Respecting Autonomy while Nudging: A Phenomenological Study of TENS Use in Post-anesthesia Care

Purpose To describe healthcare professionals lived experiences of being nudged to use transcutaneous electrical nerve stimulation (TENS) in post-anesthesia care. Design Descriptive phenomenological study. Methods A 12-week transparent, passive and asynchronous nudge strategy was implemented in a 15-bed surgical recovery ward where healthcare professionals were exposed to rotating posters to encourage TENS use. Thirteen professionals with varied peri-anesthesia roles participated in semi-structured video-recorded interviews. Data were analyzed using Giorgi's descriptive phenomenological method. Findings Nudging was experienced as a contextual and relational influence. It reawakened awareness of TENS and supported reflection when aligned with professional values, ethical transparency, and clinical relevance. Resistance occurred when nudges were perceived as excessive, misplaced, or intrusive. Relational interactions, such as peer modeling, strengthened the effect, while professional autonomy remained central. Nudging often prompted inner dialogue and reconsideration even without immediate behavioral or practice change. Conclusions Nudging can serve as an ethically acceptable, non-intrusive prompt in post-anesthesia care to re-engage clinicians with opioid-sparing strategies such as TENS. When transparent and respectful of autonomy, nudging supports ethical peri-anesthesia healthcare professionals' practices by balancing influence with professional judgment, thereby contributing to safer and more sustainable postoperative pain management.