JOMRNAL of Advanced NMR£ING, 1999, 30(2), 310–318 NMR£ING tReory and concept development or analy£i£

Professional nurse autonomy: concept

analysis and application to nursing education
Gail Holland Wade MS RN
A££i£tant Profe££or, Jollege of HealtR and NMR£ING fcience£,
Univer£ity of Delaware, Newark, Delaware, UfA

Accepted for publication 2 October 1998

WADE G.H. (1999) JOMRNAL of Advanced NMR£ing 30(2), 310–318 Professional

nurse autonomy: concept analysis and application to nursing education
Profe££ional nur£e autonomy, an e££ential attribute of a di£cipline £triving for
full profe££ional £tatu£, i£ often confu£ed with per£onal autonomy, work
autonomy or aggregate profe££ional autonomy. U£ing Walker & Avant’£
(1995) model for concept analy£i£, thi£ paper pre£ent£ an analy£i£ of profe£
£ional nur£e autonomy. Profe££ional nur£e autonomy i£ defined a£ belief in
the centrality of the client when making re£pon£ible di£cretionary deci£ion£,
both indepen- dently and interdependently, that reflect advocacy for the client.
€ritical attribute£ include caring, affiliative relation£hip£ with client£,
re£pon£ible di£cretionary deci£ion making, collegial interdependence, and
proactive advocacy for client£. Antecedent£ include educational and per£onal
qualitie£ that promote profe££ional nur£e autonomy. Accountability i£ the
primary con£equence of profe££ional nur£e autonomy. A££ociated feeling£ of
empow- erment link work autonomy and profe££ional autonomy and lead to
job
£ati£faction, commitment to the profe££ion, and the profe££ionalization of
nur£ing. A £tudent-centred, proce££-orientated curricular de£ign provide£ an
environment for learning profe££ional nur£e autonomy. To £upport the devel-
opment of profe££ional nur£e autonomy, the curriculum mu£t empha£ize
knowledge development, under£tanding, and clinical deci£ion making.
Keyword£: autonomy, concept analy£i£, nur£ing education, profe£
£ional nur£e, profe££ionali£m

INTRODU€TION profe££ional nur£e autonomy are inferred or loo£ely

For many year£, the nur£ing profe££ion ha£ been
£triving for full profe££ional £tatu£ (Bi<ler & Bi<ler 1945,
Schut- zenhofer 1988, Moloney 1992). Autonomy, an e£
£ential attribute for achieving profe££ional £tatu£, can
e<i£t on both an individual or group level (Moloney
1992). Although the importance of profe££ional nur£e
autonomy i£ addre££ed e<ten£ively in the literature,
definition£ of
Jorre£pondence: Gail Wade, 12 LMRAY Road, New Ja£tle, DE 19720, UfA.
E-mail: gRwade¢MDEL.EDM
e<plicated, leading to ambiguou£ interpretation£.
Further- more, the concept i£ often confu£ed with
per£onal autonomy, work autonomy and aggregate
profe££ional autonomy (Lach 1992).
Attitude£ toward£ profe££ional nur£e autonomy are
introduced during baccalaureate nur£ing education
programme£. Therefore, if nur£ing i£ to achieve full
profe££ional £tatu£, analy£i£ and application of the
concept to nur£ing education i£ warranted. U£ing
Walker & Avant’£ (1995) model for concept analy£i£,
thi£ paper clarifie£ the meaning of profe££ional nur£e
autonomy at the

310 © 1999 Blackwell Science Ltd

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