Second-year baccalaureate nursing students' decision making in the clinical setting

This qualitative, intrinsic case study explored the decision-making activities of baccalaureate nursing students in the second year of a 4-year program. It sought to discover how second-year students determine the need to make a clinical decision, how they respond to a pending clinical decision, the types of decisions made in the clinical setting, and the factors that enhance or impede decision making. The study involved 12 students, all of whom were enrolled in their first clinical rotation on an inpatient unit and completed journals and interviews. Inductive analysis revealed three key encounters that demonstrated students' decision making: encounters with the patient, nursing staff, and clinical tutor. Each encounter revealed an emotion-based and knowledge-based response to various clinical situations. Decisions were evident within each of the three encounters. Implications for curriculum development and clinical tutors are described.