• Lisbeth Uhrenfeldt and Elisabeth O C Hall.
• Aarhus University, Institute of Public Health, Department of Nursing Science, Høegh-Guldbergsgade 6A, Building 1633, DK-8000 Aarhus C, Denmark. lu@nursingscience.au.dk
• Nurs Ethics. 2007 May 1; 14 (3): 387-98.

AbstractThis article examines clinical wisdom, which has emerged from a broader study about nurse managers' influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses' experience and clinical practice by giving voice to the nurses themselves, and to look for differences in their practice. This was a qualitative study based on semistructured interviews followed by analysis founded on Gadamerian hermeneutics. The article describes how proficient nurses experience their practice. Proficient practice constitutes clinical wisdom based on responsibility, thinking and ethical discernment, and a drive for action. The study showed that poor working conditions cause proficient nurses to regress to non-proficient performance. Further studies are recommended to allow deeper searching into the area of working conditions and their relationship to lack of nurse proficiency.

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