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Nursing prioritization of the patient need for care: A tacit knowledge embedded in the clinical decision-making literature

Authors

  • Sarah Lake MN(Distinction) RN,

    Corresponding author
    1. PhD Candidate, Graduate School of Nursing Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
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  • Cheryle Moss PhD RN,

    1. Associate Professor, Graduate School of Nursing Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
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  • Jan Duke PhD RN RM

    1. Professor and Head of School, Graduate School of Nursing Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
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  • Cheryle Moss is currently: Associate Professor, Graduate School of Nursing Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand.

  • Jan Duke is currently: Deputy Registrar, Zealand Social Workers' Registration Board, Wellington, New Zealand.

Sarah Lake, Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, PO Box 600, Wellington, 6140, New Zealand. Email: sarah.lake@nmdhb.govt.nz

Abstract

Every day in clinical settings, nurses practise in complex and dynamic situations. Nurses work to achieve emergent order in these situations through nursing prioritization of the patient need for care. As direct research on nursing prioritization had not been reported, a study, using critical realism as method, was designed to discern the profession's embedded understanding from within the clinical decision-making literature. The research synthesizes a tacit knowledge on nursing prioritization of the patient need for care from key international literature (from 1966 to 2003). Nursing prioritization was discerned in both education and practice literatures; interrelationships between these and theoretical approaches were also identified. Nursing prioritization of the patient need for care was revealed both as a non-sequential decision-making process throughout unfolding patient situations and as an advanced skill of nursing practice. Increasing confidence with this skill is the hallmark of developing expertise.

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