Previous research has suggested that critical care nurses’ close and prolonged contact with\ud
patients places them in a unique position of improving patient outcomes and reducing the demand on critical care beds by detecting subtle signs of deterioration in a timely manner and \ud
identifying patient progression and readiness for less intensive care. Nonetheless, nurses rarely\ud
take decisions about patients’ treatment modalities on their own, and constantly need to seek advice or authorisation. Indeed, several studies suggested that one of the most frequent\ud
decisions taken by nurses during clinical practice is that of referring to medical, nursing or other health care practitioners. However, there is very limited research around the factors\ud
related to, and the actual process of, such referring. In view of this gap in the literature, the purpose of this study was to explore and explain the process of referring in the context of an intensive care unit by means of a substantive theory derived from the data. The principal research question was: What are the factors associated with critical care nurses’ decisions to seek help from medical practitioners