| Purpose. Nursing intuitive clinical decision-making is upheld as a key factor of expert nursing practice. The purpose of this research was to develop a model of the process of nursing intuitive clinical decision-making and test the proposed relationships.; Methods. A review of the extant nursing research was completed to cluster and summarize the antecedents, attributes, and consequences of intuition, insight, tacit knowing, synergy, and clinical decision-making. These data were used to develop the nursing intuitive clinical decision-making model.; Proposed relationships were tested using a randomized experimental, pretest-posttest, control group design. After obtaining informed consent, subjects completed demographic information, the Miller Intuitiveness Instrument, the Nurse Competence Scale, and the Jefferson Scale of Physician Empathy. Subjects participated in a clinical simulation and completed an analytical questionnaire and Himaya Intuition Semantic Instrument (HINTS) (Pretest). Heart rate, pulse oximetry and skin temperature were monitored. The intervention group was taught a relaxation protocol to elicit a relaxation response during the second simulation. Both groups completed an analytical decision-making questionnaire and the HINTS (Posttest).; Results. In the model, factors influencing intuitive knowing are individual nurse's personality, nurse-patient relationship, and a supportive environment. Nursing intuitive clinical decision-making is the result of a synergistic process between analytical decision-making and insight triggered by intuitive awareness.; Descriptive statistics were computed. Pearson correlations were significant for relationships between individual nurse's personality, the nurse-patient relationship and intuitive decision-making but not significant for analytical decision-making, insight and intuitive decision-making. There was no significant difference between groups on the HINTS posttest or the HINTS pretest and posttest for intervention subjects.; Conclusions and implications. Nurses who reported higher levels of intuitiveness and nurses who scored higher on patient empathy were more likely to use intuitive decision-making. The effects of insight and relaxation on intuitive decision-making were suggestive but not significant. Further development and testing of this model of the process of nursing intuitive clinical decision-making will enhance expert nursing decision-making and positively impact nursing practice. |
