American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Nursing Research. 2018, 6(4), 147-157
DOI: 10.12691/ajnr-6-4-2
Open AccessArticle

Clinical Decision-making Experience of the Critical Care Nurses’ and Its Effect on Their Job Satisfaction: Opportunities of Good Performance

Lamiaa Ismail Keshk1, , Shereen Ahmed Ahmed Qalawa2 and Azza Anwar Aly3

1Department of Nursing administration, Faculty of Nursing, Helwan University, Egypt

2Department of Medical-Surgical Nursing, Faculty of Nursing, Port -Said University, Egypt

3Department of Medical-Surgical Nursing, Faculty of Nursing, Damanhour University, Egypt

Pub. Date: May 02, 2018

Cite this paper:
Lamiaa Ismail Keshk, Shereen Ahmed Ahmed Qalawa and Azza Anwar Aly. Clinical Decision-making Experience of the Critical Care Nurses’ and Its Effect on Their Job Satisfaction: Opportunities of Good Performance. American Journal of Nursing Research. 2018; 6(4):147-157. doi: 10.12691/ajnr-6-4-2


Background: Decision making is esteemed as single of the core traits of human being for a critical care nurse and vital aspect of the performance of critical care nursing. Critical care nurses are continually faced by way of situations where they have to create well clinical decisions. Aim: This study was conducted to investigate clinical decision-making Experience of the critical care nurses’ and its effect on their Job satisfaction. Subjects and method: A descriptive exploratory research design was used. Purposive sample of all nurses were included in this study. It included 60 nurse worked in Damanhur teaching governmental hospitals from ICU and CCU units. Data were collected through using two modificated tools from; Michael, 2007 and Alzahrany (2010) which the first Tool includes nurse's job satisfaction sheet and the second tool contains nurse's clinical decision making experience quesionnaire. Results: The study discovered that the majority of the nurses were satisfied for work environment and rules, Money and reinforcement and facilities of work and autonomy and safety (75%), (68.3%), (70%) respectively with statistically significance difference. Also, it reflects unsatisfactory level regard programs and workshops and relation with work supervisors, colleagues and patients (55%), (91.7) respectively. In addition to, (53.3%) of the nurses were knowledgeable regarding clinical decision making process and satisfactory level in their job with statistically significance differences. In addition to, the nurses had more than 6 years work experience in critical care settings had satisfactory knowledge regarding clinical decision making process Conclusion & recommendations: The present study concluded that the steps of clinical decision making becomes easier and controllable when the critical care nurses become more knowledgeable and qualified. The critical care nurses had more than 6 years’ experience making better clinical decision and had job satisfaction. So, the present study recommended that there are obvious needs for strength clinical competence in nurses, the development and enhancement of critical thinking should be emphasized at the nursing college's level and nurses should be empowered to make appropriate clinical decisions and corrective actions in critical situations of care which reflected indirectly on nurse's satisfaction.

clinical decision-making experience critical care nurses effect job satisfaction opportunities of good performance

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Maharmeh M, Alasad J, Saleh Z, Darawad M(2016) Clinical Decision-Making among Critical Care Nurses: A Qualitative Study. Health, 2016, 8, 1807-1819.
[2]  Berman, A.J., & Snyder, S. (2010). Kozier & Erb's Fundamentals of Nursing: Concepts, Process, and Practice, 9th edition, Upper Saddle River, New Jersey 07458.
[3]  Hwang, S.Y., Yen, M., Lee, B.O., Huang, M., &Tseng, H. (2010). A critical thinking disposition scale for nurses: short form. Journal of Clinical Nursing, 19(21-22), 3171-6.
[4]  Eser, I ; Khorshid, L ; Demir, Y. (2007). The Tendency to Think Critically: Examining and Influencing Factors in Intensive Care Nursing. CU School of Nursing Journal, 11:13-22. (in Turkish).
[5]  Hicks, F. D., Merritt, S. L., & Elstein, A. S. (2003). Critical thinking and clinical decision making in critical care nursing: A pilot study. Heart and Lung, 32(3), 169-180.
[6]  Phillips B. 2015. Clinical Decision Making in Last Semester Senior Baccalaureate Nursing. A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Nursing at The University of Wisconsin-Milwaukee December 2015
[7]  Berkow, J.D. & Virkstis, K. (2008). Assessing new graduate nurse performance. Journal of Nursing Administration, 38, 468-474.
[8]  Benner, P., Hughes, R.G., & Sutphen, M. (2008). Clinical reasoning, decision making, and action: Thinking critically and clinically. In R.G. Hughes (Ed), Patient Safety and
[9]  Dorgham S and Al. Mahmoud S. 2013. Leadership Styles and Clinical Decision Making Autonomy among Critical Care Nurses: A Comparative Study IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 1, Issue 4 (May – Jun. 2013), PP 71-83.
[10]  Lasater, K, & Nielsen A. (2009). Reflective journaling for development of clinical judgment.Journal of Nursing Education 48 40-44.
[11]  Miller D 2006 Technological diversity, related diversification, and firm performance.
[12]  Kramer M and Schmalenberg C 2008 The Practice of Clinical Autonomy in Hospitals: 20 000 Nurses Tell Their Story American Association of Critical-Care Nurses .Crit Care Nurse 2008; 28: 58-71 Vol 28, No. 6, DECEMBER 2008.
[13]  Papathanassogloue, D. E. M. Tseroni, G.Vazalou, J. Assikou and M. Lavdaniti, Practice and clinical decision-making autonomy among Hellenic critical care nurses, Journal of Nursing Management, 13, 2005, 154-164.
[14]  Scholes, J.J. Developing Expertise in Critical Care Nursing, Blackwell Publishing (Ltd.), 1 (Oxford, 2006), 3-16.
[15]  Iliopoulou K. K. and While, A E. Professional autonomy and job satisfaction: survey of critical care nurses in mainland Greece, Journal of Advanced Nursing, 66(11), 2010, 2520-2531.
[16]  Mrayyan, M. T. (2007). Nurses' Job Satisfaction in a Private Teaching Hospital in Jordan, Faculty of Nursing. The Hashemite University, Al-Manarah, 13: p.7.
[17]  Moneke, N.1; Umeh, O. J. (2013). Factors influencing critical care nurses' perception of their overall job satisfaction: an empirical study. J Nurs Adm. Apr; 43(4): 201-7.
[18]  Dunsdon, j. (2011). professional nurses experiences of a team nursing care framework in critical care units in a private healthcare group, published master thesis in nursing science, faculty of health sciences, nelson mandela metropolitan university , jordan. pp. 1-4.
[19]  Dede, C. (2006). Technological Supports for Acquiring 21st Century Skills Commissioned for the International Encyclopedia of Education, A state leader’s action guide to 21st century skills: A new vision for education, Tucson
[20]  Lizárraga, M.A. (2007). Factors that affect decision making: gender and age differences Universidad Pública de Navarra, Españan, Arizona State University West, USA, International Journal of Psychology and Psychological Therapy: 7, (3): Pp. 381-391.
[21]  O’Neill, E., Dluhy, N. and Chin, E. (2005) Modelling Novice Clinical Reasoning for a Computerized Decision Support System. Journal of Advanced Nursing, 49, 68-77.
[22]  Dowding, D. (2008). Commentary on Banning M (2008) A Review of Clinical Decision Making: Models and Current Research. Journal of Clinical Nursing, 18, 304-311.
[23]  Banning, M. (2007). A Review of Clinical Decision Making: Models and Current Research. Journal of Clinical Nursing, 17, 187-195.
[24]  Lake, S. E. (2005). Nursing prioritization of the patient need for care: tacit knowledge of clinical decision making in nursing, Published master thesis, Nursing, Victoria University of Wellington.; P.2.
[25]  Scott-Ladd B, Travaglione A and Marshall V. (2006). Causal inferences between participation in decision making, task attributes, work effort, rewards, job satisfaction and commitment. Leadership & Organization Development Journal. Vol. 27 No. 5, 2006. pp. 399-414.
[26]  Michael, c. (2007). A study to assess job satisfaction among nursing personnel in the surgical wards of a selected hospital, published master thesis in hospital administration father muller medical college, mangalore.
[27]  Al Zahrani, S. A. (2009). Professional preference and decision making With a sample of professional college students In Jeddah, published Master's thesis in Psychology (Professional Educational Guidance), Faculty of Education Department of Psychology, Umm Al Qura University.
[28]  Yurdanur d (2016) Critical Thinking Competence and Dispositions among Critical Care Nurses: A Descriptive Study. International Journal of Caring Sciences May– August 2016 Volume 9 | Issue 2| Page 489.
[29]  Altallal S (2006). Factors Influencing Critical Care Nurses’ Decision Making in Saudi Arabia Critical Care Units. A project submitted in partial fulfilment of the requirement for the degree of Master of Nursing. School of Nursing and Midwifery Faculty of Medicine, Nursing and Health Sciences. Monash University.
[30]  Ramezani-Bader, F., Nasrabadi, A. and Yekta, P. (2009) Strategies and Criteria for Clinical Decision Making in Critical Care Nurses: A Qualitative Study. Journal of Nursing Scholarship, 41, 351-358.
[31]  Varjus, L.K. Helena and S. Tarja, Professional autonomy of nurses in hospital settings – a review of the literature Sirkka-Liisa Scand, J Caring Sci., 25, 2011, 201-207.
[32]  Mrayyan. M. T. A unit-based protocol to enhance Jordanian nurses' autonomous decision making, Journal of Nursing Management, 14, 2006, 391-396.
[33]  Altun, I., & Ersoy, N. (2003). Undertaking the role of patient advocate: A longitudinal study of nursing student. Nursing Ethics, 10(5), 462-471.Ambulance Nurses in Emergency Care Situation. International Emergency Nursing, 17, 83-89.
[34]  Berner, K., Ives, G., & Astin, F. (2004). Critical care nurses’ perceptions about their involvement in significant decisions regarding patient care. Australian Critical Care, 17(3), 123-131.
[35]  Darawad, M., Al-Hussami, M., Saleh, A., Al-Sutari, M. and Mostafa, W. (2015) Predictors of ICU Patients’ Pain Management Satisfaction. Australian Critical Care, 28, 129-133.
[36]  Saleh, A., Darawad, M. and Al-Hussami, M. (2014) Organizational Commitment and Work Satisfaction among Jordanian Nurses: A Comparative Study. Life Science Journal, 11, 31-36.
[37]  Ersoy, M; Akpinar, A. (2010). Turkish Nurses’ Decision Making in the Distribution of Intensive Care Beds. Nursing Ethics, 17, 87-98.
[38]  Hoffman, K., Aitken, L. and Duffield, C. (2009). A Comparison of Novice and Expert Nurses’ Cue Collection during Clinical Decision-Making: Verbal Protocol Analysis. International Journal of Nursing Studies, 46, 1335-1344.
[39]  Thompson, C., Dalgleish, L., Bucknall, T., et al. (2008). The Effects of Time Pressure and Experience on Nurses’ Risk Assessment Decisions. Nursing Research, 57, 302-311.
[40]  Bakalis, N. (2006). Clinical Decision-Making in Cardiac Nursing: A Review of the Literature.Nursing Standard, 21, 39-46.
[41]  Shah M.A., Al-Enezi N., Chowdhury R.I., and Al Otabi M., Determinants of job satisfaction among nurses in Kuwait, Aust J Adv Nurs., Jun-Aug, 21(4), 2004, 10-6.
[42]  Hoffman, K., & Elwin, C. (2004). The relationship between critical thinking and confidence in decision-making. Australian Journal of Advanced Nursing, 22(1), 8-12.
[43]  Cobanoglu, N., & Algier, L. (2004). A qualitative analysis of ethical problems experienced by physicians and nurses in intensive care units in Turkey. Nursing Ethics, 11(5), 444-456.