Relationship Between Supervisor Availability During Night Duty and Clinical Decision Making Confidence Among Nurses

Abstract: Introduction:Supervisor availability during night duty is a critical organizational factor influencing nurses’ clinical decision-making confidence and overall quality of patient care. Night shifts are associated with fatigue, circadian rhythm disruption, and reduced access to resources, all of which can impair cognitive functioning. This study aims to examine the relationship between supervisor availability during night duty and clinical decision-making confidence among nurses working in hospital settings. Methods:A quantitative cross-sectional correlational design was used. The study was conducted in tertiary care hospitals where nurses routinely perform rotational night duties. A sample of 120 registered nurses was selected using purposive sampling. Data were collected using a demographic questionnaire, the Supervisor Availability Scale (SAS), and the Clinical Decision-Making Confidence Scale (CDMCS). Results:The mean SAS score was 34.7 ± 5.2, indicating moderate perceived supervisor availability, while the mean CDMCS score was 76.5 ± 8.6. A strong positive correlation was found between supervisor availability and clinical decision-making confidence ($r = 0.62$, $p < 0.001$). Regression analysis indicated that supervisor availability significantly predicted decision-making confidence ($\beta = 0.62$, $p < 0.001$), accounting for 38% of the variance. Conclusion:Supervisor availability significantly impacts nurses' confidence in clinical decision-making during night shifts. Strengthening supervisory presence is a practical strategy for improving workforce performance and patient safety. Keywords:clinical decision-making; night shift nursing; supervisor support; patient safety; workforce management; nursing leadership