension, the nurses ability to understand the environment and make changes based on that evaluation. Third is the ability to project what can happen in the future, so being able to actually act on the evaluation of the situation and use that comprehension in order to make better decisions in the future for the patient (2012, p. 1444). To be able to effectively use the three levels is crucial, if nurses can accomplish that then their autonomy increases because decisions will be made with more ease.
Situational awareness is especially useful in circumstances where you have no time to look at all the data but you have to make a quick decision. When this is the case, if nurses have used situational awareness already then they are prepared to make fast, but accurate decisions. There are many places where situational awareness can break down. Lapses in situational awareness can come from interpersonal contact, distractions and time pressure (Stubbings, Chaboyer & McMurray, 2012, p. 1444). Nurses are very involved...

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