clinical judgment - week 4

Question 1

clinical judgment

Answer 1

Clinical judgment is “an interpretation or 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.”*

Question 2

attributes of clinical judgment

Answer 2

Involves a holistic view of the patient situation.
Has a process orientation (a circular process).
Requires reasoning and the interpretation of data.

Question 3

nursing care in not linear

Answer 3

One must consider multiple complex variables for clinical reasoning.

Question 4

unique situation

Answer 4

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.

Question 5

noticing

Answer 5

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.

Question 6

interpreting

Answer 6

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.v

Question 7

enironmental context

Answer 7

Environmental context or the setting of care influences what a nurse notices.
Demanding environments of care can add an increased burden on making clinical judgments and can actually interfere with competent clinical judgment.

Question 8

experience, knowlesge, expertise

Answer 8

Clinical judgment requires deep clinical knowledge and several types of thinking.
Experience does matter, but it is not solely responsible for clinical judgment.

Question 9

responding

Answer 9

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.

Question 10

reflecting

Answer 10

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.