The Clinical Decision-making and Nursing Process

Define clinical decision-making and briefly describe the nursing process.

Internal and external variables such as the nurse’s personal experience, knowledge, creative thinking ability, education, self-concept, as meshed with the nurses’ working environment, and situational stressors all can work to enhance or inhibit effective clinical decision making for a nurse. (O’Reilly, 1993) Clinical decision-making is defined as the ability to sift and synthesize information, make decisions, and appropriately implement those decisions within a clinical setting. Practicing nurses must effectively identify and solve the problems of patient diagnosis and treatment by using such a model. One means of doing so, paradoxically, is to identify the barriers to decision making so they can be overcome by the use of more effective decision-making tools. The nursing process itself involves the need for quality decision-making at every stage of assessment, diagnosis, planning, implementation, and evaluation of patient needs and demands. (“Nursing process,’ 2006, Wikipedia) Thus, both processes are interrelated; as to be a good nurse a nurse must be a good decision-maker.

Describe Patricia Benner’s stages of clinical judgment.

According to the nursing theorist Patricia Benner (2004), the novice nurse has little experience, and must essentially proceed by rote to function as an effective nurse in the clinical setting, such as a first-year nursing student who needs constant guidance from other hospital staff members. A recent graduate nurse or advanced beginner possesses some minimal clinical practice and can grasp attributes but not aspects of the clinical setting without constant assistance. In contrast, a competent nurse has a filtering device of experience to know what to ignore and what to assimilate in the clinical setting, based upon greater levels of experience than the advanced beginner nurse.

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