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The importance of decision making in nursing
Importance of critical thinking in the nursing process
Critical thinking and nursing practise
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Critical thinking and decision-making are key pieces involved in nursing care. Critical Thinking is the process in which questioning and analyzing ones thinking occurs. It is “the rational examination of ideas, inferences, assumptions, principles, arguments, conclusions, issues, statements, beliefs and actions” of a nurse (Coutts, 2014, p. 28). Critical thinking is more then making a decision, Roberts and Peterson (2013) purposes that critical thinking reflect a nurse’s wider perspective extending beyond problem solving. The process of critical thinking allows nurses to distinguish between significant observations and insignificant observations made during patient care, providing a foundation for decision-making (Roberts & Peterson, 2013, p. 86). “Clinical decision-making is a complex and dynamic process, occurring within a larger context and drawing from various dimensions of knowledge, in which nurses collect and organize information in order to form conclusions and choose actions, with the intent of creating the best outcomes for clients” (CRNBC, 2014, slide 19). The purpose of this paper is to describe a decision made in practice, explore the decision using the situated clinical decision-making framework and the practice implications involved. Description of the Decision During my acute surgical rotation, in one of the community …show more content…
“Nurses intervene, and report when necessary, when others fail to respect the dignity of a person receiving care, recognizing that to be silent and passive is to condone the behavior” (CAN, Year, Pg). During this situation I recognized the vulnerability of the patient as well as what I felt was inappropriate behavior on behalf of the registered nurse and there for intervened because I did not agree with the situation that was
Nurses are required to protect and support their patients if they are to be an efficient patient advocate. Ethically questionable situations are quite common for nurses that conflict with their professionals and personal morals. At times, the patient necessitates the nurse to speak out for them demonstrating
I agree with you that the nurses violated provision 9 of the nursing code of ethics. Nurses have an obligation to themselves, their whole team and to the patients to express their values. Communication is key in a hospital, so everyone knows what is correct and what isn’t within the workplace. In order to have a productive, ethical, positive environment. These values that should be promoted affect everyone in the hospital, especially the patients, and can have a negative outcome if those values are not lived out. Nurses have to frequently communicate and reaffirm the values they are supposed follow frequently so when a difficult situation comes along that may challenge their beliefs they will remain strong and their values will not falter.
Making a clinical decision is a skill that needs to be acquired, and nurses are accountable for any decision that is made, so they need to understand how they make decisions (Nursing and Midwifery Council (NMC), 2015). A greater understanding of how nurses make decision is essential to follow research and development of decision making skills (Clark et al, 2009) . A first step to a decision making process may entail understanding a framework or model. Baumann and Deber (1986) define decision making as situations in which a choice is made among a number of possible alternatives often involving values given to different outcomes”.
Clinical decision making involves the gathering of information, awareness, experience, and use of proper assessment tools. The term is often used when describing the critical role of nurses. The process is, therefore, continuous, contextual, and evolving. Authentic practices and experienced people are required to offer guidelines when needed. Effective decision making in clinical environment combines skills such as pattern recognition, excellent communication skills, ability to share, and working as a team, reflection, use of the available evidence and guidelines as well as application of critical thinking. A Clear understanding of this term contributes to consistency, broadening of the scope and improving the skills. However, this paper aims at providing an opinion on clinical decision making and how it is connected to nursing practices.
I have come to fully understand that in order to treat my patients in a way that is person centred, I have to treat each person as an individual and realise that every individual has different needs and different rights and preferences to me which may go against my morals and beliefs but I always have to maintain my professional boundaries and treat each individual with respect and dignity. If I was a nurse who witnessed a similar situation to Kat’s, where another healthcare professional was disregarding my patient or any patients views or requests I would go into the patient’s room and find out what the problem was. Then I would politely ask the healthcare professional to step outside of the room and I would gently remind them of the code of ethics ((Kozier, Erb's & Berman, 2010, p.97) and the Registered Nurses standards of practise (2016), and how every individual has the right to make their own independent decisions about their healthcare needs/goals based on their own values, morals and beliefs. I would further explain that the patients are our main priority and it is our responsibility as nurses’ to ensure that the patients are safe and are receiving the proper care. I would then explain to the patient what was happening and apologise to them about the situation, and I would rearrange and try to negotiate with the patient when the procedure could be performed. Then I would notify the Nurse Unit Manager on the ward to ensure that situations like this do not occur
According to the American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient” (p. 6). Nursing responsibilities should be acted upon at the highest standard and must be based on legal and ethical obligations. Healthcare provider’s perception and judgment of the patient’s well being, as well as taking into account the rights of the patient in every action, is one of the key elements in nursing practice. International Council of Nurses (ICN) (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3).
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 effective decision making
Section 5.4, which is the preservation of integrity, suggests that nurses will inevitably have to deal with threats to their moral or professional integrity at some point in their careers. Nurses should do their best to maintain professional integrity when met with adversity, weather it be from uncooperative issuance companies, an unsound work environment, or from the patients themselves. When working in an unsound or unsafe work environment that violates law or the ANA code of ethics nurses must go through the proper channels to fix the problem. If a nurse feels that a procedure or treatment their patient is having conflicts with his or her own moral integrity and they cannot participate, the nurse must report they unwilling to tr...
Reflection and analysis of critical incidents is widely regarded as a valuable learning tool for nurses. Practice requires us to explore our actions and feelings and examine evidence-based literature, thus bridging the gap between theory and practice (Bailey 1995). It also affords us the opportunity to change our way of thinking or practicing, for when we reflect on an incident we can learn valuable lessons from what did and did not work. In this way, we develop self-awareness and skills in critical thinking and problem solving (Rich & Parker 2001). Critical incidents? ?
The nursing process is one of the most fundamental yet crucial aspects of the nursing profession. It guides patient care in a manner that creates an effective, safe, and health promoting process. The purpose and focus of this assessment paper is to detail the core aspects of the nursing process and creating nursing diagnoses for patients in a formal paper. The nursing process allows nurses to identify a patient’s health status, their current health problems, and also identify any potential health risks the patient may have. The nursing process is a broad assessment tool that can be applied to every patient but results in an individualized care plan tailored to the most important needs of the patient. The nurse can then implement this outcome oriented care plan and then evaluate and modify it to fit the patient’s progress (Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P., 2011). The nursing process prioritizes care, creates safety checks so that essential assessments are not missing, and creates an organized routine, allowing nurses to be both efficient and responsible.
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal Of Nursing Terminologies & Classifications,21(2), 82-88. doi:10.1111/j.1744-618X.2010.01150.x
Caring promotes patient health, individual growth, and stimulates coping skills, and therefore must always be emphasized in holistic patient care (Zimmerman & Phillips). In addition to its value in patient care it is also a central component of a nurses critical thinking process (Zimmerman & Phillips, 2000). “According to Brookfield (1987), critical thinking is a process of active inquiry which combines reflective analysis with informed action and has an emotive or affective component that is central to this process”(Zimmerman & Phillips, 2000, p. 223). Thus, when a nurse is aware of their patient’s holistic needs they are better able to care for their patient and in doing so enhance their critical thinking abilities (Zimmerman &
For instance, critical thinking allows nurses to identify, evaluate and improve practice by bringing about change in response to feedback from various practice experiences.” However, as Gardner (2014), advocating there is a need to shift from focusing on nursing skills as an individual towards participating in a much more holistic critical process encompassing the wider social context. In this way, critical reflection incorporates principles of critical social theory. In addition, critical reflection from an essential social perspective aims to bring forth an awareness of any underlying assumptions so these may be challenged and altered for next time. As Usher and Holmes (2010) write, reflection “offers a way to bring to the surface the contradictions between what you intend to achieve in a situation and how you actually practice”. In addition, critical reflection may assist with advancing nursing practice from the status quo towards actively creating opportunities to change for a better outcome whether that may be during the experience or in the future. Reflective thinking is hypothesis testing, and real-time experimentation done in situations where “wicked problems” occurs that facilitates deeper knowledge and understanding (Rolfe, 2014). For Rolfe (2014), knowledge is a verb, not a noun, and he
The code of professional conduct for nurses’ states in conduct statement 2, that a nurse must practice in adherence to the standards of their profession and the health board. In instances where a nurse observes any circumstance that goes against professional standards, or is unethical or unlawful practice, they must report this to the appropriate authorities. Further stated, is that if the issue is not resolved internally that the nurse may notify external authorities in order to safeguard their patients (NMBA, 2008a, statement 2). In this case the witnessing nurse should approach the Registered Nurse (RN) or preceptor for the clinical placement (Charles Darwin University, 2015). The elevation of the situation is important as the hospital needs to know of any breaches in its patient’s privacy. The NMBA code of ethics for nurses (2008b) states in the value Statement 7 that a nurse must ensure that the management of patient information is carried out in a safe and ethical manner. This means that not only are records correct, but the information in the records and any information about patients and their health is kept private and confidential to only the health professionals that require it. Without patient confidentiality there can be no patient confidence in the services rendered by that facility. For
In the healthcare setting, a systematic process to ensure maximum care and maximum recovery in patients is needed, which is called the nursing process. This process consists of four steps: assessment, diagnosis, planning, implementation, and evaluation (Walton, 2016). The nursing process is important to ensure quality care and to get the preferred outcome. In the nursing process, critical thinking is used to recognize the issue and come up with a logical solution to solving it. One important aspect of the nursing process is that the plan is not set in stone; it is meant to be manipulated in order to better suit the patient. Nurses must be able to think critically in order to recognize the issue, develop a way to correct it, and be able to communicate the issue to others. Throughout the nursing process, critical thinking is used to determine the best plan of care for a patient based on their diagnosis.