What is Autonomy in Nursing? Meaning & Examples

Autonomy is one of the four main ethical principles in the nursing code of ethics.  Read on to learn about the types of autonomy in nursing and why it is important.

What is Autonomy in Nursing? 

Autonomy in nursing is the ability of nurses to understand their patient’s right to medical information and care while independently making decisions without consulting the healthcare provider. 

Autonomy also includes properly advocating for your patient. However, you must fully understand the patient’s medical wishes to do so. You must also have a grasp on all potential risks, benefits, and complications to make well-informed decisions.

Understanding autonomy in nursing can be helpful when making decisions throughout your shift. Acting under this principle helps ensure that you are acting within the scope of your practice.

Nursing Autonomy & The Nursing Code of Ethics

Autonomy is one of four ethical principles in nursing set by the American Nurses Association (ANA) Code of Ethics for Nurses. The other three ethical principles include beneficence, justice, and nonmaleficence.

The ANA developed the nursing code of ethics in the 1950s and has made countless modifications over the years. The most significant change occurred in 2015 when the ANA added nine interpretative statements or provisions to the code of ethics. These statements helped guide nursing practice more definitively.

How Well Do Nurses Understand Autonomy?

A 2020 qualitative meta-synthesis study identified a need for a better understanding of the concept of autonomy. It also researched how nurses can benefit from self-reliance to provide the best care for their patients.

Researchers found that there is a persistent lack of knowledge about autonomy in nursing despite numerous studies on the topic. Autonomy can lead to “quality of patient care through timely decision-making at the patient's bedside, as well as reducing stress, increasing job satisfaction, and attracting and retaining nurses,” according to the study.

Why is Autonomy in Nursing Important?

Nurses need autonomy to determine specific aspects of patient care without having to consult with a doctor or healthcare provider. Autonomy allows nurses to be self-motivated, think critically, and take distinct and direct actions related to patient care.

Types of Autonomy in Nursing

There are two specific types of autonomy in nursing: clinical autonomy and autonomy over nursing practice. 

• Clinical autonomy relates to nurses making decisions and judgments about their patients' care.

• Autonomy over nursing practice allows nurses to make decisions about their practice setting. These decisions include those regarding organizational structure, rules, policies, and operations.

Examples of Autonomy in Nursing 

Every day, nurses practice autonomy in nursing, probably without realizing it. Whenever they make decisions within the scope of their practice without consulting a doctor, they act with autonomy.

Nurses most commonly practice autonomy by administering pain medication and other PRN or as-needed medications. The healthcare team has already ordered these medications, which nurses can use at their discretion.

Example:

A healthcare provider prescribed oxycodone to a patient for pain greater than 5 on a scale of 1 to 10. The patient explains to a nurse that their pain is at a 6. The nurse can administer the oxycodone to their patient without having to call the medical provider.

Other nursing autonomy examples include:

• Administering vaccinations
• Implementing postoperative care
• Monitoring vitals 
• Dressing wounds and incisions
• Performing CPR
• Delegating tasks to LPNs and CNAs 

How to Improve Nursing Autonomy

Improving nursing autonomy starts with each nurse’s own understanding of their role and responsibilities to their patients. Nurses can continue their education to further their comprehension of pharmacology, pathophysiology, and health assessments. Having a deep understanding of your patient’s disease process can help you advocate for them.

Nurses should also learn to advocate for themselves within their healthcare system. Joining different unit and hospital committees may help you accomplish this goal. You can promote change by becoming more involved in your unit and the healthcare system.

Nursing Roles With the Most Autonomy

All nurses have a form of autonomy, but some have more than others. Advanced education or the nature of a nursing position may cause some roles to have more autonomy. Nursing jobs with higher autonomy include the following:

• Home health nurses
• Nurse educators
• Hospice nurses
• Nurse practitioners
• Nurse midwives
• Telehealth nurses 
• Forensic nurses /SANE nurses
• School nurses
• Nurse Anesthetist 
• Flight nurses
• Transport nurses

Final Thoughts on Autonomy in Nursing

The ANA includes autonomy in the four main ethical principles set forth by the Code of Ethics in Nursing. Autonomy's meaning in nursing refers to nurses' ability to independently make certain clinical and nursing practice decisions.

Nurses and advanced practice registered nurses (APRNs) have a duty to themselves and their patients to fully comprehend autonomy in nursing. In doing so, they will understand the care patients need and how to advocate for them.

Through thoughtful clinical reasoning and critical thinking, nurses can make decisions for their patients within the scope of their practice without consulting a healthcare provider.

You can learn more about how ethical principles like autonomy impact decision-making in nursing practice in our article 10 Examples of Ethical Dilemmas in Nursing.