Background: Professional autonomy is a key concept in understanding nursesâ?? roles in delivering patient care. Recent\nresearch exploring the role of autonomy in the nursing work environment indicated that English and American nurses\nhad differing perceptions of autonomy. This qualitative study aimed to explore the understanding and experiences of\nautonomy of nurses working in England.\nMethods: A descriptive phenomenological analysis of data from 48 semi-structured interviews with registered nurses\nfrom two National Health Service (NHS) hospitals (purposive sample) was used to explore the concept of autonomy.\nResults: Six themes were identified: working independently; working in a team; having professional skills and knowledge;\ninvolvement in autonomy; boundaries around autonomy; and developing autonomy requires support. A key finding was\nthat nurses related autonomy to their clinical work and to the immediate work environment of their ward, rather than\nto a wider professional context. Nurses also perceived that autonomy could be turned off and on rather than comprising\nan integrated aspect of nursing.\nConclusions: Findings suggest that nurses in England, as framed by the sample, had a local ward-focused\nview of autonomy in comparison to nurses in America, who were reported to relate autonomy to a wider\ninvolvement in hospital level committees. Findings further indicate that autonomy was practiced occasionally,\nrather than incorporated into practice. Findings highlight the need for nurses in England to adopt a broader\nperspective and actively contribute to writing hospital guidelines and policies that recognise the importance\nof autonomy to nurse training and practice.
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