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Clinical reasoning and decision making
Clinical reasoning and decision making
Reflection and deconstruction of the clinical reasoning essay
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Clinical Reasoning is the process of improving and understanding patient situations. This essay will outline what Clinical Reasoning is, discussing its importance in nursing and midwifery practice, and highlighting the Clinical Reasoning Process.
Clinical Reasoning is a thinking process and learning tool for nursing students to improve facts to form into judgements. According to Levett-Jones, Hoffman, Dempsey, Jeong, Noble, Norton, Roche & Hickey (2009), it is a process to assist nurses to improve their understanding of a patient problem. Clinical Reasoning is ‘feedback for self-evaluation to guide for formulating higher level thought questions to shape students’. Therefore, improving their knowledge and skills during practice. (Lasater,
LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-surgical nursing: Critical thinking in patient care (5th ed.). Upper Saddle River, NJ: Pearson Education, Inc.
Critical thinking and knowledge are the foundation of nursing practice, and the most essential elements in providing quality nursing care. Nu...
Wiles, L.L. Simko, L.C. & Schoessler, M. (2013). What do I do now? Clinical Decision making
According to Bandman & Bandman (1995), critical thinking is defined as the rational examination of ideas, inferences, assumptions, principles, arguments, conclusions, issues, statements, beliefs and actions. In this subject ‘Critical Thinking in Nursing’ has emphasized critical thinking as an essential nursing skill and its definition of critical thinking have evolved over the years. In short, the general definition of critical thinking is self-directed, self-disciplined, self-monitored and self-corrective thinking. Every nurses must cultivate rigorous standards for critical thinking, however they cannot avoid completely the situatedness and structures of the clinical traditions and practices. They must make decisions and act quickly according to
“The fact that critical thinking relies upon criteria suggests that it is well-founded, structured, and reinforced thinking, as opposed to “uncritical” thinking, which is amorphous, haphazard, and unstructured.”2 For instance, it is important in the academic field because it facilitates the individual to analyze, evaluate, and explain their thought in a clear manner. However, having this knowledge of logical inquiry doesn’t exempt people from making mistakes. Character traits such as bias can affect the effectiveness of the critical thinking process. Critical thinking skills can also be used by nurses during patient assessments. Through critical thinking, nurses can come to conclusive diagnosis or decisions of the situation at hand. Some Colleges now-a-days are including this skills in their curriculum to continue the professional development of their
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
Introduction The College of Nurses of Ontario (CNO) is the governing body of all registered nurses in Ontario and is regulated. The CNO provides expectations and guidelines to follow, which need to be met by each Registered Practical Nurse (RPN) individually. As a nursing student, I am taught about the CNO and the importance of referring back to the guidelines while caring for patients. While gaining experience in the nursing field through my clinical settings, I have realized as a nursing student there are areas I need further development in. In this paper, I will address two of my learning needs and my goals for each.
My past philosophy of cyclical time functions only as a fragment under the umbrella of my present philosophy. This cyclical time portion of my philosophy carries great significance as it conscripts the recollection of my nursing roots (Ondrejka & Barnard, 2011). Mental commemoration of such events potentiates my capacity to provide empathetic care (Ondrejka & Barnard, 2011). My present nursing philosophy is pragmatically grounded in reason. I feel that nursing science is an attempt to explain health-related affairs through the lens of truth as opposed to unsupported claims. With this in mind, I believe that nursing science and evidence-based research is simply the application of reason in its most concentrated and purest form. Retrospectively, I feel that much of the great lessons taught by my clinical preceptors ultimately boiled down to reason. Additionally, I think that reason also provides much of the structural framework for ethically sound care: an increasing concern among nurses across health care organizations globally (Dauwerse & Abma, 2012). A philosophy of reason respects the interchangeability of perspectives and the disapproval of privileging personal needs over the needs of others. Applying reason to any healthcare circumstance ensures that I refrain from egotistic views of grandiosity. In practice, this is performed by caring for a patient as I would want to
In theory and practice, the focus of nurses is on the response of the individual and the family to actual or potential health problems. To evaluate patient care steps has to be taking that incorporates the collection of data and processing that data through critical thinking. The nursing process is essential because it incorporates this concept into a well throughout steps ...
Utilizing nursing theory can help nurses develop a more focused and individualized plan of care for their patients. By understanding the nurse’s metaparadigm and how to apply theory to each concept, nurses can develop increased insight on their patients and promote interventions that are more likely to produce a greater quality of care for the patient.
Knowledge can be seen as the main focus of nursing qualities as it is a lifelong skill that is learned throughout a nurse’s career. In nursing, knowledge can be classified as theoretical or practice-based. Practice-based knowledge is attained through the nurse-patient encounter. According to Mantzoukas and Jasper (2008), a nurse’s nonverbal and verbal communication exhibits the nurse’s practice- based knowledge. When nurses demonstrate appropriate communication patients feel understood and comfortable within the relationship. It is difficult for a nurse to obtain this knowledge without taking an autonomous and individual approach for each patient (Mantzoukas & Jasper, 2008). Taking an autonomous approach allows for the nurse’s critical thinking to improve as well. Good critical thinking skills increases the chances of achieving desired patient outcomes as the nurse is able to analyze the situation effectively. Theoretical knowledge is acquired through education. This type of knowledge is expressed through what nurses know and the logical information the nurse possess in relation to their practice. Theoretical knowledge is also important as it makes the nurse competent and capable of carrying out simple tasks. From the coat of arms, it is evident that knowledge is a unifying quality that is the foundation for acquiring other qualities necessary for
I believe placing student nurses in the clinical setting is vital in becoming competent nurses. Every experience the student experiences during their placement has an educative nature therefore, it is important for the students to take some time to reflect on these experiences. A specific situation that stood out to me from my clinical experience was that; I didn’t realize I had ignored the patient’s pain until I was later asked by the nurse if the patient was in any pain.
Nursing theories are critical for education and practice. The theories suppose to provide a foundation for general knowledge and assist in practice. Thus, healthcare professionals, managers, and patients recognize the unique healthcare service. However,
Compared with medical professionals, nurses appear to be reluctant to rely on professional rationales for their actions, preferring to use managerial justifications and implementing ‘top down’ approach to care. (Adamson, 2013). When a gap in nursing care is perceived, theory is often used to improve these outcomes. Theory provides an overall vision and understanding of the profession of nursing by offering guidance. Not only in nursing, but theory can be applied to any profession as it serves as a tool for guidance of practice. The legitimacy of a profession is based on its ability to generate and apply theory (McCrae, 2012). Without nursing theory, nursing would be a profession guided by by medicine and physicians. Theory guides nurses by shaping its professional boundaries and helps nurses make decisions on current and potential patient needs.
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.