The Stages Of Clinical Reasoning

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).

5. Phase V guarantees nurses are occupied with progressing investigates and assessment of the procedure and results, building up a nonstop process (Coombe,

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.

Nurses often have to make quick decisions, usually without adequate time to consider the entire situation. Have you ever wondered, how a person knew what to do, seemingly without ever thinking about it? Barbara Carper, was able to answer this question in detail with her “Ways of Knowing Concepts”, which she developed particularly for the nursing profession (Zander, 2011). A few of her concepts will be compared to a clinical situation, personal to this author. The above question will be explained in multiple ways so the reader will better understand Carper’s concepts and how they may apply to their own situation. This will be accomplished by: describing the clinical situation, observing applicable concepts and then relating them to the situation, visiting how an understanding of her concepts explains interventions and critical thinking, and how evidence affects critical thinking and knowing.

Thinking in such a scenario shifts from mere speculations to thinking rationally by widening the scope of thinking. Nevertheless, this is a decision that the nurse makes rather than the policies and guidelines established to govern nursing practice. The nurse moves from basic reasoning to “critical reasoning through active reflection and subsequent judgment” (Benner, Hughes, & Sutphen, 2008, p. 3). This cannot take place automatically. The nurse has to be conscious or aware that s/he is thinking critically about a situation or an intervention strategy.

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

Critical thinking used throughout the nation in nursing everyday to protect and treat patients in the most effective way. An example would be if a patient walked in to the hospital with a platelet count of 1, the nurse would know that they have a risk for bleeding and would place them on “risk for bleeding” protocols. Without critical thinking, the nurse would not know what to do. Critical thinking is a learned skill that every nurse should acquire, not only during his or her education, but also throughout his or her career.

Those nurses may not have acquired the skills necessary to anticipate the needs of the team members. Moreover, they may not have learned how to cooperate, communicate, and integrate care. And, they fail to evaluate and adjust to their actions and are not able to give and receive feedback. They do not apply their knowledge and critical thinking to understand the current situation and how to act upon it. Some of the other factors that also contribute are lack of awareness of errors, lack of willingness to report errors, faulty memory, poor communication skills, or lack of patient knowledge, patient diagnosis and the names, purposes, and correct administration of the medication (Carlton & Blegen, 2006).

For this reason, it is imperative to emphasize to them that the only possible way to develop critical thinking known as " process of carefully defining and analyzing problems" (Castledine, )is to care for patients side by side an experienced nurse who meet the requirements of well-groomed

In my initial response, I stated that the two forms of therapeutic reasoning that stood out most to me were narrative and scientific. After gaining more information on the client, I agree that interactive reasoning is extremely important. Due to the fact that the client is angry and not eager to start therapy, the therapist will have to work hard to build his trust. This will require the therapist to remain aware of his feelings while helping to transfer his anger into motivation. Since the client stated he does not know what occupational therapy is, educating him on the benefits and all that he can still do will help with his motivation to participate in therapy. I also think this could cause some ethical reasoning issues regarding maintaining

Clinical reasoning in medical students and residents is stimulated by many instructional strategies. it is discovered that Structured reflection while practicing with cases fosters the learning of clinical knowledge and more effective than the generation of immediate or differential diagnoses (Mamede et al., 2012).

The clinical reasoning process is dependent and is influenced by a person’s attitude, philosophical approach and preconceptions (Hawkins, Paul, & Elder, 2010). APN nurses with effective clinical reasoning skills have a positive impact on patient outcomes. One has to understand that clinical reasoning is challenging and can be very complex and requires a different approach in nursing assessment and diagnostics. When conducting supportive assessments, APN uses clinical reasoning to consider the patient situation, collect information such as medications, vital signs, culture, care context and patient’s pathophysiology; identify the problem issue, plan and evaluate. “It is the ability of the APN to integrate and apply different types of knowledge,

Due to threatening from chronic disease and functional declines as part of age-related changes that affect to the well-being of older adults, nurses have a vital role and opportunity in caring for them. Indeed, nursing care plan and clinical reasoning has been associated along with nursing process, as it seen to be a guide for making judgments and decisions that involves with patient’s care. Moreover, Johann in this case study who living alone and is experiencing the symptoms of Parkinson’s disease such as tremor. This could be dangerous for him at home as it affects his self-management in caring during his treatment (Suzman, 2005). Hence, this essay will discuss two priorities of care including increased falls and injury risk and medication assessment and management by using two theoretical nursing frameworks, Levett-Jones’s Clinical Reasoning Model (2013) and Miller’s

Critical thinking and clinical reasoning are similar in the fact that each term represents a set of methods that guide the nurse to reliable evidence-based practice while delivering care. Critical thinking and clinical reasoning are centered on knowledge base that is associated with the discipline of nursing. With each concept, the nurse must have an existing developed knowledge base in which to apply each concept to. Nurses apply critical thinking and clinical reasoning skills when patient care decisions are made. With both critical thinking and clinical reasoning, information about the patient is collected and examined. They work together to produce clinical judgment. They both direct nursing care to meet patients’ needs resulting in higher quality of care and better patient outcomes.