Clinical Judgment in Nursing
Clinical Judgment in Nursing
Individuals get sick and seek nursing care at some point in their lives. However, the nursing domain is complicated and misunderstood. Individuals have different perceptions of the nursing role. While some perceive the nursing role as ensuring safety and creating a healthy environment to facilitate the patient’s recovery, others perceive nurses as individuals responsible for complementing the physicians’ part. However, the advancement of nursing skills has resulted in the creation of professional nurses who apply clinical judgment in the nursing process. By definition, clinical judgment is the interpretation of the patient’s concerns and nature of a sound decision action to address the patients’ needs, thus improving the overall outcome. Nurses encounter multiple dilemmas in their daily roles; therefore, it is imperative to possess clinical judgment skills to address them before they get out of control (Tanner, 2006). The article, “Thinking like a Nurse: A Research-Based Model of Clinical Judgment in Nursing,” provides insights into the following questions;
- What do you feel are the most significant influences on clinical judgment? Is it experience, knowledge, or a combination of those things?
Tanner (2006) indicates that clinical judgment is a sophisticated tool required to assess uncertain, unclear, and conflicting situations. The complexity of clinical judgment also results from the fact that sometimes nurses work in critical care units where they have to deal with multiple patients in a row thus need to prioritize the competing needs of the patients. Additionally, nurses should resolve family conflicts, relay information wisely, and develop a care management plan for the patients. Thus, clinical nurses should be flexible enough to respond to situations head-on. They also need adequate knowledge to recognize the underlying causes of the problem and take the necessary corrective action. Good clinical judgment is dependent upon the theoretical understanding of the clinical situation presented, which is knowledge acquired from the nursing profession. Again, clinical nurses need to have prior experience of the illness and the patient’s family history. The nurses should also possess sound knowledge about the clients’ emotional physical, and social well-being, thus developing a sound coping mechanism.
Sound clinical judgment takes various forms of knowledge that is a generalizable knowledge that they can apply in their daily encounter; the philosophy is acquired from a theoretical framework. However, experience gained from the scenarios encountered in real-life practice complements the application of knowledge in clinical situations. Experience also grows from continually understanding the patients. An experienced nurse facing the specific clinical situation possess readily dispensable knowledge to deliberate the role immediately as they already know what to do. Intelligence to deduce the clinical situation is imperative for a clinical nurse in the early years of practice. In this case, knowledge and experience are inextricable. Knowledge influences clinical judgment in that it affects the nursing perceptions towards various clinical situations. For instance, Christine Turner informs that nurses may have diverse ideas about confusion in older persons; thus, identifying the clinical condition may take different approaches (Tanner 2006).
Additionally, Tanner (2006) asserts that clinical judgment depends on previous experiences with the patient and understanding response patterns to specific clinical situations. Nurses grasp the clinical cases better when they continually work with the patients, listening to their experiences with the condition, and continuously monitoring them. By doing this, nurses gain tacit knowledge thus can recognize the aspects of the illness to prioritize upon, effectively monitor the patient’s response to the medical interventions, and develop an individualized care management plan for the patient, thus improving patient’s outcomes.
Consequently, Tanner (2006) informs that nursing judgment is influenced by knowledge gained from the textbook and the experiences gained during their daily encounter with the patients in the nursing unit. Knowledge also hails from observation during practice and their interactions with other physicians. Collaboration between physicians also helps determine what situations require nursing judgment and knowledge needed to address the specific conditions. Furthermore, knowledge and experience affect the reasoning patterns that nurses adopt while making clinical judgment.
In summary, I feel that clinical judgment is influenced by a combination of both knowledge and experience. Tanner (2006) depicts instances where both knowledge and expertise are essential in making clinical knowledge. The explanations above affirm that knowledge and expertise are inextricable and imperative in making clinical judgment.
- In your opinion, what part does intuition play in clinical judgment? How do you think you’ll be able to develop nursing intuition?
Tanner (2006) describes intuition as the immediate recognition of a clinical problem, and intuitive capability depends on prior encounters with a similar problem. Intuition helps the clinical nurses to recognize the patterns of the issue at hand. Clinical judgment is a critical aspect of nursing practice, and critical thinking skills facilitate sound clinical decisions. (Pearson,2013) argues that intuition plays a significant role in critical thinking skills. Nurses use intuitions to intervene and set priorities to address the competing needs of the patients. Sometimes nurses in acute care need to make rapid decisions, and sometimes they make unconscious decisions based on intuition. Intuition helps in evaluating the possible interventions to a clinical situation and establish the best solution. Intuition enhances collaboration between nurses and facilitates fast response to critical conditions encountered by nurses in their duty of care.
I can develop intuition by being open and flexible in the way I respond to clinical situations; This will allow me to gain the experience to judge the right and the wrong approaches, gauge the authenticity of the information and decide on the best action. I will also continuously gain knowledge and foster to gain experience in nursing practice to become updated with the new trends in the nursing field.
Pearson, H. (2013). Science and intuition: do both have a place in clinical decision making?. British Journal of Nursing, 22(4), 212-215.
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of nursing education, 45(6), 204-211.