Expert thinking in nursing practice: implications for supporting expertise.

The complexity of the art of expert nursing practice is an elusive phenomenon, which is difficult to articulate in concrete terms that can be translated into achieving quality patient care outcomes. The present study describes the findings of two hermeneutic (interpretive) studies on expert thinking that captured the holistic practice of expert clinicians. The findings from these studies provide insight into how expert practice can be administratively supported. These findings also have strong implications for strategies to facilitate the development of expertise in practice. In order to provide holistic care, nurses must spend time with their patients so that the particularities and meaning inherent in each unique patient situation can be understood. The art of expert thinking is a temporal and ethical activity, which needs to be supported and cultivated in a changing health-care delivery system.

[1]  L Rew,et al.  Intuition in decision-making. , 1988, Image--the journal of nursing scholarship.

[2]  W. Ammentorp,et al.  Information Structures: An Analysis of Nursing Performance , 1979, Nursing research.

[3]  Fonteyn Me,et al.  Expert system development in nursing: implications for critical care nursing practice. , 1994 .

[4]  K R Hammond,et al.  Clinical inference in nursing; information units used. , 1966, Nursing research.

[5]  S. Corcoran,et al.  Task Complexity and Nursing Expertise as Factors In Decision Making , 1986, Nursing research.

[6]  C. E. Young Intuition and nursing process , 1987, Holistic nursing practice.

[7]  P N Stern,et al.  Discovery of Nursing Gestalt in critical care nursing: the importance of the Gray Gorilla syndrome. , 1983, Image--the journal of nursing scholarship.

[8]  K. R. Hammond,et al.  CLINICAL INFERENCE IN NURSING: USE OF INFORMATION‐SEEKING STRATEGIES BY NURSES , 1966 .

[9]  C A Tanner,et al.  Diagnostic reasoning in critical care nursing. , 1985, Heart & lung : the journal of critical care.

[10]  K R Hammond,et al.  Clinical inference in nursing: revising judgments. , 1967, Nursing research.

[11]  J K Itano A comparison of the clinical judgment process in experienced registered nurses and student nurses. , 1989, The Journal of nursing education.

[12]  C. Kenny Nursing intuition: can it be researched? , 1994, British journal of nursing.

[13]  A. Farrington Intuition and expert clinical practice in nursing. , 1993, British journal of nursing.

[14]  K. R. Hammond Probabilistic functioning and the clinical method. , 1955, Psychological review.

[15]  C. Tanner,et al.  Diagnostic Reasoning Strategies Of Nurses and Nursing Students , 1987, Nursing research.

[16]  P. Benner,et al.  Clinical judgment: how expert nurses use intuition. , 1987, The American journal of nursing.

[17]  M. Aspinall,et al.  Use of a Decision Tree to Improve Accuracy of Diagnosis , 1979, Nursing research.

[18]  B Crandall,et al.  Critical decision method: A technique for eliciting concrete assessment indicators from the intuition of NICU nurses , 1993, ANS. Advances in nursing science.