Nurses' Perceptions of Their Professional Autonomy in Nonpharmacologic Pain Management: A Qualitative Study.

Abstract

Purpose: The aim was to examine nurses' experiences and opinions regarding using their professional autonomy in nonpharmacologic pain management.

Design: A qualitative descriptive approach was used in the study.

Methods: The study was conducted in the acute care services of a public hospital between December 10, 2022, and March 2023. It was completed with 29 nurses using the purposive sampling method. Data were collected using an ``Interview Guide'' consisting of semi-structured open-ended questions and analyzed using the content analysis method.

Results: Four main categories emerged. (1) Individual qualities behind independent actions, (2) physician influence in professional autonomy, (3) establishing a positive therapeutic relationship in professional autonomy, and (4) recognizing barriers to professional autonomy. Nurses perceive that they enhance their professional autonomy in nonpharmacologic pain management by making independent decisions and selecting the nonpharmacologic intervention that will optimally benefit the patient. This is achieved by making the most beneficial nonpharmacologic application for the patient, having professional competencies, and realizing physician-nurse collaboration.

Conclusions: Nurses can improve their professional autonomy in nonpharmacologic pain management by gaining knowledge, skills, expertise, and leadership skills, participating in joint decision-making processes with physicians, and considering patient preferences and needs. Discussions regarding complete professional autonomy among nurses were limited by the patients' conditions, physicians' opinions, and management's decisions. Nurse managers can use their experience to offer additional details on care, protocols and practices.

Clinical implications: Nurse managers can support nurses in their units and use their expertise to develop care, practices, and processes. At the organizational level, they can create a working environment in which nurses can better participate in multiprofessional working groups. Supportive management can have a significant positive impact on nurses' professional autonomy. It creates a work culture in the organization where there is an opportunity for shared decision-making and development of daily work without hierarchy and where employees feel trusted and valued.