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Intuition comes of age: workplace applications of intuitive skill for occupational and environmental health nurses.

1. Intuition is an internal experience. It is a way of knowing something directly without an intervening analytic thought. It functions more subjectively than objectively. 2. The subjective nature of intuition makes it challenging to use in the business world yet the value it adds makes it worth the effort. Intuition adds value when making judgment calls, managing unforeseeables, when creativity and innovation are necessary. Intuition is the skill of responding appropriately, in the moment, to specific situations. Intuition "opens the doors" to new possibilities which can then be applied and evaluated analytically. 3. Intuition can be enhanced in the workplace by becoming familiar with some of the ways it is experienced, and facilitate co-workers to express their intuitions more openly. Another way to enhance intuition at work is to ask questions which collect non-analytic data. 4. Making intuitive thinking a regular part of team meetings will improve the productivity of the team and encourage individual use of intuitive skill. Individual intuitive skill can be increased with paying regular attention to physical responses, images, feelings, and synchronicities.

Clinical Competence

Characteristics of intuitive nurses.

A description is provided of the process used to verify characteristics of intuitive nurses that had been reported in the literature. These characteristics supplied the framework for construction of the Miller Intuitiveness Instrument (MII) reported earlier (Miller, 1993). Evidence for validity of the MII was provided in the Miller (1993) study by examining factor analyses and correlations with the intuitive component of the Myers-Briggs Type Indicator (MBTI). The following characteristics were subsequently verified: Intuitive nurses are willing to act on their intuitions, are skilled clinicians, and incorporate a spiritual component in their practices. In addition, intuitive nurses express an interest in the abstract nature of things and are risk takers. Intuitive nurses prefer intuition to sensing (as reflected by the MBTI) as a way to take in information. They are extroverted and express confidence in their intuitions. Likewise, nurses who delay making decisions until all the information is in are more intuitive than those who make decisions abruptly.

Clinical Competence

Intuition--a problematic form of knowledge in nursing.

The purpose of this article is to discuss the concept and phenomenon of intuition in nursing. With an overview of theories of intuition in philosophy and empirical research as the starting point, the authors discuss the conceptualization of intuition in nursing. Concept analyses, intuition as phenomenological nursing knowledge, intuition as clinical knowledge and intuition as spiritual connection are discussed. The authors conclude that the conceptions of intuition in nursing differ with respect to their philosophical underpinnings and that it can be questioned whether 'intuition' is always a proper term for the kind of knowledge investigated. Intuition is seen as an important concept in nursing, but there are still philosophical as well as empirical and practical problems to investigate.

Concept Formation

Intuition and the nurse manager.

In spite of the present move in health care into the computer age, there is increasing awareness that intuition is an important nursing management technique and that it is linked to success as a manager. Intuition is most effectively implemented by the self-confident manager with experience and expertise as a manager. Nevertheless, a novice manager who values and seeks intuition will find it a technique that will assist in the development of excellence as a manager. Managers who perceive themselves as having limited skills in intuition and yet are sensitive to the need for intuition can compensate for this deficiency by close association with a coworker who can provide intuitive perceptions and evaluations. For example, a head nurse who is primarily analytical may discuss assignment of nurses with an assistant who is highly intuitive. Managers who are able to compensate for intuitive deficiencies by surrounding themselves with competent and trusted subordinates who have intuitive qualities may be able to effectively use both analytic and nonanalytic managerial techniques.

Creativity

Intuition in nursing practice: deep connections.

The purpose of this study was to describe the phenomenon of intuition in nursing culture. The aims of the study were to (a) identify and describe terminology used with intuition in nursing care practice, (b) describe examples of experiential knowledge of intuition, (c) describe actions taken on intuitive experiences, (d) describe feelings associated with intuitive experience, and (e) compare and contrast patterns and processes of nursing intuition. The design of the study was ethnography. Sampling involved 40 nurses from all levels of the hospital and home health care practice. Intuition was found to (a) facilitate the depth of nurse-client relationships; (b) lead to a deeper understanding and connection with client patterns; (c) be acknowledged as a professional risk; (d) emphasize the significant influence of autonomy, independence, and assertiveness in nursing practice; and (e) contribute to excellence in nursing care. Intuition was identified as a manifestation of transpersonal caring in the art of nursing practice and was deeply connected to caring as the moral ideal of the nursing profession.

Adult

Intuition and rational decision-making in professional thinking: a false dichotomy?

A number of researchers have sought to understand what enables the 'expert' professional to achieve a rapid and effortless understanding of presenting situations. Central to many of the explanations offered is the term 'intuition'. It might be thought, therefore, that the word describes a coherent concept embracing certain related features and used with consistency. A study of the literature suggests that this is not so. 'Intuition' is more than a contested concept, it is also used in ways that lack both clarity and coherence. Some of the confusion associated with the concept seems to stem from the belief that intuition is an irrational process. As a consequence, it is assumed that intuition can be neither fully understood nor explained. In this paper we discuss a number of issues relating to the nature of 'intuition'. We argue that intuition may be understood as an irrational process that has a rational basis. Intuitive thinking has certain essential features and involves the use of a sound, rational, relevant knowledge base in situations that, through experience, are so familiar that the person has learned how to recognize and act on appropriate patterns.

Awareness

Intuition and nursing practice implications for nurse educators: a review of the literature.

Intuitive knowledge is an essential component of the art of nursing and of the nursing process. This article provides an analysis and review of the literature on intuition. The author addresses the use of intuition in nursing science, characteristics of intuitive nurses, receptivity of intuitive knowledge, and the importance of expanding nursing's utilization of the intuitive process. Strategies are provided for promoting intuitive skills in continuing education/staff development settings.

Clinical Competence

Heuristics, servants to intuition, in clinical decision-making.

This paper explores intuitive judgements of nurses in clinical decision-making situations. The qualities of intuition are presented from both theoretical and practical perspectives and attitudes towards intuition from both nurses themselves and other health professionals are identified. An heuristic framework from cognitive psychology is applied to intuitive aspects of the clinical judgements that nurses have made. This interpretation is proposed as a partial explanation of intuition, and its use in advancing the understanding of intuition is recommended.

Clinical Competence

Intuition: a critical review of the research and rhetoric.

This paper will explore the concept of intuition in nursing from an acute care and community nursing perspective. It will consider definitions of intuition and examine the research which can inform our understanding of this important component of decision making. In the current health service climate, which demands measurable research-based evidence, the involvement of intuition as an element of judgement is often denigrated. The result is that many nurses are being forced to be covert in their use of this crucial aspect of judgement and focus solely on the conscious elements of decision-making. However, research evidence would suggest that intuition occurs in response to knowledge, is a trigger for action and/or reflection and thus has a direct bearing on analytical processes in patient/client care. The authors therefore argue that the essential nature of intuition cannot be ignored in the practice, management, education and research of nursing.

Clinical Competence

Intuition in nursing relationships: the result of 'skills' or 'qualities'?

Maintaining the scientific orientation of health and nursing care systems has resulted in a lack of focus on nurses' intuitive knowledge base. Consequently, confusion exists as to whether intuition in nursing is the result of acquired skills, or is dependent upon the inherent qualities of the individual. In deconstructing the apparently intuitive process of building rapport, neuro-linguistic programming (NLP) can offer insight, suggesting that rapport building depends on learnt skills that have moved into unconscious competence. The examination of nurses' intuitive knowledge, in order to identify underlying skills, needs to be just as rigorous as the acquisition of scientific knowledge. Examining intuitive knowledge can be achieved within a framework of reflective practice to counter the inherent dangers of an increasingly scientific approach operating within a caring profession.

Clinical Competence

Antenatal fetal heart rate and "maternal intuition" as predictors of fetal sex.

OBJECTIVE: To determine if the antenatal fetal heart rate is a reliable predictor of fetal sex, if there is any correlation between "maternal intuition" and fetal gender, and if maternal intuition favors one sex over the other. STUDY DESIGN: Two hundred twelve consecutive maternity patients with singleton gestations underwent a total of 2,261 antepartum visits. Fetal heart rate assessment was carried out between 14 and 41 weeks of gestation. At 32 weeks, participants were asked if they had a strong intuitive feeling regarding the fetal gender. Following birth, data on the infant were recorded, and the information was analyzed. RESULTS: There was no significant difference in the baseline fetal heart rate between male and female fetuses at any recorded gestational age. One hundred ten patients (51.9%) in the sample indicated a strong belief about the sex of their fetuses, with the majority (63.6%) predicting a male. The accuracy of maternal intuition, however, was not significantly different from that of random guessing. CONCLUSION: In the current era of declining family size, an increased focus on absolute reproductive choice and proliferating reproductive technological services, prenatal sex determination and sex selection will continue to provoke increasing attention. Fetal heart rate determination and maternal intuition, however, are not valid predictors of fetal gender.

Adolescent

Intuition, cognitive style, and hemispheric processing.

200 undergraduate volunteers were administered Westcott's Test of Intuitive Ability, Witkin's Group Embedded Figures Test, Paivio's Revised Individual Differences Questionnaire, and visual and aural dominance measures using a three-field tachistoscope and dichotic listening device, respectively. Field dependence was consistently related to poorer intuitive performance. No sex-related differences were found on intuition, embedded figures, Paivio's questionnaire, or dominance scores although the amount of intuition explained by cognitive style and dominance differed by hand and gender. Visual-verbal style was not associated with dominance while the relation of field dependence-independence and dominance was inconsistent. Neither dominance nor visual-verbal style was consistently related to intuition although complicated associations were indicated by hand and sex, suggesting differences in cognitive organization.

Adult

Intuition and consciousness.

Intuition represents an unconscious cognitive activity, the results of which become conscious at some point. Some recent nonpsychoanalytic explorations of cognition and consciousness are examined to illuminate our understanding of these processes and their relation to the psychoanalytic process. Our thesis is that intuition may be most usefully viewed as a form of unconscious pattern-matching cognition, which becomes conscious under certain conditions and which is only loosely related to primary process. A clinical example is given of the analyst's intuition to illustrate the initial ostensibly theory-free nature of the raw intuition and the subsequent theory-bound explorations of the intuitive conclusion. Implications for teaching and learning psychoanalysis are noted.

Adult

Leveraging clinical intuition to improve accuracy of phenotype-driven prioritization.

PURPOSE: Clinical intuition is commonly incorporated into the differential diagnosis as an assessment of the likelihood of candidate diagnoses based either on the patient population being seen in a specific clinic or on the signs and symptoms of the initial presentation. Algorithms to support diagnostic sequencing in individuals with a suspected rare genetic disease do not yet incorporate intuition and instead assume that each Mendelian disease has an equal pretest probability. METHODS: The LIkelihood Ratio Interpretation of Clinical AbnormaLities (LIRICAL) algorithm calculates the likelihood ratio of clinical manifestations represented by Human Phenotype Ontology terms to rank candidate diagnoses. The initial version of LIRICAL assumed an equal pretest probability for each disease in its calculation of the posttest probability (where the test is diagnostic exome or genome sequencing). We introduce Clinical Intuition for Likelihood Ratios (ClintLR), an extension of the LIRICAL algorithm that boosts the pretest probability of groups of related diseases deemed to be more likely. RESULTS: The average rank of the correct diagnosis in simulations using ClintLR showed a statistically significant improvement over a range of adjustment factors. CONCLUSION: ClintLR successfully encodes clinical intuition to improve ranking of rare diseases in diagnostic sequencing. ClintLR is freely available at https://github.com/TheJacksonLaboratory/ClintLR.

Humans

Fostering intuition: a role of the trauma nurse mentor.

Intuitive knowledge is a relative component of the critical thinking process. Intuition is discussed along with examples of how nurses have demonstrated intuitive thinking in the trauma setting. Recommendations are offered for how the mentor trauma nurse can foster an awareness and the development of intuition in the novice practitioner.

Clinical Competence

Intuition and the coronary care nurse.

The paper sets out to explore the place of intuition in coronary care nursing. The Dreyfus (1985) and Benner (1984) models are used to explore the relevance of intuition to clinical practice. Examples from clinical practice are used to discuss the status of intuition in current practice. Conclusions suggest that further work is needed to explore the value of intuition and its contribution to clinical care.

Coronary Care Units

Comparison of the use of standardized diagnostic criteria and intuitive clinical diagnosis in the diagnosis of common viral warts (verrucae vulgaris).

OBJECTIVE: To assess the diagnostic value of standardized diagnostic criteria compared with the clinical intuitive diagnosis for verrucae vulgaris. DESIGN: A blind comparison with cross-over of experienced dermatologists using either intuitive clinical diagnosis or else recording the presence of standardized diagnostic criteria in verrucae vulgaris. SETTING: Clinical outpatient department in a major teaching hospital. PATIENTS: Fifteen patients aged 6 to 60 years with 21 verrucae vulgaris and 24 control lesions. INTERVENTION: Dermatologists examined the lesions and recorded either the diagnosis by the usual clinical intuitive method or else whether standardized diagnostic criteria were present in the lesion of each patient. Each dermatologist did 1 only of the 2 methods for each lesion with the other doing the alternative method for the same lesion, neither of them having previously been aware of any of the diagnoses. MAIN OUTCOME MEASURE: The sensitivity, specificity, and positive predictive, negative predictive, and relative values for each diagnostic approach were compared. RESULTS: Use of intuitive clinical diagnosis resulted in 100% specificity, sensitivity, and positive predictive, negative predictive, and relative values for both the verrucae vulgaris and the control lesions. Recording the presence of the diagnostic criteria reduced to a varying extent all the parameters of diagnostic accuracy with site--fingers and hands, elbows, and knees--being the most efficacious of the criteria. CONCLUSIONS: These data indicate that care is required in relying too much on standardized criteria as the basis for clinical diagnosis, even for a lesion as simple as a wart. They also reinforce the value of clinical experience obtained from repeated exposure to multiple variants of a disease in the traditional bedside teaching model.

Adolescent

Improving Predictive Accuracy with a Combination of Human Intuition and Mechanical Decision Aids.

This study examines the intuitive combination of human judgment and mechanical prediction under varied information conditions. As expected, mechanical prediction outperformed human intuition when based on the same information, but a combined approach was best when judges had access to relevant information not captured by the model (information asymmetry). The model was useful for differentiating between the event outcomes (improved slope), while eliminating the bias caused by base-rate neglect. Human intuition was useful for incorporating relevant information outside the scope of the model, resulting in improved slope and reduced judgment scatter. The addition of irrelevant information was detrimental to judgment accuracy, causing an increase in bias and a reduction in slope. These results provide insight into how and when combining mechanical prediction and human intuition is likely to result in improved accuracy. Copyright 1998 Academic Press.

Journal Article