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Amero 1

Tara Amero

Senior Capstone Scholarly Paper

Clinical Nursing Judgment

March 13th, 2017


Clinical judgment is a term commonly used in the medical field. Nurses, doctors,

and other healthcare workers are always being told to use clinical judgment with their

patients. As we hear this term so often, does anyone truly know what it means? Such an

important term is not so easy to define, as there is no set in stone definition. Does clinical

judgment define if a nurse is good or not? Does clinical judgment come with time and

experience within a field? Or are some people more knowledgeable than others, which

gives them better clinical judgment? Clinical judgment requires knowledge of various

types: generalized, abstract, and applicable (Tanner, 2006).

The term clinical judgment can be broken down into numerous parts. According

to Tanner (2006), clinical judgment requires an understanding in many different topics. It

requires an understanding of the diagnostic and pathophysiological stand point of the

disease, but also requires an understanding of the physical and emotional strength of the

patient and their family. Also, an understanding of how the disease is affecting the patient

is crucial. While clinical judgment is extremely important from the disease aspect,

knowing the patient is equally as important. Knowing the patient and the response to the

disease and treatments can provide nurses more knowledge and help assist with their

clinical judgment towards that individual. Most new nurses take time to analyze and

reason with the situation, which helps them grow and recognize these situations when

they happen again. After so much experience, they begin to feel familiar with different

types of situations, and can act quickly with their clinical judgment.

Clinical judgment is not only knowing how and why to perform an intervention,

but also being able to explain and defend why the judgment for it be done was made.

(Standing. 2008). Judgments require observation, data collection, detection of


interrelationships between information, a hypothesis, and testing the hypotheses

(Standing. 2008). Nurses are constantly doing those steps, without even knowing.

According to the article, the usual response to uncertainty is to seek more information.

This can easily be applied to nursing and when making clinical judgments. Nurses are

always seeking more information, whether it is from the patient or family member, or

searching through the charts for labs and previous doctors notes. Any additional

information found can greatly help making clinical judgments.

Depending on what type of unit a nurse is on, they could be making clinical

judgment decisions every 10 minutes (Thompson, Aitken, Doran, Dowding, 2013). Their

research shows that nurses working in acute care make decisions every 10 minutes and

critical care nurses can make them every 30 seconds. Regardless of the type of healthcare

system, all nurses have to make clinical judgment choices. Patients are putting their

complete trust in the nurse to make these decisions in the best interest for their health. A

study showed that when nurses were given the same information, different judgments and

decisions were made (Thompson, et al. 2013). This was related back to what nurses do

with the information and how they translate it. More experienced nurses are quicker to

act, while novice nurses, every choice made is thoroughly though out before being acted


A few years ago, my dad came home from work because he didnt feel well. After

convincing him to go to the doctor, they diagnosed with a urinary tract infection, and sent

him home with antibiotics. Thinking nothing much of it, my mom and I went along with

our day. Later that night, my mom came into my room, said my dad was actin odd, and

wanted me to go to their room and check on him. He was lying in bed, shivering under a

blanket, while profusely sweating. I asked him what he was feeling and all he kept saying

how freezing the room felt. I went over and felt his head, which was burning up. While

talking with my dad, he seemed very dazed, confused, and was not answering my

question properly. As Tanner says, knowing the patient is extremely important and I knew

this patient better than most. Just within the first 30 seconds of interacting with him, I

knew this was not his normal behavior. I used my clinical judgment, adding together the

symptoms of fever, chills, confusion, and told my mom we needed to call an ambulance.

The ambulance came and took him to St. Elizabeths in Boardman. After doing cultures

and tests, they found that his UTI had spread to the blood, and he had sepsis. Using my

judgment and paying attention to the signs, my mother and I made the right choice by

bringing him to the hospital. After learning about Tanners theory regarding clinical

judgment, I realized how important it really is. Knowing the patient and their background

can greatly affect the nurses clinical judgment.



Standing, M. (2008). Clinical judgement and decision-making in nursing nine modes of practice
in a revised cognitive continuum. Journal Of Advanced Nursing, 62(1), 124-134.

Tanner, C. (2017). Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in

Nursing. Journal Of Nursing Education, 45(6), 204-211.

Thompson, C., Aitken, L., Doran, D., & Dowding, D. (2013). An agenda for clinical decision
making and judgement in nursing research and education. International Journal Of Nursing
Studies, 50(12), 1720-1726.