Professional autonomy is a key concept in understanding nurses’ roles in delivering patient care. Recent research exploring the role of autonomy in the nursing work environment indicated that English and American nurses had differing perceptions of autonomy. This qualitative study aimed to explore the understanding and experiences of autonomy of nurses working in England. A descriptive phenomenological analysis of data from 48 semi-structured interviews with registered nurses from two National Health Service (NHS) hospitals (purposive sample) was used to explore the concept of autonomy. Six themes were identified: working independently; working in a team; having professional skills and knowledge; involvement in autonomy; boundaries around autonomy; and developing autonomy requires support. A key finding was that nurses related autonomy to their clinical work and to the immediate work environment of their ward, rather than to a wider professional context. Nurses also perceived that autonomy could be turned off and on rather than comprising an integrated aspect of nursing. Findings suggest that nurses in England, as framed by the sample, had a local ward-focused view of autonomy in comparison to nurses in America, who were reported to relate autonomy to a wider involvement in hospital level committees. Findings further indicate that autonomy was practiced occasionally, rather than incorporated into practice. Findings highlight the need for nurses in England to adopt a broader perspective and actively contribute to writing hospital guidelines and policies that recognise the importance of autonomy to nurse training and practice.

中文翻译：

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注册护士对自主权的认知和体验：描述性现象学研究

专业自主权是理解护士在提供病人护理中的作用的一个关键概念。最近探索自治在护理工作环境中的作用的研究表明，英国和美国护士对自治有不同的看法。这项定性研究旨在探讨对在英国工作的护士自主权的理解和经验。对来自两家国民保健服务 (NHS) 医院（目的样本）的注册护士的 48 次半结构化访谈的数据进行描述性现象学分析，以探索自治的概念。确定了六个主题：独立工作；在团队中工作；具有专业技能和知识；参与自治；围绕自治的界限；发展自治需要支持。一个关键的发现是，护士将自主权与他们的临床工作和病房的直接工作环境相关联，而不是与更广泛的专业环境相关联。护士们还认为，自主性可以被关闭和打开，而不是包含护理的一个综合方面。调查结果表明，与样本相比，英格兰的护士对自治权有一种以当地病房为中心的观点，据报道，美国护士将自治权与更广泛地参与医院级委员会联系起来。调查结果进一步表明，自治是偶尔进行的，而不是纳入实践。调查结果强调了英格兰护士需要采取更广泛的视角，并积极参与编写医院指南和政策，以认识到自主权对护士培训和实践的重要性。