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Nursing Capstone
Clinical nursing judgement is a very important part of not only nursing but any health
professional because of the importance of how it is used in the importance in patient care and
how to prepare the best type of care for the patient to gain the most effective care for the patient
that promotes optimum health. Each area of nursing uses clinical nursing judgements that are
used appropriately to help the patient in that area of nursing whether it be mental health nursing
or it be an ICU nurse taking care of a critical patient. I will tell about how I think about the
different areas of clinical nursing judgement and how the different articles I have gathered view
their different ideas of nursing judgement and how they define what it is.
As said by Thompson (2013) “Nurses’ judgements and decisions have the potential to
help healthcare systems allocate resources efficiently, promote health gain and patient benefit
and prevent harm” (p. 1). Their idea of nursing judgement from this statement is saying how
much of an impact nurses really have in the healthcare industry and how they can make a change
in the hospital for a few reasons. One thought is that most nurses are with patients every day that
they are working and this allows them to see how what they implement for someone can affect
them directly. This allows them to make the right decisions based on the situation that the patient
is in because of how direct their care is and also allows them to use the different types of
technology that is available to them to help the patient safely and effectively. Since they are
using all these different pieces of equipment, nurses are able to voice their opinion of how these
instruments either aide or cause a detriment to the patient. With this knowledge, they are able to
see a patient in certain situation and really understand what would be the best method of
treatment would be for the patient. Even if they aren’t able to make orders like the doctor can, it
does not mean that any nurse can make a suggestion for the care plan of the patient to the doctor
or any other professionals that might be working with the patient. Another idea that this
statement might mean is that nurses also have the ability to actually research different treatment
methods or interactions with the patients or mostly anything else within their scope of practice
and make that research into a complete study. This allows nurses to really delve deep into a
certain topic about the healthcare field and can be able to gather the most information about the
topic they can. This allows future researchers and nurses to look at their information gathered
and make a clinical judgement on what the outcome of the topic might have been whether it was
good or bad and allow them to make changes in that area of care if it is more beneficial to the
patient.
Another great part about clinical nursing judgement is that the seasoned nurse is able to
use his/her years of knowledge to make decisions much more efficiently than a newer nurse.
The concept of clinical judgement is difficult to put into practice. Perhaps this partly
explains why nurses experience difficulty mastering this essential skill. Another obstacle
is the lack of importance granted to clinical judgement in certain forms of training as well
emphasized. The intellectual elements are thus often superseded by the more technical
an easy thing to not only learn but to master as well; this being very evident from the fact of the
difference in care that a more experienced nurse provides to a patient than a newer nurse might
provide. Now this is not saying that the new nurse is providing care that is not as good as the
experienced nurse but there is a more apparent idea of how the veteran nurse can come to a
conclusion about what the best method of care for the patient is and how they can look at a
certain situation the patient might be experiencing and decide the most appropriate intervention
and promote the best outcome and maintain optimum health for the patient. As a student myself,
I will need many more years to be very efficient in my clinical nursing judgement but it does not
mean I am not able to come to a decision for my patient throughout the time in my clinical
experience.
I have been in nursing school for four years now and can say with confidence that my
ability to clinically think in the hospital setting has increased and allows me to be more confident
in my patient care.
Education also has to render visible how decisions are made so that, together, curriculum
design and practice facilitation offer students a clinical decision-making framework that
can be understood and applied in any unique real-world situation across the clinical
To me this is saying how a student needs to make the most of their time in not only the school
setting but the hospital setting as well. Also states that when you use the skills and knowledge
you have gathered in the school setting then you can have the confidence to make those clinical
decisions in the real world. An example of when I had made a clinical nursing judgement is
during my time as being a nurse’s aide actually. My scope of practice is different when I am
working as an aide but I still use my clinical nursing judgements to help the nurses as best I can.
During one of my shifts, I was sitting at the nurse’s station charting on my patients and heard one
of the patients Spo2 monitor alarms going off (this patient was on a continuous monitor that
alarmed whenever it dropped below a certain level) and didn’t think too much of it because the
alarms go off all the time and its usually because the patient is moving or adjusting their nasal
cannula. However this patient was on a high flow nasal cannula at fifteen liters as well as a
rebreather mask which was also on fifteen liters so this patient was receiving 30 liters of oxygen
total which is significantly higher than most patients receive. Since I knew how much the patient
was receiving and the alarm was going off for about a minute now without it turning off, I go in
to check out the patient because the nurse was busy and see that their Spo2 was down to 64%. I
immediately looked at the patient and made sure both of their oxygen devices were on them
which they were and there were no tubing kinks and the monitor was connected directly to the
patient without any connection issue. I was also able to see that the patient was in great distress
with how shallow they were breathing and their excessive use of their accessory muscles to try to
increase ventilation as well as the purple discoloration in the extremities even after I raised the
head of the bed to try to improve ventilation. I immediately got the nurse and she was able to call
the rapid response team who were in the room within a minute to help the patient by giving
different medications to improve their ventilation and allow them to breathe easier and after the
patient was stabilized they were transferred to another unit for closer monitoring and the patient
ended up recovering from the situation. I was pleased with myself for the fact that I was able to
identify the situation and act appropriately for what was best for the patient and help them to
Clinical nursing judgement is something nurses will use now and forever. It is a great
method of determining the most effective care plan for any patient no matter the situation. Even
if you are not able to determine the best treatment for a patient, you are always working with
other nurses who have years of knowledge and are able to put their minds to together in any high
stress situation.
References
Dowding, D., Gurbutt, R., Murphy, M., Lascelles, M., Pearman, A. and Summers, B.
2018].
Phaneuf, M. (2018). Clinical Judgement – An Essential Tool in the Nursing Profession. [online]
http://www.infiressources.ca/fer/Depotdocument_anglais/Clinical_Judgement%E2%80%
Thompson, C., Aitken, L., Doran, D. and Dowding, D. (2018). An agenda for clinical decision
making and judgement in nursing research and education. [online] International Journal