MAGNET MONDAY: We need it, we want it, we have it. What is “it”?

MAGNET MONDAY: We need it, we want it, we have it. What is “it”?


Autonomy. Yes, of course we want it, we need it, and here at AAMC we have it…but can we define it? Now that is tough. In all honesty, I had to consult the literature to put a definition down on paper.

Apparently I am not the only one who struggles with verbalizing a definition for autonomy. Researchers asked 20,000 nurses for their input and came up with this definition:

“Autonomy is the freedom to act on what you know in the best interests of the patient…to make independent clinical decisions in the nursing sphere of practice and interdependent decisions in those spheres where nursing overlaps with other disciplines.

“It often exceeds standard practice, is facilitated through evidence-based practice, includes being held accountable in a constructive, positive manner, and nurse manager support.”

Why is autonomy important? Autonomy leads to safe patient care, quality patient care and nurse’s job satisfaction.

How do we see this played out at AAMC? Autonomy is the nurse using his/her C.U.S. words (“I am Concerned,” “I am Uncomfortable” and “This is a Safety issue.”) to communicate with a physician or nurse leader until the patient’s needs are met.

Autonomy is working with an interdisciplinary team during rounds or as the need arises to make a plan in the best interests of the patient

Autonomy is illustrated in this patient story, shared by MSU3: We had a husband and wife admitted in separate rooms: “The husband was on isolation, but we managed to get him in a recliner in his room and his wife in a recliner outside his room. They had a dinner date. Made their night and mine!”

How do you see autonomy in action on your units? How do you practice autonomy? How does having autonomy shape your nursing practice? Share here.  –Rita Linnenkamp, RN

Reference: Kramer, M. and Schmalenberg, C. (2008). The practice of clinical autonomy in hospitals: 20,000 nurses tell their story. Critical Care Nurse, 12(28), 58-71.

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