07/09/2021
Information processing and decision making is one of the key elements of nursing and midwifery practice! I love sharing my learnings to help optimise every nurses’ performance. Nurses are like fine tuned athletes! And I’m so proud of many of my colleagues having great debates on decision making and situational awarensss models! My comments on this great post by The Nurse Break: The nurses gut instinct may be quantified in a few theoretical ways. Firstly it may be known as ‘naturalistic decision making’. In this style of decision making the nurse uses pattern recognition to make swift judgements based on previous experience. Also known as recognition primed decision making - the nurse makes a quick decision based on experience. The greater the experience the more effective the decision making. It has up to 75% efficacy. It’s efficiency is debatable in the novice (an expert is defined as 7+ years). Most people know this as fast thinking versus slow thinking made famous by Daniel Kahneman. Secondly, it could be decision making based on heuristics or ‘rule of thumbs’ - once again based on experience but a heuristic is open to bias errors. Finally, it’s all part of the information processing of situational awareness. Situational awareness is made up of three concepts - perception, comprehension and projection. The gut feeling is based on perception - that ‘something is not right with this picture’ so to build a clearer mental model further information is needed. Once again experience and biases will impact on this style of decision making. What is intriguing to me is the gut feeling of so called novices - unconscious competence also plays a part. You don’t know what you don’t know! Fascinating topic!
Some evening food for thought.....Nurses and a GUT FEELING.
By saying we have a 'gut feeling' that something is wrong with a patient, are we unintentionally doing nursing a disservice and undermining nurses intelligence?
POST IN COMMENTS: Should we be changing the terminology from gut feeling to something that reflects correctly the knowledge behind the 'gut feeling'
"Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care."
Source: Melin-Johansson C, Palmqvist R, Rönnberg L. Clinical intuition in the nursing process and decision-making-A mixed-studies review. J Clin Nurs. 2017 Dec;26(23-24):3936-3949. doi: 10.1111/jocn.13814. Epub 2017 Jun 22. PMID: 28329439.