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Importance Of Clinical Reasoning And Clinical Judgement In Nursing Process

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Clinical Reasoning and Clinical Judgement in Nursing Process
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.
Clinical Reasoning Skills in Scenario
The main clinical issue in the scenario is the need of a “Do Not Resuscitate” order by the client. In the pre-briefing process, I predicted that the patient needs medication to reduce his chronic pain related to his previous medical history of prostate cancer and transurethral resection of prostate. Using the nursing process, I am able to systematically assess and deliver appropriate interventions to the patient. I prioritize his chronic pain over his feelings, based on the Maslow’s Hierarchy of Needs. As I complete his physical assessment, I noticed that his pain level is the only variable that is out of the normal limits. I examined his pain in detail using the PQRST pain assessment tool. I tried to look for more gaps in my assessment when I inquire about his feelings in which I learned that the patient would like to have a DNR order.
In the planning phase, the health care team had a discussion about priorities on one hand, the patient’s pain level is eight out of

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