By David Ferguson

"Nurse intuition" doesn't sound scientific, but it could play a key role in critical-care outcomes.

Nurses have incorporated the idea of basing care decisions on their intuition into nursing discipline for decades, according to the authors, but educational institutions have largely ignored the concept in recent years.

The researchers conducted a descriptive phenomenological study, interviewing 12 nurses who had at least three years of work experience in critical care units of hospitals affiliated with Kermanshah University of Medical Sciences in Iran. In their analysis of the interviews, researchers identified three themes:

Patient condition: Nurses found that their intuition came into play when they felt a patient's clinical signs did not match what their gut was telling them about the patient's actual condition. Similarly, they found their intuition triggered by changes in patient behavior. Nearly all of the nurses surveyed said that their intuition had informed some aspect of their care with regards to a patient's outcome.

Nurse readiness: Nurses reported that their sixth sense led them to take measures to be prepared should a patient's condition suddenly worsen. One nurse told interviewers her attention span had improved and been refined over time, allowing her to interpret evidence and act quickly. Another said, "Sometimes when a patient entered the unit, given my intuition signs, I told my colleague that the emergency trolley should be put beside the patient bed" along with other measures to ensure rapid response time.

Prognosis/outcome: Most of the nurses interviewed said intuitive feeling led them to double-check patient prognoses. Researchers said the nurses had a keener sense of their patients' conditions and could see beyond the clinical details to the bigger picture.

Due to the small size of the study, more research is needed, However, the results indicate that many nurses use intuition in the practice of providing healthcare, the study authors noted.

Previous research found that nurses use intuition extensively when providing patient care. A 2007 study determined that intuition is a main component of decision-making and judgment in nursing. However, most nursing training treats intuition as an unreliable tool. Decision-making in critical care is already divided terrain as the drive toward evidence-based care sometimes clashes with physicians' and other care providers' desire to rely on their experience-derived opinions.