The work of RN is becoming increasingly complex. Every day nurses have to make many decisions involving patient’s needs, prioritizing patients’ treatments, delegating tasks, reporting results and changes of condition, etc. Most of these decisions influence directly or indirectly the outcome of the patients’ treatment. For us, as beginner nurses, it is very important to understand the decision making process, the variables that influence it and the steps involved in it “in order to develop our own decision making style” and be successful as nurses in the future (B. Kunkel, 2014). The New Jersey Board of Nursing provides a Seven Step Decision Making Model that “has been designed to assist nurses in using the information available to them for resolving scope of practice issues.” Any nurse that has a question about nursing practice “can refer to this model and follow each step to make her decision”. (“Decision-Making Model Algorithm”, 1999) Decision making in RN’s practice starts with the beginning of a nurse’s day. The nurse must prioritize which patient to access first and which patient to administer medications first, especially in light of upcoming surgeries and procedures. The nurse must also consider patient’s current blood and other test results in order to decide whether it might be necessary to contact the healthcare provider and report any abnormalities. Since the nurse is the person that is the most with the patient during his hospital stay, she is the one that is the most familiar with that patient and his condition. Therefore even a subtle change she notices in her patient’s condition on assessment, can lead to change of treatment which in some cases might save that patient’s life or greatly contribute to the positive o... ... middle of paper ... ...gorithm”, 1999) This example clearly shows that one seemingly small decision on nurse’s behalf might in a long run bring harmful consequences and put the patient at risk of infection and other complications. As nurses, we will witness good and bad decision making. The Board of Nursing as well as our nursing education provided the necessary tools to help us make well informed professional decisions. In the Decision Making Model it detailed step by step how we can make such decisions to benefit the patients’ improvement. It depends on us to follow these steps and contribute to the patients’ well being. References Department of Law & Public Safety (1999) Decision Making Model Algorithm, Guidelines for: Determining Scope of Nursing Practice and Making Delegation Decisions [Data file]. Retrieved from http://www.njconsumeraffairs.gov/nursing/algo1.htm
- Nurse should place the patients well being above their personal beliefs and values. They should focus on treating the patient and making sure the patient’s needs are being met. This also means that tough decisions have to be made in the process whether it goes against what the health care team wants or it goes against what Mrs. Dawson wants.
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”.
By using the NMBA’s Nursing Practice Decision Making Framework, it enables the clinician who are making the referral decide whether or not the person they are referring Angela to are accountable, responsible, have authority and competent and/or require supervision to carry out a particular task (Nursing and Midwifery Board of Australia, 2013). A range of inter-professional team which are considered essential for Angela’s care include GP, psychologists, psychiatrists, registered nurses, and social workers (Department of Health, 2014). These members can be delegated as well as are the delegator different roles and responsibilities as they all provide different aspects of Angela’s care as they have different skills and knowledge (Davies & Fox-Young,
Every nurse will be faced with a decision making dilemma at some point in his or her career. Being familiar with the nursing code of ethics, what is ethically and morally expected in society and how to approach the situations can help make dilemmas less of a nightmare. “The purpose of nursing ethics is to inspire questions and examine what would be the ethically right action in health care situations demanding a choice between at least two undesirable alternatives” (Toren & Wagner, 2010, p. 394). There are many different ways one can approach a situation to reach a resolution, finding a method that works best with the situation at hand is ideal.
Within nursing literature it is widely recognised that there are two models of decision making: the information processing model (‘analytical model’); and the intuitive-humanist model (‘intuitive model’) (Banning, 2008). The analytical model supports a nurse basing a decision on examining rational logic whilst the intuitive model marks the move from notice to expert, with the expert able to rely on their experience to guide their actions, similar to Carper’s (1978) “ways of knowing”. However it is important to remember that intuition relies on a thought that a nurse may not recall outside of the moment, which questions the accuracy of solely using intuitive judgement. Many studies are reliant on participant recall and conclude that in reality nurses will often use a combination of reasoning patterns to arrive at a decision. The combination of reasoning patterns fits more into heuristics, where a complex decision can be simplified through the use of experiential knowledge (Benner et al, 1996). Nurses have been shown, in qualitative studies, to rely on heuristics in order to reach decisions quickly and efficiently (Cioffi et al, 2005; Simmons et
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.
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
Nursing is field where prioritisation of complex needs is essential to maintain and promote effective patient care. Prioritising care will help in time management and will make sure that the patient’s most important needs are met first. Planning and prioritising care accordingly can be very difficult for RN’s at times due to constant demands on time, lack of knowledge and support. Therefore as an RN we must not just focus on the patients’ medical diagnosis but consider the patient holistically as a human experiencing a range of health issues. (The University of Nottingham, 2014) For the following assignment Case Study one on Jim Cooper Week 1 was chosen.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
I use different strategies when I do clinical decision making especially working with birth to18-years-old, our physical therapy program alone will not provide a good clinical decision making skills. Besides our physical therapy program I take every year continuing education in my field (Pediatric) through online or onsite seminars. I learned a lot now, when compare to the beginning of my physical therapy carrier. Our learning is never going to stop especially in our heath care field and every day we learn something new in our field. When I was in college my principal used to tell us that after we finish our physical therapy program we should work under senior physical therapist for at least two years to gain more experience before working independently. In the beginning, I was not really comfortable working with babies. But now I want to work only with children not adults because I am very comfortable with children after learning them well. I am still learning and getting more experience with children every day. ever before.
582). Ethical decision making is defined as “The process of choosing between actions based on a system of beliefs and values” (Black, 2014, p. 347). The nurse handling the ethical problem must first identify that there is in fact a problem. The second step is to acquire all of the required information related to the current situation. The third step is to come up with multiple choices and options to solve the ethical problem. The fourth step is to actually pick one of the choices utilizing sound ethical judgement. The fifth step would be to enact the made decision. The final step in the process is to reassess your decision and look for effectiveness and
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
Traditionally nurse’s role in evaluating a patient has to record the observations made but not to interpret them. The main observation includes pulse, temperature, rate of respiratory, blood pressure and consciousness level (Alice, 1985). The ability of nurse to record such observations accurately will determine the priority of the patient care. Assessment based on priority setting is one of the major skills that nurses that are newly fit may lack. Th...
In daily practice of the pediatric oncology nurse, they find themselves experiencing predicaments as they attempt to balance providing care, communicating with and educating family, working collaboratively with medical teams, as well as advocating for the voices of their patients. An essential role in nursing is caring, compassion and empathy. ( (friberg) 50. “Caring presence is mutual trust and sharing, transcending connectedness, and experience. This special way of being a caring presence involves devotion to a client’s well-being while bringing scientific knowledge and expertise to the relationship” (Covington (2005) states, p. 169). However, part of nursing is the relief of suffering, but complex interventions often cause
An employee does an unsatisfactory job on an assigned project. Explain the attribution process that this person's manager will use to form judgments about this employee's job performance.