Upon reading Christine A. Tanner’s article titled, “ Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing ” various aspects of the concept of clinical judgement are addressed. The research based model paper discusses factors of clinical judgement such as influence, impact, causes and effective uses based on the review of over 200 studies related to clinical judgement. The paper highlights and elaborates on the influence of nurses on clinical judgement. Also, the constitution of a sound clinical judgement, influences based on the context of the situation, the impact of proper practice in making proper clinical judgements among other matters are addressed in this research based paper by Christine Tanner. The main objective of this paper according to the author is to elaborate on the complexity of clinical judgement and how this can be applied to improve the nursing practice. By studying this paper I have developed various notions on the influences on clinical judgement. From the study I have also developed an understanding of the relation of intuition to clinical judgement in nursing practice as this paper will illustrate.
Influences on Clinical Judgments
In my opinion both experience and knowledge play significant and equal roles in influencing clinical judgement. This is because the clinical situation that demands for the use of clinical judgement require the use of both knowledge acquired in the course and practical training of nursing as well as experience gained in the field of practice for a proper clinical judgment to be made ( Tanner, 2006) . A nurse making a clinical judgement needs to assess the situation based on evidences in symptoms, medical history data to determine pathophysiological development and make accurate diagnostics before relevant action is taken (Musen et al., 2014). This forms the knowledge aspect in the influence of a nurse’s clinical judgement. However, given the situations in which clinical judgement is applied there is a complexity that may lead to error, thus the application of this knowledge in making a diagnosis and forming a relevant medical intervention requires a strong foundation. This foundation is built upon experience in the medical matter, which includes the experience of the nurse on the matter at hand as well as the family’s and the patient’s, social and physical incidences with the illness or injury that is to be tackled.
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With the complexity of situations that warrant clinical judgement as Christine Tanner elaborates on her paper error is highly likely to occur. To avoid this error, knowledge influences a nurse in the work environment by guiding them on the proper approach based on abstract concepts, and their experience influences the foundation of this knowledge by influencing its application in a practical approach ( Tanner, 2006) . An example of a situation where a nurse is required to use both knowledge and experience to influence their clinical judgement is when they have to attend to a varying number of patients and are tasked with prioritizing on which of them requires urgent care. However, in such a situation, more factors are required than just experience and knowledge in determining a nurse’s clinical judgement. One such factor is intuition.
Role of Intuition in Clinical Judgments
In my opinion intuition plays a significant role in influencing and the execution of clinical judgment to improve patient outcomes in the nursing practice. The knowledge acquired during the nursing training process is abstract since it is based on studied and concluded theories that inform the nurse on the professional practice (Stokke et al., 2014). Nonetheless, once they begin the practice experience is gained and this enables nurses to practically apply the knowledge acquired in their training in a healthcare institution setting. With time these nurses are able recognize medical states that require medical attention based on familiarity and are able to act promptly and efficiently in the tackling of the situation with proper medical interventions. This is known as intuition and it plays a major role in improving the nurse’s response and efficiency in handling clinical situations. Intuition is particularly efficient during the handling of emergency medical situations since it enables a nurse to act promptly, decisively and efficiently due to the knowledge in theory and experience that is readily available based on a pattern of practice. This therefore makes intuition a major contributor in terms of efficiency in influencing clinical judgement.
How to Develop Nursing Intuition
As an important aspect in the determining of proper clinical judgment and ultimately improving patient outcomes in the nursing practice it is necessary to develop intuition. Intuition can be developed based on the two factors that form its foundation, which are knowledge and experience in improving clinical reasoning ( Tanner, 2006) . To achieve this, the knowledge learned and its practice in the nursing profession is applied in the break-down of medical intervention process.
This entails the following stages; noticing stage where a nurse applies their knowledge to form expectations and make relevant assessments, interpreting and responding phases where the nurse use their knowledge to determine the next course of action, and the reflective stage where the situation, action and outcomes are assessed and clinical learning is derived from the whole process. The repetition of this process creates a pattern of experience that enables the nurse to intuitively assess and respond to clinical situations appropriately using the knowledge and experience patterns that have been developed over time and has formed a pattern of practice.
References
Musen, M. A., Middleton, B., & Greenes, R. A. (2014). Clinical decision-support systems. In Biomedical informatics (pp. 643-674). Springer, London.
Stokke, K., Olsen, N. R., Espehaug, B., & Nortvedt, M. W. (2014). Evidence based practice beliefs and implementation among nurses: a cross-sectional study. BMC nursing , 13 (1), 8.
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of nursing education , 45 (6).
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