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Running Head: CLINICAL NURSING JUDGEMENT

Anna Ohlin

Youngstown State University

4852 Senior Capstone Seminar

Mrs. Thomas & Mrs. Ballone

February 28, 2022

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Running Head: CLINICAL NURSING JUDGEMENT

Clinical Nursing Judgement

The concept of “clinical nursing judgment” can be defined as the actions and decisions a

nurse will take to improve the outcomes of their patients. Nurses play a crucial role in the

decisions within heath care system. To start, a nurse must develop their decision-making skills

with the use of their clinical experience in the working field. A nurse’s mind must be trained to

make critical decisions to better improve the lives of their patients. To do so, a nurse must use

their own experiences to research what must be done correctly and efficiently. Nurses work in

many specialty areas and have different ways of thinking regarding their patient’s needs and

health. They must use the tools, evidence, and personal researched knowledge to promote a safe

and healthy environment for their patients and themselves.

In the scholarly article by Carl Thompson, there is research that varying principles play a

role in the decisions made by a nurse. “If we understand why these variations occur and identify

those areas where, and how, variation impacts on patient care then developing the kinds of

complex interventions required to improve practice may prove possible” (Anderson, 2008). This

scholarly article explores the idea that nurses need to gain the skill of critical thinking by varying

their environment. A nurse must become familiar with a multitude of situations to shape their

clinical decision-making skills. I have personally experienced many different environments

where situations vary, therefore my decisions are altered. During my educational career at

Youngstown State University, I was able to attend many different areas of nursing that will later

help shape my views and experience on caring for many types of patients. Many areas of nursing

that I have attended include home health care, medical-surgical units, mental health nursing

units, and intensive care units. Each of the environments differ in the type of patients and the
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Running Head: CLINICAL NURSING JUDGEMENT

decisions needed to care for each person. I have been able to shape my understanding of the

different diagnoses to provide optimal care.

Not only must a nurse have the physical experience to shape their clinical decision-

making skills, but they must also have solid knowledge on the components of a nursing career.

The scholarly article, “Do educational interventions improve nurses’ clinical decision making

and judgement? A systematic review”, explores how education on the nursing environment can

help better a nurses’ decisions while caring for their patients. The article states, “Decision

making is a core nursing competence in many countries’ health systems and a plethora of

approaches to teaching judgement skills and decision-making exist for educators to choose from”

(Thompson, Stapley, 2010). Education on different diseases, disorders, medications, and much

more, will assist in shaping the mind of a nurse. For example, a nurse will make decisions on

medication administration based on their ability to recognize all details about that certain

medication. A strong education will build knowledge to help a nurse in dire situations regarding

their patient’s life.

Nurses often reflect on their own personal experiences in nursing school and in their

career within the nursing field. Many nurses are educated though physical experience and the

help of their educators and fellow co-workers. As a nursing student, I modify my way of thinking

based on the education of my educators, whether they be my professors or my clinical

instructors. “Clinical judgment: The last frontier for evaluation” is a nursing journal that explores

the clinical judgement of former students. When a student is taught by their preceptor how to

react in clinical situations, they build off that knowledge to create a strong judgement for their

future experiences. With the use of reflection, a nurse can create better outcomes for a future

situation. As the journal states, “Nursing educators have learned that guided reflections are often
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Running Head: CLINICAL NURSING JUDGEMENT

the best tool to elicit the level of learning students need to develop their thinking for at least two

reasons: (a) students vary widely in their ability to be reflective and (b) often, they need guidance

to learn what is important to notice to develop their thinking like a nurse (Craft, 2005; Lasater

and Nielsen, 2010). Reflection on the pros and cons of the decisions made during a clinical

situation will create a better outcome for the nurse in their future experiences.

I have had many personal experiences in the nursing field that required me to use my

knowledge and background. One experience that always sticks-out to me was during my shift

while working at the hospital. I work on an Ortho-surgical unit and have shaped my

understanding of post-surgical patients over the past two years. During one of my shifts, I had to

use my clinical nursing judgement to keep my patient, and myself, safe. While I was assisting a

post-operative cholecystectomy patient to the restroom, she began to feel light-headed. I had to

think quickly and efficiently. My former education of post-anesthesia patients led me to believe

of the possibility that this patient may pass-out. The patient was much larger than me and I began

to panic as I was unsure if I would be able to help if she fell. I decided that the best decision

would be to act as quickly as possible, as the patient began to fall. I put my arms under her

armpits, catching her while she fell. Based on my education on the topic of patient safety, I used

my own body to slowly lower the patient to the ground, while taking special precaution in

protecting her head. I was able to call for help while staying with the patient and making sure she

was alert and oriented. I feel as though I was able to use my judgement skills in a safe and

effective manner during this situation. After this experience, I was able to reflect on what had

happened and apply it to every one of my patients afterward. This helped me to truly use my

educational and reflection skills to shape my clinical nursing judgement for my future nursing

career and my future patients.

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Running Head: CLINICAL NURSING JUDGEMENT

References

Lasater, K. (2011). Clinical judgment: The last frontier for evaluation. Nurse Education in
Practice, 11(2), 86–92. https://doi.org/10.1016/j.nepr.2010.11.013

Thompson, C., & Stapley, S. (2011). DO educational interventions improve nurses’ clinical
decision making and judgement? A systematic review. International Journal of Nursing
Studies, 48(7), 881–893. https://doi.org/10.1016/j.ijnurstu.2010.12.005

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. https://doi.org/10.1016/j.ijnurstu.2013.05.003