What is autonomy in nursing? The autonomy of nurses refers to their ability to exercise critical thinking skills and make clinical decisions independently, without needing supervision. Autonomy in the nursing profession can improve patient outcomes, increase job satisfaction for RNs, optimize the delivery of care and foster professional growth.
If you’ve ever been hospitalized, you know that the healthcare providers with whom you had the most contact were registered nurses (RNs). You may have only spoken with your treating physician once per day.
Although physicians are responsible for diagnosing medical conditions and ordering treatment plans, nurses provide the bulk of the actual patient care. This system works because there is a great deal of autonomy in nursing.
At Northeastern University’s Accelerated Bachelor of Science in Nursing (ABSN) program, our nursing students learn how to become highly competent healthcare providers capable of exercising independent judgment and making clinical decisions within their scope of practice.
If you have prior non-nursing education, you could be eligible to apply to our ABSN program and earn your nursing degree in as few as 16 months, not including the time needed to complete prerequisites.
What’s the fastest way to get a BSN? Learn how accelerated nursing programs work.
While looking ahead to your nursing career, it’s important to understand autonomy’s meaning in nursing and why it matters. It can also be helpful to compare the autonomy of RNs with that of other healthcare providers, such as advanced practice registered nurses (APRNs).
Autonomy Meaning in Nursing
Most career fields offer some degree of autonomy to professionals, although this often depends on experience level and rank within the company. In nursing, all registered nurses can practice autonomously within their scope of practice. What does autonomy in nursing mean, exactly? It encompasses the following:
- Reliance on one’s critical thinking and analytical reasoning skills to evaluate a patient care situation
- Forming independent nursing decisions based on one’s education and experience
- Executing clinical decisions without requiring direction from other healthcare providers
Although nurses often work collaboratively with fellow nurses and other healthcare providers, such as physicians, some situations call for rapid decision-making and clinical action. For instance, if a patient goes into cardiac arrest, an RN can initiate CPR without first consulting other healthcare providers.
Autonomy benefits patients, RNs, healthcare organizations and the nursing profession. It helps accomplish the following:
- Encourages innovation in nursing practice
- Fosters professional growth
- Increases job satisfaction
- Leads to better patient outcomes
- Optimizes patient care
- Reduces stress on healthcare professionals
- Shortens emergency response times
- Supports nursing advocacy
Compare nurses and doctors to understand the differences between these healthcare roles.
The Autonomy of Nurses in Various Care Settings
Autonomy in the nursing profession is needed within all care settings, although it sometimes looks different depending on the specialty. For instance, in critical care, nurses can act autonomously but as part of a team. If a patient goes into cardiac arrest, one nurse can start CPR without consulting another provider while another nurse begins other interventions.
In contrast, a home health nurse may be the only provider caring for a patient. Others might regularly work with the patient, but the RN handles in-home appointments alone. RNs in these settings exercise a great deal of autonomy, with less input and collaboration from the care team.
No matter the care setting, autonomy can greatly influence patient care. In numerous situations, the autonomy of nurses plays an important role. These include:
- Administering PRN (“as needed”) medications
- Delegating tasks to other clinicians when acting in a nursing leadership role
- Delivering patient and family caregiver education
- Performing patient assessments
- Responding to emergencies
- Voicing concerns when procedures or practices may violate the professional code of ethics
As you can see, autonomy in nursing affects both patients and nurses, benefiting both.
How to Work Autonomously: Nursing Healthcare Teams
It’s important to balance autonomy with collaboration in a healthcare team. Some situations call for a nurse to act autonomously, such as when PRN medications need to be administered.
RNs must always act within their scope of practice when making independent clinical decisions. For example, while an RN can administer PRN medications, they cannot legally prescribe medications and must only administer medications that have already been prescribed to the patient.
Collaboration also plays an important role in nursing. Nurses must collaborate with patients to ensure that patients maintain their own autonomy, as patients have the right to informed consent. For example, nurses cannot administer a treatment if the patient does not want that treatment.
Nurses also need to collaborate with other providers frequently. For example, when treating a complex case involving a patient with multiple comorbidities, it might be helpful for a nurse to consult another nurse with more experience. Nurses can also consult other types of providers, including physicians. In short, nurses work both collaboratively and autonomously.
Comparing the Autonomy of RNs to APRNs
It’s important to note that the autonomy of nurses differs across levels of nursing. For instance, licensed practical nurses have far less autonomy than RNs, while APRNs have greater autonomy than RNs.
Given their advanced education, training and board certification, APRNs are better equipped to serve as nurse leaders and mentors with a broader scope of practice and can make decisions with greater independence. For example, nurse practitioners (NPs) can prescribe medications in many states.
Which nursing specialties are in demand today? Consider these 14 types of nurses.
Challenges and Barriers to Achieving Full Autonomy in Nursing
Although the autonomy of nurses is crucial for better patient care, there are some barriers to achieving full autonomy.
Regulatory Landscape
The regulations applicable to nursing autonomy vary from one state to the next. In some states, for example, nurse practitioners have full practice authority, including the following without the supervision of a physician:
- Diagnosing patients
- Prescribing medications
- Providing treatments
In other states, nurse practitioners can prescribe medication but only with a physician’s supervision.
It’s possible that the regulatory landscape may become more standardized over time. For instance, the Nurse Licensure Compact (NLC) allows nurses to hold a multistate license that is valid in many different states. This way, nurses do not have to obtain a single-state license for each state in which they practice as long as the states are part of the NLC.
Given this industry push toward standardization, the regulatory landscape may become more uniform in terms of practice authority.
Need for Professional Development
Professional development can be another challenge. For nurses to practice autonomously, they need to be fully equipped to make independent clinical decisions. Nurses with a BSN are generally better prepared to act autonomously than nurses with an associate degree simply because of their more extensive nursing education.
Need for Institutional/Managerial Support
The autonomy of nurses can bring about greater job satisfaction and a more supportive work culture, but only with institutional support. Nurses need to know that their managers and their healthcare organizations support their practice authority and encourage professional development.
Pursue a Nursing Career at Northeastern
If you’re interested in switching to a career field with robust job growth, diverse specializations, strong earning potential and career advancement opportunities, nursing could be the right fit for you.
Northeastern University’s ABSN program allows you to get started sooner, with three start dates each year, three ABSN program locations and a 16-month nursing curriculum. You’ll benefit from small class sizes and attentive nursing instructors.
Through a combination of interactive online coursework, hands-on nursing labs and clinical rotations, students are prepared to take the NCLEX-RN exam with confidence and set themselves on the path toward becoming skilled RNs.
Contact an admissions counselor at Northeastern today and take the first step toward a nursing career.
