Essay on Nursing Process and Clinical Decision Making

Critical thinking is a term you will often here in regards to nursing education and the ability to be a successful nurse. Critical thinking is one of the most important skills of a nurse. Nurses must be able to constantly asses and analyze situations in order to prioritize what is the most important task to accomplish next. This is an ever changing situation in health care and especially in the Intensive Care Units.

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

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.

Alfaro-LeFevre, R. (2013). Critical thinking, clinical reasoning, and clinical judgment : A practical approach (Fifth ed.).

I believe that the clinical decision making process associated with the actions to be taken in Jack and Jacqueline’s care were quite similar between the Canadian and the Rwandan perspectives. This is because both perspectives took on a holistic view of Jack and Jacqueline’s situation and thereby worked to develop goals that would not only address Jack’s physical health, but also the emotional and mental health of Jack, Jacqueline, and even Charles. These holistic based goals included, but were not limited to the utilization of various community supports to foster Jack’s cognitive development as well as the formation and implementation of diverse coping strategies for Jacqueline and Charles to use during times of stress.

In addition to these characteristics, nursing also involves critical thinking. "Critical thinking is the active, organized, cognitive process used to carefully examine one's thinking and the thinking of others. It involves the use of the mind in forming conclusions, making decisions, drawing inferences, and reflecting" (Perry,

Critical thinking is a nursing process that includes reflective practice, problem solving and decision making which are connected to one another. The definition of critical thinking is transferring and applying knowledge and skills in a new situation. The critical thinking is needed in a lot of aspects of the nurses’ job such as when the nurses need to provide the precise identification in the specific problems had by the patients. They need to be in detail and also critical to themselves in every time in order to be able to provide identification precisely. When you have the profession in nursing, it is important to be critical thinker. The nurses have the high responsibilities and their responsibilities are increasing from time to time.

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 ).

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.

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

Critical thinking and clinical judgment are important skills that professional nurses use in every day clinical setting. In 2012, a mix method qualitative study by Dr. Jeanne Mann was done to evaluate the effectiveness of educational strategy to develop clinical judgment skills in nursing students. In this study, the population was identified as volunteered Level II baccalaureate nursing students from a Midwest nursing program. The variables identified in this article are the relation between critical thinking and clinical judgment. The title of the article clearly indicated the focus of the study and created an interest in reading the research due to nurses utilize their ability to critical think and

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.

In this essay, I will share my experience when I was still a novice in the nursing profession and how my understanding of critical thinking has radically transformed, the importance of critical thinking skills in this profession and useful ways on how to develop this specific skill.

Critical thinking skills, decision-making and problem-solving are attributes that nurses must have in today's healthcare environment. Strategies such as the use of nursing theories are sometimes implemented in education of nurses (Oldenburg & Hung, 2010). When examining the decision making and problem solving utilization within nursing theories, the reason behind