Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study

Abstract

Aim: The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services.

Introduction: Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation.

Methods: A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis.

Findings: The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses.

Conclusion: The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN.

Keywords: Ambulance; Clinical rotation; Decision-making; Education; Prehospital emergency care; Prehospital emergency care students.