The role of intuition in nurses who activate the Rapid Response Team (RRT) in medical-surgical and telemetry units

The process of making decisions in nursing is filled not only with rational, cognitive ways of knowing, but also with non-rational, intuitive ways of knowing that foster holistic care. In professional practice, nurses should not be limited to cognitive rational processes alone. Williams, Newman and Jones (2011) reported, "Nurses viewed the Rapid Response Team (RRT) as a way to call for help when they knew something was wrong, especially when they could not pinpoint the cause" (p. 268). This study and other evidence suggest that additional research is needed to better understand nurses' perspectives of RRTs, how they impact the work environment, and the relevance of RRT composition. Limited understanding exists about nurses' perspectives regarding the use of intuition in activating RRT. The purpose of the proposed qualitative study was to explore the experiences of staff nurses using nursing intuition in the process of activating RRT for patients being cared for in medical-surgical and telemetry units. The primary data for this qualitative study were collected through in-depth, face-to-face interviews ranging from 45 to 60 minutes in duration. The interviews were semi-structured and open-ended to explore the phenomenon of nursing intuition in activating the RRT. Following the requirements of GT methodology (Strauss & Corbin, 1998), the sample of participants recruited for this study was purposive. The participants were purposely selected because of their knowledge of activating the RRT. The sample of N = 32 adult registered nurses currently worked full time with 12 hour shifts in adult medical-surgical, and telemetry units. Open, axial, and selective coding of 295 units of communication elicited from 32 registered nurses working in medical-surgical and telemetry units resulted ultimately in the generation of a theory grounded in data to increase understanding of the role of intuition in nurses who activate the RRT for patients in medical-surgical and telemetry units. According to this theory, nursing intuition cannot be defined in terms of a linear process of reasoning. The theory proposes that nursing intuition is rooted in the recognition of patterns among a complex combination of factual information and subjective inferences collected from the patient. The components of these patterns are classified for the purposes of the theory as objective assessment, visual observation, verbal interaction, and subjective assessment. Having collected and interpreted the assessment data, the decision to activate the RRT is moderated by emotional and physiological reactions, collaboration with others, education, and historical experience. These moderating factors help to enhance a nurse's ability to trust in his or her feelings and inspire confidence to call the RRT, leading to a beneficial patient outcome, as well as the development and acquisition of the nurse's knowledge.