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Registered nurses perform a fundamental role in caring for a surgical patient. Effective clinical reasoning involves a method of planning and implementing interventions by processing information, collecting cues, understanding the patient situation, evaluating the outcomes and reflecting and learning from the procedure performed. ‘Failure to rescue’ is one of the key causes of adverse patient outcomes due to nursing compliance, the advances in medical technology, more complex conditions being faced and the increased patient to nurse ratios. Throughout this assignment, a patient has been admitted to hospital for a left knee replacement. This discussion will relate to the appropriate nursing actions performed by a nurse in order to prevent post-operative complications and promote discharge planning. …show more content…
Clinical reasoning has been defined by Tanner (2006) as ‘a process by which nurses make clinical judgements by selecting from alternatives, weighing evidence, using intuition and by pattern recognition’. It involves the judgements of what is wrong and clinical decision-making of what to do (Levett-Jones et al.,
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
Critical thinking and knowledge are the foundation of nursing practice, and the most essential elements in providing quality nursing care. Nu...
nurses who frequently enhance the communication problems in discharge planning, and who strive to improve the working relationship, collaboration and who use the teamwork approach to patient and family centered discharge planning will greatly reduce patient readmission (Lo, Stuenkel, and Rodriguez, 2009, p. 160). Lo, Stuenkel and Rodriguez (2009) emphasize that an organized and well prepared discharge planning, education of patients with multi-lingual services and use of different methods of teaching greatly improves the patients’ outcome (p.157). These include an experienced and well-taught phone call follow-up sessions after discharge along with ensuring the extension of adequate postoperative care. Another way nurses can deliver a planned discharged teaching is by providing direct checklist for patient and family to follow. One must understand that these approaches will enforce the staff nurses and other health care providers to develop the safe patient transition to home.
Define a critical thinking task that your staff does frequently (Examples: treat high blood sugar, address low blood pressure, pain management, treat fever, etc.). Create a concept map or flow chart of the critical thinking process nurses should take to determine the correct intervention. Include how much autonomy a nurse should have to apply personal wisdom to the process. If the critical thinking process was automated, list two instances where a nurse may use “wisdom” to override the automated outcome suggested. Note the risks and benefits of using clinical decision-making systems.
Clinical decision making involves the gathering of information, awareness, experience, and use of proper assessment tools. The term is often used when describing the critical role of nurses. The process is, therefore, continuous, contextual, and evolving. Authentic practices and experienced people are required to offer guidelines when needed. Effective decision making in clinical environment combines skills such as pattern recognition, excellent communication skills, ability to share, and working as a team, reflection, use of the available evidence and guidelines as well as application of critical thinking. A Clear understanding of this term contributes to consistency, broadening of the scope and improving the skills. However, this paper aims at providing an opinion on clinical decision making and how it is connected to nursing practices.
In order behave professionally, first of all, one needs the willingness to learn and be self-aware. Self-awareness would allow the respondent to realise her limitation on “between the flags” policy and be willing to learn and improve her clinical knowledge. If she had done so, she would realise the importance of documentation and the urgent need to arrange medical review for Patient A, preventing her condition from further deteriorating instead of making assumption that urgent medical assistant was unnecessary as long as the continuous administration of antibiotics. Additionally, with a sound professional experience and knowledge, clinical reasoning skills are also essential in professional behaviour. If the respondent had used problem solving, critical thinking and intuitive thinking skills to recognise and respond on Patient A’s deteriorating condition, she would have applied clinical judgement and decision making skill to prioritise the patient’ need to be urgently medical reviewed by the ED doctor even though she may receive some verbal abuse. Once she is confident with her clinical reasoning and judgement, she would take action on arranging urgent medical review, documenting her assessment for further examination and
The healthcare system is very complex, and the nurses should be aware of all the policies, laws, ethics, and available sources to provide quality care to all patients. The following case study will explore some of the decision-making processes the nurses consider while caring for their patients to keep high standards of care.
We are not only responsible for patient care, but we are also included in many other roles. Before nursing school, I thought that the main responsibility of the nurse is to take care of patient. During nursing school, I learned that patient care was not the nurses known just for. We took many general courses and nursing course work to prepare ourselves to be an educated member. For example, it was required to us to take microbiology, anatomy, leadership, professionalisms, etc to help us to become a better nurse and have a foundation base of education. We give patient care in the hospital, but we are also provider of care. We use the nursing process to help and make decision for our patient. Our decisions are based on critical thinking, clinical reasoning, and accountability. We are hold accountable for everything we do and based on our judgment to provide care to the best of patient’s benefit. We are also known for our role as a manager, designer, and coordinator of patient care. I plan and coordinate patient’s care based on their health care needs. In clinical, my patient has a Foley catheter, I will know to plan and implement Foley care to help with personal hygiene and preventing infections. It is important to make decisions based on priorities, time, and resources. As nurses, we need to know how to delegate and ask for assistance when needed. For example, I needed help to ambulate my patient who has a total knee replacement, I then ask
pg. 19, 2014). The first rule of nursing is to do no harm, but since we are human, errors will happen. Inaccuracies in delivering treatment are due to mistaken identity, falls, burns, nosocomial infections, suicides, death or injuries due to restraints, wrong site surgery, surgical injuries, transfusion errors, adverse drug events and pressure ulcers (Kohn and Donaldson, pg. 35, 2000). Nurses use autonomy to contemplate on where corrections can be made through their daily routine. By knowing where the shortcomings are in delivering treatment, allows for errors to be corrected and to decrease adverse patient outcomes.
The general idea of, K, is that a nurse must have knowledge in the diversity of cultures, ethics, and education. The significance of this faction being that if the nurse is cognizant of the patient 's culture, beliefs, family values, support systems, and education level, a more thorough and comprehensive plan of care can be formulated. The premise of, S, is that a nurse must be skilled in the ability to communicate with and advocate for the patient, assess for and properly treat pain, and incorporate the needs and concerns of the patient and their family. The significance of this group and development of these skills include the achievement of pain control, increased rehabilitation periods, and an increase in patient/family satisfaction. The theme of, A, requires that a nurse maintains an open attitude toward the patient and to respect and validate the nurse-patient relationship, which will aid in a positive nurse-patient
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal Of Nursing Terminologies & Classifications,21(2), 82-88. doi:10.1111/j.1744-618X.2010.01150.x
A diagnosis is the expert and clinical judgment of the patient 's present or potential medical issue. During the 1970s and 1980s, a controversy about nurses using the term “diagnosis” began. Up until then, only physicians held the ability to diagnose a patient. But the nursing diagnosis is completely different than a medical diagnosis. In other words, a nursing diagnosis is a judgment based on a comprehensive nursing assessment (NANDA, 2013). Nursing diagnoses must be promoted by data or signs and symptoms.
There are many members of the inter-professional team, all of which are contributing to the healthcare of acute and critically ill patients. Every member of the team has had education and obtained a license of practice compatible to their level of knowledge (Prater, Fundamentals of Nursing, 2013). As a practical nurse you need to be mindful of your scope of practice in relation to registered nurses, certified nurses’ assistants and other healthcare professionals. With so many different people involved in the immediate care of a patient, there is always the possibility of a mix up. The purpose of this paper is to help differentiate between the roles of the healthcare staff, which will in turn help develop a knowledge base for prioritizing care;
Second method of how healthcare workers such as nurses make judgments and decisions has been known as Intuition. Intuition is defined by Shaban (2005) as “understanding without a rationale or an immediate knowing of something without the conscious use of reason, or a knowledge of a fact or truth, as a whole, with immediate possession of knowledge and an independence from linear reasoning process. There is no definite definition of intuition but the common contextual meaning of it is that the judgment and reasoning process just happens, cannot be explained and is not rational.” Based on a series of ingenious experiments, some cognitive scientists have posited that much of our intelligence and problem-solving capacities are not conscious
Compared with medical professionals, nurses appear to be reluctant to rely on professional rationales for their actions, preferring to use managerial justifications and implementing ‘top down’ approach to care. (Adamson, 2013). When a gap in nursing care is perceived, theory is often used to improve these outcomes. Theory provides an overall vision and understanding of the profession of nursing by offering guidance. Not only in nursing, but theory can be applied to any profession as it serves as a tool for guidance of practice. The legitimacy of a profession is based on its ability to generate and apply theory (McCrae, 2012). Without nursing theory, nursing would be a profession guided by by medicine and physicians. Theory guides nurses by shaping its professional boundaries and helps nurses make decisions on current and potential patient needs.