Nursing Instinct

Patricia Benner describes nursing intuition as part of the art of nursing, an instinct used subconsciously by experienced, expert nurses. In nursing school, our instructors talked about a "spidey sense" or sixth sense which we baby nurses may one day develop. Any number of us, from student nurse to new nurse to new parent, however, can benefit from listening to our guts from time to time. At the very least, it points us in a good direction to gather more data.

Nursing intuition is a widely recognized phenomenon and current research validates the clinical significance of nursing instinct.

A 2016 qualitative and quantitative study by Lora Cork, FNP, proves nursing intuition as statistically valid as objective data in predicting the severity of injury in trauma patients in the emergency department. If nothing else is going to tell you, your spidey sense is better than nothing when a patient is secretly bleeding internally or about to throw a clot in the lungs (pulmonary embolism), brain (stroke), or heart ( <3 attack).

Evident through interviews and review of medical records, intuition is used effectively by intensive care nurses as well (Hassani et al.). Experienced ICU nurses can often tell a patient is about go downhill before observable signs appear. If healthcare workers are ahead of the game, patients have a better shot at this no-fun game show called Life.

Similarly, parental intuition can be helpful in pediatric case studies (Renz), partly because parents know their children far better a healthcare worker meeting them for the first time. Not only does Mother know best, sometimes she knows worst before anyone else.

So what do we do with a feeling that something is wrong, even if no evidence jumps out immediately? Use that hunch to look for more clues--trending laboratory levels, vital signs, suggesting possible imaging/tests, or simply examining the patient more and asking more questions.

Often, as a parent or as a nurse, when we feel like something is wrong, it just might be, and catching something before it becomes more serious can go a long way towards better outcomes.

References
Cork, L. L. (2014). Nursing intuition as an assessment tool in predicting severity of injury in trauma patients. Journal of Trauma Nursing 21(5), 244–252.
Hassani, P., Abdi, A., Jalali, R., & Salari, N. (2016). Use of intuition by critical care nurses: a phenomenological study. Advances in Medical Education and Practice 7, 5-71.
Renz, M. C. (1993). Learning from intuition. Nursing, 23(7), 44–45.