Running head: THE IMPORTANCE OF CLINICAL NURSING JUDGEMENT 1

The Importance of Clinical Nursing Judgement

Jasmine Crook

Youngstown State University

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Discussion

Clinical nursing judgement starts the minute a nurse walks onto the unit. Nurses begin to

assess and analyze every piece of data thrown their way. It is a nurses job every day to perform

the safest and most effective care possible. From listening to report, reading the patients chart,

doing a head to toe assessment, labs, diagnostics, there is constant interpretation of information.

It is the job of the nurse to take all of the information and assessment findings to formulate a

nursing diagnosis. From there appropriate nursing actions and goals are set for the patient. The

end goal being that the patient returns back to their optimal health. This process in which nurses

do multiple times a day is known as clinical nursing judgement.

Clinical nursing judgement is the foundation to the profession of nursing. From the

beginning of nursing school students are taught how to think clinically and critically to make the

best outcome for their patients. Thus preparing students to make difficult clinical decisions when

presented with a problem. According to Nielsen, Lasater, and Stock’s (2016) article that studied

the development of new nurse’s clinical judgement “New graduate nurses use clinical situations

as a way to connect their theoretical learning with practice and to develop and deepen their

thinking about patient situations. They rely on individual knowledge, standards of care, and unit

procedures to guide their decisions; they depend on the clinical judgment of others, especially in

ambiguous or unfamiliar situations”. The above statement couldn’t be more true. The foundation

to developing clinical nursing judgement is not only practiced in the classroom, but a huge part

of that development is learned from clinical experiences. It is so important for new graduate

nurses to not only be able to take the information learned in the classroom but then to transfer

that learned information to the clinical setting. Although clinical judgement can be taught in the

classroom setting it is important for students to get hands on experience with making clinical
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judgement such as simulation labs. The following articles will discuss the importance of

alternative learning methods such as human patient simulators to prepare undergraduate nursing

students to make appropriate and safe clinical judgment.

According to Lasater (2007) “Clinical judgment refers to the ways in which nurses come

to understand the problems, issues, or concerns of clients/patients, to attend to salient

information and to respond in concerned and involved ways; included in our understanding of

the term is both the deliberate, conscious decision-making characteristic of competent

performance and the holistic discrimination and intuitive response typical of proficient and

expert performance”. In addition she adds this comment about learning in the form of

simulations “is especially adaptable to adult learners; [it gives] opportunity to see real

consequences of one's actions, to feel the exhilaration of success and the frustration of failure"

(Lasater 2007). Simulation labs are a time when a nursing student is able to make mistakes. As

a novice nurse you are going to make mistakes and by doing so through trial and error in

simulations it allows for the student to grow as a nurse and recognize those faults. Simulations

also provide confidence to students. After learning about a certain skill or disease process in the

classroom setting and to then be able perform or use those skills in simulation and be

successful can be self-assuring to the student. It also presents similar real life situations that

could happen in the hospital setting and allows the student nurse to be able to make quick

clinical judgement on how to tend to the patient.

Youngstown State starts doing simulation labs sophomore year and continues simulations

through senior year of the nursing program and it has allowed students to gain the clinical

judgment skills they need to enable the students to feel more confident in the nursing field.

According to Sinclair and Ferguson (2009) “Simulation is designed to encourage active

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participation in the learning process allowing students to construct knowledge, explore

assumptions, and develop psychomotor skills in a safe environment”. Throughout my clinical

experience and simulations labs I have been able to gain confidence in even the simplest skills

as vital signs. As you continue to grow as a nurse and gain confidence you begin to go with

your gut and trust your assessment skills. One particular moment when I found this to be true

was during my OB rotation. I was in the nursery that day getting the babies bathed and doing

vital signs. After taking two babies vital signs I got to the last baby and counted his respiratory

rate which was normal and then continued to his heart rate. After counting his heart rate for a

full minute I got a count of 90. I took the stethoscope out of my ears and told my clinical

instructor the number with worry and doubtfulness in my voice. She told me that couldn’t be

right. After she listened and two other classmates listened she confirmed that I was right and his

heart rate was low. We then took the baby and placed him on the warmer and took his

temperature and his temperature was only 97.5. We then checked his blood sugar and his sugar

was only 33. After we got his temperature to come up his heart rate came back within normal

limits and we took him back so the mother could do skin to skin with him and breastfeed him.

As simple as it was to catch a mistake in vital signs I stuck with my clinical judgment that

something was wrong and I am proud to of caught this before something worse could of

happened.

Conclusion

In conclusion, the emphasis of having sound clinical nursing judgement is at the upmost

highest. Having excellent nursing judgement not only starts as a student but all the way up until

you retire from the nursing profession. At the end of the day as a nurse you have another

human’s life in your hands and having the proper knowledge to make judgement calls could be
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a decision of life or death. The above articles discussed the importance of having clinical

nursing judgment and different ways of learning nursing judgment through simulation labs. In

the end while clinical nursing judgement can be taught in the classroom it is something that as

new nurses we have to experience over time.

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References

Lasater, K., EdD, RN. (2007). High-Fidelity Simulation and the Development of Clinical

Judgment: Students' Experiences, 46(6), 269-276. Retrieved March 5, 2018.

Nielsen, A., Lasater, K., & Stock, M. (2016). A framework to support preceptors ’ evaluation and

development of new nurses’ clinical judgment, 84-90. Retrieved March 5, 2018.

Sinclaire, B. & Ferguson, K. (2009). Integrating simulated teaching/learning strategies in

undergraduate nursing education. International Journal of Nursing Education Scholarship, 6

(1), 1–11. Retrieved March 5, 2018.

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4852 Capstone
Scholarly Paper Rubric

Scholarly Capstone Paper

 A component of the capstone course, worth 20% of the final grade

 An in-depth exploration on the topic “Clinical Nursing Judgment”
 3 page paper
 APA format
 Minimum of 3 references citing recent Nursing Journals
 Define the concept, identify the importance of clinical nursing judgment, and then discuss
a personal experience where you used “clinical nursing judgment” in a specific situation.

Requirements: Possible Points Achieved Points

1. organization and clarity of topic present 20 _________

2. content quality 20 _________

3. reflection of topic 20 _________

4. APA format and correct grammar 20 _________

5. Cited References 20 _________

Final Grade
_________/100 points

4852 capstone paperubric ksb2017