How do healthcare professionals manage uncertainty in making decisions? Applying theory to nurses’ experiences of uncertainty regarding antibiotics in residential aged-care facilities

Abstract

The experience of uncertainty is inherent to the practice of medicine. It influences healthcare professionals’ perceptions of risk and decision-making. Our objective was to provide empirical insights into how healthcare professionals manage uncertainty and navigate risk related to antibiotics in residential aged-care facilities. Interview data from aged-care nurses was coded deductively, drawing on a taxonomy of uncertainty tolerance in medical decision-making developed by Han and colleagues (2021). Additional themes that did not map onto existing codes were inductively coded. Views from the 16 nurses in the study revealed use of a wide range of strategies that often co-occurred when managing their uncertainty. Consulting with colleagues and deferring to others were the most commonly used strategies to reduce uncertainty. ‘Avoidance’ and ‘reflection’ were response-focused strategies that had not been previously described in the taxonomy. Managing uncertainty is an active and ongoing process that requires clinicians to engage multiple strategies, often with conflicting aims. These findings have implications for deepening our understanding of how uncertainty affects healthcare professionals engaged in risk work. They also highlight the need to expand educational interventions to include cognitive strategies focused on managing uncertainty. Additionally, the findings point to the importance of involving multiple stakeholders in sharing the burdens associated with uncertainty in clinical decision-making