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Clinical judgment is a nurse's interpretation of a patient's needs and health problems that informs decisions about patient care. It is not a linear process but involves considering multiple complex factors with no clear answers. It requires a holistic view of the patient situation and reasoning about clinical data. Each patient and nurse situation is unique, so the clinical reasoning that leads to judgment is also unique. The clinical judgment process involves noticing patterns, interpreting information, responding with appropriate actions, and reflecting on experiences to develop knowledge and improve reasoning over time. Experience contributes to but does not solely determine a nurse's clinical judgment abilities.
Clinical judgment is a nurse's interpretation of a patient's needs and health problems that informs decisions about patient care. It is not a linear process but involves considering multiple complex factors with no clear answers. It requires a holistic view of the patient situation and reasoning about clinical data. Each patient and nurse situation is unique, so the clinical reasoning that leads to judgment is also unique. The clinical judgment process involves noticing patterns, interpreting information, responding with appropriate actions, and reflecting on experiences to develop knowledge and improve reasoning over time. Experience contributes to but does not solely determine a nurse's clinical judgment abilities.
Clinical judgment is a nurse's interpretation of a patient's needs and health problems that informs decisions about patient care. It is not a linear process but involves considering multiple complex factors with no clear answers. It requires a holistic view of the patient situation and reasoning about clinical data. Each patient and nurse situation is unique, so the clinical reasoning that leads to judgment is also unique. The clinical judgment process involves noticing patterns, interpreting information, responding with appropriate actions, and reflecting on experiences to develop knowledge and improve reasoning over time. Experience contributes to but does not solely determine a nurse's clinical judgment abilities.
conclusion about a patient’s needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient’s response” (Tanner, 2006*). Nursing Care Is Not Linear • One must consider multiple complex variables for clinical Multiple reasoning. factors
No clear-cut answers Attributes of Clinical Judgment
• Involves a holistic view of the patient
situation. • Requires reasoning and the interpretation of data. Unique Situation • The nurse must recognize the unique situation of the patient, including a deep understanding of both the clinical situation and the nurse’s contribution to the patient care situation. • Each patient situation and each nurse is different; so, too, is the clinical reasoning that leads to clinical judgment. IDENTIFY THE WAYS THAT NURSES MAKE JUDGMENTS Clinical Judgment Process
• Noticing • Interpreting • Responding • Reflecting Model of Clinical Judgment
Clinical judgment is not a linear process.
Noticing
• A nurse notices things about a patient in the
context of the nurse’s background and experience, context of environment, and knowing the patient. • A nurse is looking for patterns that are consistent with previous experiences and uses that information to guide care. Interpreting • Interpreting is the process of assembling information to make sense of it. • Types of reasoning patterns tend to vary with the experience of the nurse. – Novice nurses tend to rely on analytic reasoning. – Expert nurses draw from a variety of reasoning patterns—analytic, intuitive, and narrative. Responding
• Responding is the implementation of actions
and interventions, based on patient needs. • Depending on the level of expertise, the nurse may or may not be able to judge the effectiveness of the intervention before initiating it. Reflecting • Reflecting is the process of thinking and learning from experiences. – Reflection-in-action happens in real time while care is occurring. – Reflection-on-action happens after the patient care occurs. • Reflecting is critical for development of knowledge and improvement in reasoning. Experience, Knowledge, Expertise
• Clinical judgment requires deep clinical
knowledge and several types of thinking. • Experience does matter, but it is not solely responsible for clinical judgment.