Effective Clinical Reasoning Essay

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

Clinical reasoning is embedded in nurses’ thinking for patient care (Levett-Jones 2013). It is a spiral, continuous mental process, underpinned by critical thinking theory and a sound body of nursing knowledge (Levett-Jones 2013). The clinical reasoning cycle includes considering patient’s situation, collecting cues, processing information, identifying problems, establishing goals, taking action, evaluating outcomes and reflecting on the process undertaken (Levett-Jones 2013). Nursing practice for registered nurses is guided both by the National Competency Standard (Nursing and Midwifery Board of Australia 2006) and the Nursing Practice Decision Flowchart (Nursing and Midwifery Board of Australia 2010) to ensure patients’ safety and to optimise care by challenging medical assumptions and facilitating evidence-based practice. The clinical reasoning framework, therefore, allows nurses to prioritise the most time sensitive and specific information, to recognise deteriorating patients and to manage complex clinical situations (Levett-Jones & Bourgeois 2011). This paper will focus on processing information and identifying the two major problems in the case study of Mr. Brown, a 74-year-old man, who was admitted to hospital after a ‘fainting’ episode with chief complaint of dizziness.

Over the past 30 years nursing has evolved from a task-oriented to a logical and systematic approach to care, using theories and models to guide practice. According to Jasper (2007, p117) theories of decision making in medicine tend to favour logical, precise analytical models which are held to be testable, unambiguous and repeatable, therefore satisfying scientific principles. These represent important ideas of certainty and rationality that are intended to provide a sense of security and reliability. When used correctly a nursing model should give direction to nurses working in a particular area, as it should help them understand more fully the logic behind their actions. It should also act as a guide in decision-making and so reduce conflict within the team of nurses as a whole. This in turn should lead to continuity and consistency of the nursing care received by patients according to Pearson et al (1999,p ).

This shift in the setting for health care is moving health care back into the patient’s environment and also requiring people to take a greater role in their individual health management. Nurses can offer professional guidance in this trend as well. Proper diagnosis and treatment will be of paramount importance in the future so that health care funds can be better applied and the nursing experience and knowledge gleaned can be more widely disseminated in the field. (Saver, 2006)

Johnny O’Brien is a 78-year-old man who suffered a fall in a RSL club and was promptly admitted to the emergency department. Clinical reasoning will be applied to Mr O’Brien’s situation, Clinical reasoning is a process which incites clinicians to think critically when attempting to solve a problem that may occur with a patient. It is imperative to health professionals as inadequate clinical reasoning skills can jeopardize a patient’s safety and reduce the effectiveness of how a situation is dealt with this can occur due to bad decision making, ignorance to multiple possibilities and failure to act on the information that is provided clinical reasoning aims to avoid these issues (Levett-Jones, 2013).

When was the last time you stop to think of the process on how your doctor concluded what your illness maybe? Most of us would not think much about the process and would just be happy to know that someone knows the answer. The process the doctor used to determine your illness was Clinical Reasoning (CR). CR is “defined as thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnosis, or treatment of a clinical problem in a specific patient” (Hawkins, Elder & Paul, 2010). CR has been around for over three decades, with a look back at what has occurred there can be a better understand of what is currently being taught. In addition, looking at the realms of medical education and psychological education may offer a viewpoint of how different, yet similar techniques like Gagne’s intellectual skills, are compared to CR. Finally, past and current research will show the different tools and techniques currently being utilized and as to what exactly the skills needed are, and how to assess the process someone undergoes when using CR.

Ms. Costa' s position allows her to provide a full range of nursing practice using her clinical reasoning skills while referencing to the ANA Standards of Nursing Practice. The application of clinical reasoning and critical thinking skills are evident with every patient encounter. She advocates for diabetic patients who require

According to Hawkins, Elder, & Paul (2010) Clinical reasoning is “thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnoses, or treatment of a clinical problem in a specific patient” (p. 3.) The

Benner et al. (2009) develops another major assumption that care cannot be based on knowledge alone. Clinical understanding must be acquired and utilized to meet the totality of needs of a patient. An expert nurse knows that an actual clinical situation cannot be guided by principles but rather the situation must be approached and guided with insight and engagement (Benner et al., 2009, p.20-21). This openness and willingness of the nurse to fully submit his or herself allows them to recognize the patients needs and respond to them. Ultimately, a professional nurse will be able to fluidly apply classroom knowledge, skilled know how, and ethical comportment despite the unpredictability of a situation (Handwerker,

“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

Making sound and client-centered clinical decisions in an area that demands accountability and evidence-based practice requires not only scientific knowledge, but also a deep knowledge of the practice of one’s profession and of what it means to be human in the world of combined strength and vulnerability that is health care.

As a nurse that values both clinical skills and theoretical knowledge, I will disagree that nurses disregard theoretical knowledge because in most patients’ care and clinical judgments, we as nurses apply both ideologies in order to render the best treatment or care. This nurse usually obtains positive objectives and outcomes by applying clinical skills and theoretical knowledge. Though, clinical skills and theoretical knowledge are connected; however, as much as the professional nursing is to be in existence, the model of theoretical knowledge must be incorporated into our daily nursing care.

Nursing is an exciting, challenging, satisfying and rewarding profession. Nurses are required to have a wide and an extraordinary range of skills and talent in managing their clinical duty and responsibilities. Nurses are urged to deliver the highest achievable of quality care in a compassionate approach. In order to achieve these nurses need to access and evaluate extensive clinical information and integrate it to improve clinical decision making. Nurses are seen as lifelong learners, having the ability to reflect on, evaluate and modify their clinical practice based on new knowledge and thoughts. Nurses are advised to become producers of new knowledge via nursing research (Fink, et. al. 2005).

Clinical exams are also very useful because they can check for symptoms of depression, delusions, attention deficits, memory skills, and much more. The Mini Mental State Examination (MMSE) is a questionnaire given to a suspected AD patient. The MMSE asks questions that measures the cognitive impairment as well as language skills of an individual. It also tests subjects on their memory skills by asking basic questions like the date, where they are, and to recall objects that were just previously shown to them. The Blessed Dementia State Scale is used to measure changes in a person’s habits, personality, and everyday life. The level of depression can be determined with the Hamilton Depression Scale. The Present State Examination is a test that identifies the

As a senior nurse Susan is expected to use better judgment because of her experience and/or expectation of job duties. Unfortunately, this was not the case. Susan did not use her critical thinking skills to the best of her capabilities. According to Aristotle a person who does their job well, or performs their function well, will use reason and rationale and use it well. As a nurse manager, Susan did not use her use her reason and rationale well concerning her staffing issue. Her careless action ultimately led to severe patient incidents, bad publicity and ramification for her institution and ultimately her termination from her