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Clinical Nursing Research
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Participation of Nurses in Decision Making for Seriously III Adults

Mary J. Kennard

MetroHealth Medical Center

Theodore Speroff

MetroHealth Medical Center

Ann Louise Puopolo

Beth Israel Hospital

Marilyn A. Follen

Marshfield Clinic/St. Joseph Hospital

Lee Mallatratt

Duke University Medical Center

Russell Phillips

Beth Israel Hospital

Norman Desbiens

Marshfield Clinic/St. Joseph Hospital

Robert M. Califf

Duke University Medical Center

Alfred F. Connors, Jr.

MetroHealth Medical Center

The purpose of this study is to describe the involvement of nurses in the decision-making process of seriously ill hospitalized adults. Nurses (696) completed interviews with 1,427 patients. Patient, surrogate, and physician interviews were also completed. Patients and surrogates perceive the nurse as more influential in decision making than does the nurse or physician. Many nurses reported having no (31%) or little (36%) knowledge of their patients' preferences, and 53% of the nurses did not advocate for their patients' preferences. Only 50% of the nurses reported educating their patients about the treatment plan chosen or discussing treatment options with their patients, and few (17%) discuss prognosis. This study indicates nurses are not actively involved in the decision-making process of their patients, especially older or more experienced nurses and those working in intensive care units.

Clinical Nursing Research, Vol. 5, No. 2, 199-219 (1996)
DOI: 10.1177/105477389600500207
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