Revealing the relational nature of clinical decision making of dietitians in the acute care setting

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The practice of acute care clinical dietetics involves daily clinical decision making regarding patient care. The aim of this doctoral research was to uncover the nature of clinical decision making of dietitians in the acute setting. A qualitative design within the interpretative paradigm was used, specifically philosophical hermeneutics. Philosophical hermeneutics is concerned with the human experience but more specifically, the interpreted meaning of this experience. This study involved two recorded semi-structured interviews with ten acute care dietitians which were transcribed and interpreted using the principles of hermeneutics. A reference group was then used to provide rigour and further interpretation. The participants have revealed that this complex and dynamic process all occurs with high amounts of dependent engagement with other health professionals, particularly the medical practitioner. Dominant themes included the need for earning and maintaining respect, the role of power and autonomy when making decisions as well as knowing and engaging within the traditional medical hierarchy that is still prevalent in the hospital setting. Dietitians indicated they spend considerable time and energy on knowing how to optimally decide on whom, how and for what reason to engage with the medical team for the nutritional care of patients. Participants who expressed confidence in these relational skills indicated a strong professional identity and expanded scope of practice as an acute care dietitian. A deeper understanding of this phenomenon will provide insight into how decision making occurs and therefore potentially contribute to education, professional development and research activities which subsequently optimise patient care.
Original languageEnglish
Pages (from-to)30
Number of pages1
JournalNutrition and Dietetics
Issue numberS1
Publication statusPublished - 18 May 2018
EventDietitians Association of Australia Annual 35th National Conference - Sydney, Australia
Duration: 17 May 201819 May 2018


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