Enacting Strategic Memory: A Grounded Theory of Critical Care Nurse Decision Making in Crises
Date
2019-01-14
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Abstract
Decision-making is a key component of registered nurse practice. The decisions registered nurses make in practice have important consequences for healthcare provision and patient outcomes. In critical care, nurses make decisions in complex circumstances, including crisis events in which nurses and others must respond quickly and effectively. The ways that nurses in critical care environments make decisions during crises has not been well studied. Within the nursing and other literature there are numerous theories, conceptualizations, and expert opinions about what constitutes decision-making but few of these describe what is happening when nurses make decisions in their practice contexts. This study was a classical grounded theory study to explain how critical care nurses make decision in crises. Data were collected from ten participants and analyzed using constant comparative analysis. The theory Enacting Strategic Memory accounts for the data provided by participants and explains how nurses make decisions. Findings showed that nurses engage in decision-making through the strategic use of cognitive and physical resources by recognizing triggers, negotiating past and present, and telling stories. The theory is discussed in light of extant literature and recommendations for practice, research, and policy are made.
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Keywords
clinical judgment, clinical wisdom, crisis resource management, critical care, decision making, grounded theory
Citation
MacDougall, G. (2019). Enacting Strategic Memory: A Grounded Theory of Critical Care Nurse Decision Making in Crises (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.