The Tension Between Science and Intuition in Nursing

The Tension Between Science and Intuition in Nursing

By Alexandra Clark, Kalandra Academic Manager  02.04.20

Medicine and by inference, patient care is based around the principles of scientific research. Science according to the Cambridge Dictionary means: “knowledge from the careful study of… especially by watching, measuring and doing experiments, and the development of theories to describe the results of these activities” (2019). 
Science is true, it is based on evidence, observations and fact. I think of chemistry class and experiments. Everything in my job as a RN is based around science - the diagnostic tests we do, the reasoning behind the tests and what diagnosis they lead to, the medication we give, even the questions we ask etc. I have always believed that I, as a Registered Nurse, am a scientist. My work is guided by policies and procedures that are evidence based. I work best with numbers and reason e.g. the patient’s heart rate is elevated because I caused him pain by inserting an intravenous line. I always believe science and the scientific perspective is the basis of health care. 
However, over the years I have developed a gut instinct. A young boy was carried in by his parents, he was about 6 months old. They told me a familiar story of a runny nose, fever and cough. Not drinking as much as normal. His vital signs indicated that he was slightly dehydrated but otherwise stable – I sent the patient to a side room (non-urgent) for further assessment. Suddenly I had this overwhelming urge to relook at the little boy triggered by a sense of dread. I had triaged hundreds of children before this and had never felt this awful sense of dread. Quickly following the family, I looked at him and he wasn’t breathing. This was the first time I ever trusted my ‘gut instinct’ as a nurse and I have never doubted it again. 

This was hard to reconcile with my scientific based training and work. However, my gut instinct or intuition has guided a great deal of my work and has never failed me.  How does this fit into a field, such as healthcare, that is so scientifically based? 

Intuition is defined by the Encyclopaedia Britannica as "the power of obtaining knowledge that cannot be acquired either by inference or observation, by reason or experience." Initially I was conflicted. The medical profession is guided by science and is traditional in thinking but the more I thought about it I discovered that the nursing profession is guided by science but does acknowledge that other non-tangible occurrences exist such as the ‘gut instinct’. 

It is no longer frowned upon or laughed at.  Although intuition isn’t scientific, perhaps the first recoded instance of the ‘gut instinct’ or ‘professional intuition’ was Descartes when he identified the Pineal Gland as the origin of thoughts with no obvious scientific reasoning. I like to believe that Intuition has some small link to science and comes from a science background even if it is just a subconscious interpretation of data and evidence as some researchers believe. 

Intuition or the Nurses Gut is strong and should never be ignored. It may facilitate further scientific based tests and responses but there are many instances where this guidance has surpassed science and indeed saved lives. Nurses need to trust their gut. 

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