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Clinical Judgement Point of View from a COVID-19 Nursing Student

Isabella Ricottilli

Nursing Department, Youngstown State University

NURS 4852: Senior Capstone

Professors Kim Ballone and Wendy Thomas

February 28, 2022

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Clinical Judgement Point of View from a COVID-19 Nursing Student

Clinical nursing judgment is defined as the ability of nurses to critically think, make

educated decisions, and assess for outcomes. Clinical nursing judgement skills are learned

through experiences, not just text book learning. The COVID-19 pandemic caused hardships in

clinical judgment for nursing students. The transition of in classroom learning to online learning

caused a lot of issues for new nursing students. Nursing students never thought they would have

to face such challenging times, that still continue through the present day. This caused clinical

experiences and judgement skills to become difficult to understand from an electronic device.

The switch to online learning became the start of a new world for nursing students and soon to be

RN’s.

Clinical judgment is seen though live experiences whether in a hospital or another form

of healthcare facility. While most university students use distance learning approaches, many

healthcare students continue to attend hospitals and healthcare centers (Tofani et al., 2021). It’s

not just learning inside the classroom that allows students to become a well rounded nurse. It’s

the skills students need outside of a book like communicating, multitasking, empathy, and patient

center care to make a new nurse successful. Those are a few of many skills that are not learned

though nursing school. Without some of these skills the art of nursing can be very difficult to

manage as a career.

This pandemic started and took away multiple opportunities from students who use

offsite learning to continue through educational programs such as nursing. Students all over the

world including Youngstown State had to remotely learn from March of 2020 until an unknown

time. Another example of remote learning from Gallagher et al. (2022), on March 6, 2020, Penn
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Medicine’s journey to a virtual nurse residency program began. This new form of learning would

become the new way of life for all nursing students across the world. Students didn’t know what

would happen from week to week, even sometimes day to day. Contamination began to flood

students while going to clinicals causing quarantine for the whole group.

A distinct impact on all educational experiences within healthcare in 2020 as clinical

placement sites were unable to accommodate student experiences because of risk factors,

personal protective equipment conservation, and limiting group sizes (Smith et al., 2021). This

create unknowns that to this day universities are still trying to figure out. Clinical sites used in

the past did not want students entering for safety purposes. Some sites didn’t have enough

equipment for their own employees. Then sending students to that site would put everyone at risk

for infection of COVID-19. Not allowing students into the building became a major struggle the

nursing department thought they would never have to face.

The clinical aspect of nursing school throughout my experience has gotten better with

time. The university started virtually doing class and clinical then slowly progressed into being

in the classroom and going to offsites. This was a big step and allowed working with patients if

we are vaccinated. Being that our patient exposure was minimal there were deficits seen

throughout our clinical experiences.

A clinical judgement experience I had as a precepting student did not come with

confidence in my abilities. The ability to perform a wound care assessment and dressing change

on a patient created unease because of my time spent preforming wound care. When starting my

shift it was weighing on my mind that we had a huge wound assessment and dressing change to

preform before the end of the shift. During the first year of school that was where in class

learning was terminated. This experience of wound care dressings and check offs were
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completely moved March of 2020 and started online. It was known that I didn’t have a well-

rounded clinical judgment for wound care needs of patients. I never had a patient at clinical with

a wound that was as involved as this one. My judgement skills of how to even approach this type

of patient centered care were diminished. I had the mentor help guide my through the steps and

was able to critically think about how to pack the wound properly and apply a dressing. As

researched further by Smith et al. (2021), there is a recurring recommendation for organizations

to consider that NGNs (new graduate nurses) have been impacted by the loss of didactic

education, peer support, limited time to learn clinical skills, loss of opportunity to develop

critical thinking and clinical reasoning or to work on prioritization and organization, and a loss of

time to develop interprofessional communication skills. Reflecting back on the struggles that I

have gone through is helping me realize how lucky I am to have had these experiences

(Gallagher et al. 2022). This really helped ease the mind of other nursing students going through

unprecedented times, like a COVID-19 pandemic.

In conclusion, clinical nursing judgement is what nursing students put into it through

school, work experiences, clinical time and opportunities that come about through your career as

a nurse. Unfortunately the way nursing programs have run smoothly for years had to be

completely changed in 2020. There were many positives and negatives taken from this

experience that have affected my clinical nursing judgment. Many experiences throughout my

career as a new graduate nurse will cause great stress. Feelings about the pandemic learning from

Gallagher et al. (2022), without these experiences, I would not have noticed the depth of my

strength and character. Some things in life can only be taught through difficult times and

experiences; it has truly shaped me (Gallagher et al. 2022). This pandemic goes to show how

nursing has evolved so much over the years and still comes out on top. Every enormous struggle
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handed to the entire nursing field in the end works out. Nurses are strong, resilience, and willing

to change to put their needs above others. Over periods of time and with learning through trial

and error, nursing judgement skills will improve for the best patient outcomes!
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References

Gallagher, K. A. (2022). Adaptable, flexible, resilient, and strong: A nurse residency transition

during a global pandemic... : Journal for Nurses in Professional Development. LWW.

https://journals.lww.com/jnsdonline/Fulltext/2022/01000/Adaptable,_Flexible,_Resilient,_

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Smith, S. M., Buckner, M., Jessee, M. A., Robbins, V., Horst, T., & Ivory, C. H. (2021). Impact

of COVID-19 on new graduate nurses' transition to practice: loss or gain?. Nurse

educator, 46(4), 209–214. https://doi.org/10.1097/NNE.0000000000001042

Tofani, M., Berardi, A., Maceca, M., Valente, D., Mazzaccara, A., Polimeni, A., & Galeoto, G.

(2021). Fighting COVID-19 contagion among university students of healthcare

professions: an italian cross-sectional study. International Journal of Environmental

Research and Public Health, 18(23).

https://web-s-ebscohost-com.eps.cc.ysu.edu/ehost/pdfviewer/pdfviewer?vid=8&sid=bbaf559a-

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