Decision Making And Clinical Reasoning Skills

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.

In my week five, I learned about person-centered care(PCC) and we watch two powerful videos related to PCC. The activity about Jim to consider the first four elements of the Clinical Reasoning Cycle(CRC). PCC is the key element of professional nursing practice in Code of conduct (NMBA, 2018) and to achieve this, clinical reasoning skill is fundamental and effects the patient outcome greatly (Cooper et al., 2011). When I was watching video about a senior female patient who were treated from nurses like a task to finish, I was so sad and irritated by their nonprofessional attitudes. In contrast, the other video with Rio 2016 Paralympics was one of my favorite video it is strong and inspiring. I could realize the importance

Most decisions are made with analysis, but some are judgment calls not susceptible to analysis due to time or information constraints. Please write about a judgment call you’ve made recently that couldn’t be analyzed. It can be a big or small one, but should focus on a business issue. What was the situation, the alternatives you considered and evaluated, and your decision making process? Be sure to explain why you chose the alternative you did relative to others considered.

As I begin my fifth year of working as a nurse practitioner in a leading children’s hospital, I am certain the pediatric acute care setting is where I will continue my career of service to children and their families. Although I hold a masters degree in nursing and have been a primary care certified pediatric nurse practitioner for many years, I wish to expand my knowledge of pediatric nursing to encompass the unique and challenging aspects of pediatric acute care.

During the past few shifts, I have been astonished, and thankful about how often the nurses, doctors, and respiratory therapists have been providing me with learning opportunities. I feel this is because they have observed my enthusiasm and willingness to learn. For example, I asked a nurse if I could observe her giving care to a 24-week old preemie with necrotizing entercolitis. This nurse explained, that because of this baby’s immature age, she had to cluster the baby’s cares, and monitor this baby’s oxygen saturation. If the baby was overly stimulated her oxygen saturation would decrease, and the nurse needed to stop working with the baby. This nurse also pulled up a PowerPoint about NEC, so I had a visual of this baby’s condition. She provided me with a NICU parent book, and I read the section about NEC. This nurse said that she gives NICU parents this book to read, so that they have a better understanding about their baby’s condition. This is an awesome education technique that I want to adopt. This is because the parents will hear the diagnosis explained from the doctor and nurse. They may or

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.

My practice in nursing has been influenced by various elements within my career. I have come to embrace that nursing is a learning process and one should expect constructive criticism. When I began as a “novice,” I found myself nervous in some clinical situations but I managed to remain focused on

As experienced nurse, I have learned how to effectively time manage, prioritize patient care and work independently, as

Articles discussing the accurate recordings of pediatric patient’s body temperature were cited in this article. A logical sequence is followed in the literature review. It begins with a general overview of the historical importance of accurately recording a patient’s body temperature. The authors get more specific and cite studies on temperature recording techniques in children. For instance, in justifying conflicting data, the researchers cite a similar study conducted on new born babies by Polit & Beck (2008), where the recordings from the two methods were

She believed that years of experience is what ultimately sets apart a novice and expert nurse. “Clinicians at different levels of practice live in different clinical worlds, recognizing and responding to different situated needs for action” (Alligood & Tomey, 2010, p. 141).

Critical thinking and clinical reasoning are essential skills to develop a sound clinical judgement. Nurses use critical thinking models and processes to support and organize the interventions that they perform in the clinical setting. In the scenario of Mr. Patient requesting for a “Do Not Resuscitate” order, I used the nursing process to serve as the framework of the patient care and the Lasater’s Clinical Judgment Rubric by Kathie Lasater (2007) to guide my reflection. In this paper, I will describe the critical reasoning skills and activities in relation to the nursing process, provide analysis of the model and application of learning in terms of CNO competencies, and evaluate my clinical decision-making in terms of patient outcomes. While, the nursing process, served as a guide to organize my thought process in relation to the overall picture of the patient, I also incorporated thinking structures such as ABC and Maslow’s Hierarchy Of Needs to determine the prioritization in each activity. Furthermore, I utilized the Structured Prebriefing Worksheet by Karin Page-Cutrara (2015) to make inferences from the data before engaging in the scenario.

Starting the Registered Nurse (RN) to Bachelorette of Science in Nursing (BSN) program at Jacksonville University in June 2015 was a simple transition for me. I had graduated an Associates Degree in Nursing (ADN) program in December 2014 and became a licensed RN in January 2015. I had just gotten hired for my first nursing position the month prior to the start of class and had not yet started working. I was very much still in student mode. While this makes it a bit easier to learn and process information in a classroom setting, I had no real world experience to help guide me. Through the knowledge I have gained as a student at Jacksonville University I have become a competent and well-rounded nurse. I am able to quickly problem solve and utilize critical thinking to identify and rectify issues. I have even put together, and will be presenting, and presentation about nursing practice for staff members at the facility where I work.

Clinical reasoning can be defined as, ‘the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient’s problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process’ (Levett-Jones & Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006, p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that ‘cognitive failure’ resulted in approximately 57% of unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse’s preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of the patient and provide the best, most appropriate care.

Critical thinking and clinical reasoning are terms often used interchangeably throughout the history of nursing. However, they are not the same, and distinguishing the difference amongst them is important. The purpose of this paper is to define critical thinking and clinical reasoning, discuss each concepts similarities and differences, as well as share this author’s perspective on how critical thinking and clinical reasoning have developed and evolved throughout my own career, guiding my clinical practice decisions.

Decision making in health care is a challenge, health care providers had to deal with this challenge as they make decision in the clinical setting. Nurses are always with the patient 24/7 and are the first person to observe any challenges in patient’s condition. As a result, making clinical decision is an important role of the nurses. Nurses are mandated to own and manage the care environment making sure that the resources are available. Nurses lead many services also and this gives the nurse greater autonomy in decision making. Nonetheless, most of the decisions in practice occur in intricate setting in partnership with wide healthcare team and in collaboration with patients with complicated needs.