Clinical Reasoning: A Summary

This paper will discuss three theories of decision-making that can be adopted in nursing practice, additionally how decision-making theories are able to be implemented and used. Decision-making in nursing is adopted through the critical thinking process that provides each nurse a model to make the best choices, solve problems and to meet goals in clinical practice (Berman & Kozier 2018, pp. 199-200; Levett-Jones & Hoffman 2013, pp. 4-5). Effective decision-making in nursing is a vital component and part of the role of a registered nurse; each year a substantial number of patients die due to medical errors and poor decision-making (Levett-Jones & Hoffman 2013, pp. 4-5; Nibbelink & Brewer 2017, p. 3). Through the use of

It is widely known that early recognition of a deteriorating patient can contribute largely to a successful outcome, through recognising and taking action on the deteriorating health status of the patient (National Consensus Statement, 2010). This report will explore the ways in which deteriorating patients and clinical reasoning are used in the public health care system in New South Wales (NSW).

Standing (2011), defines clinical decision-making as a complex process that involves observation, gathering information, critical thinking, evaluating evidence, applying necessary knowledge, reflection and problem-solving skills. Every day nurses make important clinical decisions and these decisions have important implications for patient outcomes and deserve serious consideration. Therefore, it is important for nurses to have a better insight of the decision-making process, be able to deliver holistic care and meet essential and complex physical and mental health needs of the patient.

The simulation environment offers a safe place for students to practice critical scenarios and gain confidence in proscribed settings (Decker, Sportsman, Puetz, & Billings, 2008). Simulation helps faculty to facilitate learning which meets one of the NLN’s core competencies. Simulation also enhances communication through emerging leadership and delegation skills, and builds teamwork through goal and priority setting (Dillon, Noble, & Kaplan, 2009). Therefore, according to Lasater (2007) simulation is highly effective as an adjunct teaching strategy in clinical practice.

The differences in critical thinking skills can be applied to a clinical setting to compare the differences between an ADN, diploma and BSN education. One of the clinical setting scenarios that illustrate the differences in decision-making based on educational preparation is in the case of discharge planning. The clinical picture is that of an eighty-year old female being discharged after a fall that created a significant wound requiring complex wound care and a wound vacuum. Her spouse requires a walker and help with his activity of daily living (ADLs). They live together and up until this point the female drove for both of them. It is up to the RN to

This review is to discuss an overview of this case study with a clinical reasoning model and all contributing factors of this event. Then, the critical analysis of three articles relating to the factors with the reasons for the selection and their evaluation will be presented.

Huber (2006, p154) states that clinical decision making in nursing relates to the quality of care the patient receives and how competent the nurse is.

Thinking like a nurse. This statement alone can take one in many different direction when searched on the internet. Christine Tanner is one out of a thousand other authors who have written an article on the topic of thinking like a nurse. In 2006 Tanner wrote a literature review article on clinical judgement in nursing. Some of her highlighted key points in this article is the research on clinical judgement, a research-based model of clinical judgement, and the educational implications of the model.

My time spent in the Clinical setting, so far, has been extremely inciteful as to how to become a better educator in a classroom setting. Through the data I collected I was able to connect Borich’s Seven Variables of learning to the students. By being in the clinical setting for nearly two months, I have been exposed to new ways of thinking when it comes to structuring a classroom and instructing a classroom. Within this reflection you will find out how I would better plan an effective lesson for the pupils in my future classroom. You will also discover what I will do about certain issues in the classroom and how I will address/fix them.

Within the practice of nursing, situations often arise where nurses are forced to make decisions regardless of their level of experience in the profession. Providing care and following the physician’s orders historically were the nurse’s sole responsibilities. However, social change, changes in health care finances, increasing international perspectives, and demographic population changes, have resulted in a significant evolution of the roles and responsibilities emplaced on today’s nurses (The National Association of Clinical Nurse Specialists (NACNS), 2007). Kelly and Crawford (2013) believe budget cuts, higher client acuity and clients with complex needs, mergers of hospital corporations as well as a general shortage of qualified nurses has made it necessary for nurses to play a role in decision making. Decision making is defined as “cognitive process leading to the selection of a course of action among alternatives” (Kelly & Crawford, 2013, p. 352).

Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. Critical thinking has been described as the ability to gather and process data in such a way as to arrive at the best conclusion using the filters of prior knowledge, experience and external resources to overcome personal emotions, biases, and assumptions. (This description was developed during NUR/300 class, University of Phoenix, S. Colorado, March 16, 2006) Note that critical thinking is described as a

For the next simulation, I am hoping that I have improved my critical thinking skills in nursing to effectively perform whatever role I will have. Moreover, since simulations are actual situations in real life clinical settings that are being played out by the students, I will research on applicable evidenced based nursing intervention and applied it during the simulation. Applying this type of intervention during the simulation will reinforce my knowledge of effective nursing intervention and will enable me to acquire a more meaningful experience that could be applied in actual clinical setting. I will also try my very best to find out what possible equipment will be used in carrying out nursing care for a given clinical

The clinical reasoning process provides a template for health professionals to use as a tool when caring for individuals. It allows an individual to be cared for in their own way, focusing on their own needs. The purpose of this essay is to present a comprehensive discussion and justification identifying two care priorities in relation to Jessica’s case using the Levett-Jones’ Clinical Reasoning Cycle while providing a critical analysis and justification of the care priorities. Two care priorities that are evident in Jessica’s situation are her desire to fall pregnancy while suffering from epilepsy, and Jessica’s non-compliance to her diabetes management.

“Differences in Clinical Reasoning Among Nurses Working in Highly Specialised Paediatric Care,” an article published in the Journal Of Clinical Nursing, investigates the manner in which nurses with varying degrees of experience approach the clinical decision making process. As might be expected, Andersson, Klang, and Petersson concluded that strategies used for clinical reasoning differ between newly licensed nurses and those with greater clinical experience (2012). They found that nurses with less experience tended to take a superficial “task-and action-oriented approach,” were less likely to ask clarifying questions and “…seemed to identify each problem in the case separately without relating them to each other” (p. 873). This superficial

Mode five, ‘peer-aided judgement’, suggests that decisions are made from people acting upon data in a passive and intuitive way (Offredy 2008, p. 858). Mode six is called ‘intuitive judgement’ (Offredy 2008, p. 858). Intuitive judgement for decision making is largely based on nursing