Ashley McKee

2-22-22

Senior Capstone

Scholarly Paper

Clinical Nursing judgment is a skill developed over time as a nurse works in the field.

The more time students are exposed to critical patients where critical thinking is required,

the more skills they develop to take with them for the rest of their careers. As a student

myself, I am navigating the nursing world and developing clinical judgment in every clinical I

go to. I have seen myself grow into more of a confident nursing student as I progress in this

program. Clinical judgement is a very crucial part in the nursing field because nurses need

to be able to analyze information objectively and subjectively and understand how to react

and treat each unique situation. I observe the nurse’s I work with and each and every one of

them exhibit clinical judgement in all aspects of their work. The way they can use their

knowledge and skills is very admirable and I know that will come with more experience.

Having clinical judgement skills may be one of the most important skills a nurse can

develop because in some cases it can be a lifesaving decision made or caught by the nurse.

As stated in a nursing journal, “Clinical decision making is particularly influenced by

interpersonal relationships with colleagues, patient conditions, availability of resources,

knowledge, and experience” (Benner et al). This is encouraging because experience will

make clinical judgement easier and more secondhand nature as time goes on. Depending

on the conditions of the patient’s that the nurse is taking care of, directly influences the
amount of clinical decision-making skills they need. As nurses gain experience, they become

more confident in their knowledge and skills because they’ve seen many patients that have

had similar diagnoses.

As a senior in my last semester, I am on the floor more than I ever have been and

with being there more often, it is getting easier to make judgements that will benefit the

patients I am caring for. Clinical judgement is a skill that can always be improved on and

having good role models and teachers definitely help develop it. Clinical judgment is

defined as “the accumulation of knowledge and skills over time, which contributes to the

nurse's ability to analyze and synthesize the patient presentation, objective and subjective

data, and then provide evidence-based nursing interventions to improve patient outcomes;

clinical decision making” (KLUWER). A skilled and experience nurse is able to look at a

patient’s situation and make decision’s to better their outcome and enhance their

prognosis. As time goes on and new nurse’s work in the field, it will become part of their

everyday routine to use clinical judgment.

Even though I don’t work in the hospital outside of nursing school, I have still had

scenarios where I had to use clinical judgement for the safety and security of a patient. The

scenario that comes to mind when I think of using clinical judgement is a time where I was

doing my assessment on a patient and noticed there was a pinky tint to their foley bag. I

noticed in the previous assessments no one had documented the urine having a pink tint to

it, so I went to my nurse and explained my findings. I remembered in class we were taught

that if we saw that color in the urine it could mean they have a bleed. This patient was on a
heparin drip and that can cause the blood to thin to prevent clots. After explaining to the

nurse what I had assessed she then went into the room and she noticed the new findings

and immediately notified the physician. This simple assessment quickly turned into a very

important finding and the heparin was discontinued.

Although this was a simple example of using clinical judgement, it proved that I am

starting to use my knowledge from class and put it into practice at the hospital. It’s easy to

memorize things for a test but to then be able to pick it out in a real-life scenario and know

that it’s abnormal is what evolving as a nurse is supposed to look like. At that moment the

nurse thanked me for bringing it to her attention so that she could intervene quickly. In the

future, I hope to have more critical situations where I have to put my clinical judgement

skills to the test but it’s exciting that I’m starting to learn that aspect of nursing and become

more confident in my knowledge.

All in all, I am very excited to gain more critical thinking and clinical judgement skills

as my career moves forward. In the short amount of time I have spent in the hospital, I have

used glimmers of clinical judgement and times where decision making was very important

for the patient’s well-being. I admire experienced nurses because I can see how confident

they are in their skills and the knowledge that they have. They also exhibit interpersonal

skills with colleagues and co-workers, and everyone is very receptive to one another. I have

seen many times where a nurse asks another nurse a question or clarification on a situation

and they were so helpful and I’m hopeful I will be like them one day.
 References

Benner, P. (n.d.). Clinical reasoning, decisionmaking, and action: Thinking critically and

clinically. Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

Retrieved February 23, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK2643/

Embler, P. (2021, March 9). Imparting clinical judgment leading to sound clinical decision-

making and patient advocacy. Back to top. Retrieved February 23, 2022, from

https://www.wolterskluwer.com/en/expert-insights/imparting-clinical-judgement

Seidi, J., Alhani, F., & Salsali, M. (2015, September 28). Nurses' clinical judgment

development: A qualitative research in Iran. Iranian Red Crescent medical journal.

Retrieved February 23, 2022, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601210/