Empowering Nurses: Autonomy in Nursing Practice
Autonomy, or the ability to make one's own decisions, is an important concept for nurses that can help them provide high-quality patient care. As Kellee White, MSN, RN-to-BSN faculty member in Purdue Global’s School of Nursing, emphasizes, “Autonomy empowers nurses to make critical patient-centered decisions.”
Read on to learn more about the importance of autonomy in nursing and the role it plays in nurses’ everyday professional lives.
What Is Autonomy in Nursing?
Autonomy in nursing, according to the American Nurses Association (ANA), extends to both the nurse and the patient. This allows for the patient to make their own health care decisions and for the nurse to perform their duties using their best judgment and in accordance with the guidelines established by state regulations and organizational policies.
Clinical Autonomy and Professional Autonomy
When examining autonomy and how it relates specifically to nurses, there are two types: clinical and professional.
Clinical autonomy (i.e., the ability of a nurse to use their best judgment when treating a patient) is important in the day-to-day decisions that nurses are required to make. Professional autonomy, also known as control over nursing practice (CONP), refers to nurses’ ability to shape health care policies, improve practices, and advocate for themselves in their workplace.
This article focuses on clinical autonomy in nursing, although both clinical and professional autonomy are important.
Why Is Autonomy in Nursing Important?
Autonomy in nursing can have tangible benefits for patients, nurses, and health care organizations as a whole. In addition, it's one of the ethical principles for nurses. Provision 4 of the Nursing Code of Ethics emphasizes the autonomy of nurses and the role it plays in patient care. This provision states: “Nurses have authority over nursing practice and are responsible and accountable for their practice consistent with their obligations to promote health, prevent illness, and provide optimal care.”
Some benefits of autonomy include:
Lower patient mortality rate: A study examined data for patients in hospitals where nurses have higher levels of autonomy and found that patients may have a lower risk of dying within 30 days of admission and a lower risk of experiencing serious complications that lead to death.
Increased job satisfaction: Studies have shown that, in general, autonomy is linked to a higher level of job satisfaction and general well-being. Nursing studies have shown a similar trend. In addition, the ANA cites increasing autonomy as a strategy that can be used to help retain nurses.
Examples of Nurse Autonomy
Autonomy in nursing takes many forms across various settings, allowing nurses to use their clinical knowledge, critical thinking skills, and professional judgment to make impactful decisions. Here are some real-world examples where nursing autonomy helps enhance patient care and improve outcomes:
1. Quick Decision-Making in Emergency Situations
In emergency departments, nurse practitioners (NPs) are often the first to assess patients who may be in pain. “A nurse practitioner doesn’t have to wait for a physician to start their assessments, relieve the patient’s pain, or order tests such as a CT scan or ultrasound,” White explains. “They have their outline of how they’re going to treat the patient, and that improves care and patient flow.”
2. Telehealth and Remote Patient Monitoring
Since the expansion of telemedicine, especially after the COVID-19 pandemic, nurses have had increased autonomy in monitoring and assessing patients remotely. In telehealth roles, nurses independently evaluate symptoms, conduct follow-ups, and make adjustments to care plans without direct, onsite supervision. “Nurse practitioners are definitely using autonomy in these types of expanded roles,” White says.
3. Implementing Evidence-Based Practices in Patient Care
Nurses rely on the latest research to make informed decisions, choosing care approaches that align with proven best practices. White says, “Autonomous nursing necessitates an evidence-based approach to nursing,” underscoring how evidence-based practice empowers nurses to make patient care decisions rooted in research and clinical expertise.
How Can Nurses Increase Their Autonomy?
Increasing autonomy in nursing requires a combination of organizational support, ongoing education, and mentorship. Here are a few of the strategies White recommends for improving nurse autonomy:
1. Seek Out Leadership Support
Leadership plays a critical role in encouraging nurse autonomy by setting a clear vision that prioritizes independent decision-making. According to White, a health care organization needs solid leadership to support autonomy effectively. From making clinical decisions and shaping policies to advocating for their patients and providing input on treatment plans, support from organizational leadership is essential for empowering nurses.
2. Pursue Ongoing Education and Professional Development Programs
Autonomy in nursing is closely tied to ongoing education and skills development. By participating in training focused on clinical decision-making, critical thinking, and evidence-based practice, nurses can act confidently and competently in the field. White emphasizes that autonomy is “intertwined into all of our courses” in the RN-to-BSN program at Purdue Global, preparing nurses to make informed, independent decisions.
For nurses who have earned a BSN degree and are interested in garnering more autonomy, a master's degree in nursing could prepare them for a nurse practitioner career. While autonomy is a vital component of nursing practice, a nurse’s degree of autonomy may depend on their level of experience, clinical competence, and the complexity of the care setting.
3. Take Advantage of Mentorship Programs
Mentorship is an essential strategy for fostering autonomy in nursing. Working with experienced mentors allows new nurses to observe autonomous practice in action, which can build their confidence to make patient care decisions. “Through mentorship, nurses can navigate complex clinical situations with the support of experienced colleagues and continue building confidence,” says White. This structured support enables them to refine their judgment, navigate complex scenarios, and gradually assume more responsibility.
Combined, these elements create a foundation for nurses to confidently exercise independent clinical judgment and advocate for their patients.
Advance Your Autonomy in Nursing
Purdue Global provides the flexibility and support needed to grow through our online nursing programs, including an RN-to-BSN degree program and MSN degree.
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