There is a large part of nursing where, in that vital moment of decision making, nurses have to dig deep, rely on their gut-feel and act. Call it what you might: sixth sense, ESP, a hunch or a gut-feel. There is a reaction deep within that comes into play.

ESP is one of those skills that seasoned nurses just “have”. I’m not sure if it’s something they witness, repeat, learn, see, or simply acquire through experience. Or if it is simply there as part of the calling to be a nurse. Maybe it’s just that tried and true “learn as you go” skill? Nurses who claim they have it say they are not sure of the ‘how’s’, but they know it just exists.

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To some, “Nurse intuition” might not sound scientific enough, but it could definitely play a major role in the outcomes of care. This, according to a small study published in DovePress. It is nothing new that nurses have included the idea of basing care decisions on their intuition for decades, according to the authors, but the concept has remained largely unrecognized by educational institutions in recent years.

The researchers conducted a descriptive phenomenological study, interviewing 12 nurses with a minimum of three years of work experience in critical care units of hospitals affiliated with Kermanshah University of Medical Sciences in Iran. In their analysis of these interviews, three themes were identified:

  • Patient condition: Nurses found that their sixth sense came into play when they felt a patient’s clinical signs did not match what their gut was telling them about the patient’s actual condition. Similarly, they found their intuition was also triggered by changes in the patient’s behavior. Nearly all the nurses interviewed said that their intuition had informed some aspect of their care with regards to a patient’s outcome.
  • Nurse readiness: Nurses reported that their sixth sense led them to take measures to be prepared should a patient’s condition suddenly worsen. One nurse told interviewers her attention span had improved and been refined over time, allowing her to interpret evidence and act quickly. Another said, “Sometimes when a patient entered the unit, given my intuition signs, I told my colleague that the emergency trolley should be put beside the patient bed” along with other measures to ensure rapid response time.
  • Prognosis/outcome: Most of the nurses interviewed said intuitive feeling led them to double-check patient prognoses. Researchers said the nurses had a keener sense of their patients’ conditions and could see beyond the clinical details to the bigger picture.

However, the study is not too conclusive due to the small sample and size of the study. More research is needed if a wider public is to be convinced. However, one certainty is that the results indicate that many nurses use intuition in the practice of providing health care.

Previous research has found that nurses use intuition extensively when providing patient care. A less recent study published in Advances in Nursing Science in 2007 determined that intuition is the main component of decision-making and judgment in nursing.

However, most nursing training treats intuition as an unreliable tool. Decision-making in critical care is already divided terrain as the drive toward evidence-based care sometimes clashes with physicians’ and other care providers’ desire to rely on their experience-derived opinions.

What is your experience of relying on ESP/intuition – gut feel in the treatment of patients?

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