Findings illuminate how nurses experience their work in
different parts of the Norwegian health care system. The
interpretation of the meanings of these nurses’ experiences
allowed an understanding of autonomy in nursing practice.
The nurses describe autonomy as influenced by their responsibilities
in their workplaces as well as of certain challenges in
particular situations. They emphasise management, decision
making in patient care and performing tasks as contexts
where they are expected to practice autonomously and the
study captured experiences connected to constraints and
challenges in these contexts.
As found in previous research (Bjo¨rkstro¨m et al. 2006,
Christiansen 2008, Hallin & Danielson 2008), the nurses are
aware of providing the best quality of care and regard
themselves as the main person responsible in the health care
team when it comes to understanding what the patient needs.
However, to have the authority of holistic care does not
always coincide with the freedom to act accordingly in
situations. The findings indicate that knowing the right things
to do in situations seems to be influenced by the understanding
of acceptable practice in the workplace and this connects
to what Mantzoukas and Jasper (2008) call development of
cultural knowledge. The nurses in medical and surgery wards
express this when they emphasise their responsibilities for
completing medications and procedures and that restrictions
in the freedom to act connects to the time left to prioritise