Chapter 15: Clinical Judgement in Nursing Practice Flashcards
What is clinical judgment?
combination of critical thinking and decision making skills
what is truth-seeking?
be objective when asking patients questions
- ex: “do you drink/smoke/do drugs?”
what is open- mindness?
being tolerant of the patient’s views and beliefs
- ex: the impact of culture and religion it has on the patient
what is analyticity?
anticipate how a patient may respond to a treatment
what is systematically?
based your nursing care on patient priorities
- ex: what the nurse will do first
what is self- confidence?
trusting your own reasoning process
what is inquisitiveness?
value learning for its own sake
- ex: what you are learning in nursing school is a speck of dust, you will learn more on the field
what is mature?
reflecting your own judgments
- a great way to improve your critical thinking skills
what is critical thinking defined?
thinking in a logical manner and in a systematic way
what does the “R” stand in reflect model?
Recall the events during the simulation
what does the “E” stand in reflect model?
Examine your responses
- how you act in the simulation
what does the “F” stand in reflect model?
Acknowledge feelings
- tell me one word how you felt during the simulation
what does the “L” stand in reflect model?
Learn from the experience
- taking the information and applying it when you become a nurse
what does the second “E” stand in reflect model?
Explore options
- the next time you are in this situation, how will you handle it differently
what does the “C” stand in reflect model?
Create a plan of action
- how you will improve your critical thinking skills (reading observations)
what is problem solving?
working with an elderly patient who can’t see their medication label, after assessing the patient we realize they are having problems with their vision
- result: we would recommend the pharmacist to make the pill box label bigger
what is decision-making?
presenting both roles to the patient and letting the patient make the decision
- ex: presenting both roles as a physician and as a midwife
what would a decision-making question be about a problem?
is the problem clear and understandable?
what would a decision-making question be about your perspective?
you are looking at the problem from the view of __. Why?
- ex: the nurse had a perspective that the patient is a drug seeker, you as a nurse need to look at what the patient says the pain is
what would a decision-making question be about assumptions?
you are assuming __. How does that affect your analysis of the problem?
what would a decision-making question be about evidence?
what evidence supports your assumption?
- everything we do is based on evidence or evidence based practice
what is inductive reasoning?
go to specific to general
- ex: a patient is weak in the legs, unsteady on their feet and has a history of falls
conclusion: the patient is at risk for falls
what is deductive reasoning?
going to very general to specific
- ex: using a theorist in your clinical practice or Maslow’s Hierarchy of Needs
how do you get to know your patient?
by caring for a group for a long period of time and evidence based practice
A nurse is caring for a patient who has poor pain control. The patient has a history of opioid abuse. During the day the patient made frequent requests for a pain medication. In order to make an effective clinical decision about this patient, the nurse needs to ask questions about the data available on the patient to make a thorough and thoughtful decision. The nurse asks herself, “How does my view about the patient’s pain tolerance compare with the patient’s, and does that pose a problem?” This is an example of:
A. A question about assumptions.
B. A question about evidence.
C. A question about procedure.
D. A question about perspective
D. A question about perspective
A nurse is assigned to care for a woman who is expecting her first child. The nurse is organized and plans to gather data about the patient by applying Pender’s health promotion model, including the patient’s characteristics and experiences and situational influences. She plans to observe the patient’s behavior and consider the patient’s psychosocial issues. Such data will offer a clear understanding to help the nurse identify the patient’s needs. This is an example of which of the following concepts? (Select all that apply.)
A. Diagnostic reasoning
B. Deductive reasoning
C. Inductive reasoning
D. Assessment
E. Problem solving
B. Deductive reasoning
D. Assessment
One element of clinical decision-making is knowing the patient. Which of the following activities affect a nurse’s ability to know patients better? (Select all that apply.)
A. Caring for similar groups of patients over time
B. Reading the evidence-based practices appropriate to patients
C. Learning how patients typically respond to their clinical situations
D. Observing patients
E. Engaging with patients experiencing illness
A. Caring for similar groups of patients over time
B. Reading the evidence- based practices appropriate to patients
what is competence?
hands on procedures and physical examination techniques
what is an example of hands-on procedure?
sterile dressing changes
what is an example of physical examination techniques?
- working with a baby: you want to do a head-to-toe assessment
- working with a mom: you want to use the body system method: check the lungs, heart, abdomen
we teach these methods because we can do things systematically (won’t skip things)
what is specific knowledge base?
- schooling in a foundation
- CEU are to renew your license and maintain your certification
- reading journals to help you
what is experience?
in clinical they will teach you how to make clinical decision-making skills
what is the nursing process competency?
A Delicious Pie
- how you will apply your critical thinking skills