Dimensions of professional autonomy among Mexican nurses: Implications for health system strengthening

Professional autonomy is a term that is often not well defined within the nursing profession and particularly in countries where the nursing role and profession are evolving.  In order to strengthen public health systems, clarifying the nature of professional autonomy in nursing can help strengthen the production of nursing human resources, their role capabilities, and further delineate the scope of practice between different levels of nursing professionals and their medical counterparts.  This study sought to clarify the meaning of professional autonomy among Mexican nurses in order to help accomplish those goals.

To study the concept of professional autonomy in Mexican nurses, I conducted a secondary content analysis of 48 interviews with Mexican nurses about professionalization processes.  Nurses came from four regions of the country, a diverse set of socioeconomic backgrounds, a variety of educational levels (from technical to masters degrees), and covered all clinical practice settings from acute care to public health.

Interview analysis revealed three dimensions of professional autonomy for Mexican nurses: Education, Role-Based, and Governance.  Factors external to the nursing profession most often affected the education and governance theme while internal factors strongly influenced the dimension of role-based autonomy.  Nurses cited having a strong knowledge base as central to their ability to make autonomous decisions about patient care actions.  A striking finding from the study was that nurses without at least a bachelor’s degree in nursing had difficulty understanding the concept of autonomy or expressing an opinion about it.  These findings suggest that more education enhances a nurses’ decision-making ability and may ultimately benefit patient outcomes.           

By identifying the dimensions of professional autonomy among Mexican nurses, policymakers can focus infrastructure investments that will direct enhance the quality of nursing services patients experience.  Further replication of this study is recommended to confirm its applicability in settings outside of Mexico.