The nursing practice requires that all nurses are able to display the qualities of sound judgment and good decision-making skills. This is so because critical thinking and clinical judgment form the fundamental basis of the nursing practice. Clinical judgment is believed to be affected by the context in which a situation occurs in addition to the culture of the nursing unit. It follows the steps of observation, reasoning that may involve knowledge and experience, critical thinking, and finally making the judgment (Alfaro-LeFevre, 2015). I can, therefore, define clinical judgment and reasoning as an enlightened opinion taken by the nurse after observations and the reflection and analysis of these observations. In this essay, therefore, I will make a self-reflection about my learning sessions throughout the semester.
The subject learning outcomes included integrated clinical performance, cooperation, clinical judgment, and leadership. By the end of the semester, I was supposed to develop skills in integrated clinical performance. This would ensure that clinical performance is desegregated to ensure that everyone regardless of their race is taken care of. As a result, a culture of excellence in patient experience, patient safety, and quality of care is improved. I was also required to develop cooperative skills by the end of the semester. These skills would help me in cooperating with health practitioners from other departments and ensure that patients receive quality care thus ensuring patient safety. Skills of cooperation would also help in case I wanted to persuade a patient to cooperate with the clinical procedures to guarantee quality care. Another subject learning outcome that was necessary was the skill of clinical judgment that would ensure that every clinical decision I make is well thought of and safe. Finally, I was supposed to develop leadership skills. This is because when a time to make a critical decision about the health of a patient comes, then one has to show leadership qualities and make the informed decision carefully.
I understood that all these learning outcomes were very important in the nursing practice and from the beginning of the semester; I strived to realize these learning outcomes. I responded best by having my personal learning outcomes. I wanted to use clinical judgment and reasoning to provide safe and quality care that would promote the health of patients, their families, community, and society at large. This would thus enable me to make decisions and reach clinical judgments as health situations of individuals change (Cappelletti, Engel & Prentice, 2014). As a result, I would make improvements in the care of patients, their families, the community and society.
There are some proofs and pieces of evidence showing that I achieved both the subject and my personal learning outcomes. Firstly, through integrated clinical performance, I was able to implement the principle of patient focus. According to studies, meeting the needs of the patients rather than the providers is a very strong justification for an integrated delivery system. Any organization or health practitioner that fails to place the patient at the center of the care delivery rarely sees any success. I was thus able to receive good success with some of the patients I cared for during my learning and this also helped to build trust with them. Additionally, due to my great clinical judgment qualities that I was able to build throughout the semester, all my colleagues respected me and in their eyes, I was a leader. In most cases, my opinions on several decision-making situations were always needed. This showed that they believed in me to get things done and to make sound clinical judgments. This success was also as a result of the great cooperation I had with all my colleagues and some of the patients that I attended to. My skills in clinical judgment and reasoning also ensured that I provided quality care to all the patients to improve their health and their families.
I can confidently say that neither my goals nor my personal learning outcomes changed. At the beginning of the semester, I had a clear mind of what I intended to achieve. I, therefore, worked hard to achieve all these goals and to realize my personal learning outcomes. There were some notable changes in my behavior and practice. For example, I focused more on providing a patient-centered approach to care as this technique always led to better health outcomes. I also applied evidence-based decision making to ensure that care was accurate and safe for all patients.
Judgments Regarding the Subject
I would say that the learning of this subject was a success and it taught me a lot that I had never known before. I gained a lot from the set learning outcomes. I improved on my leadership skills, my cooperation with the patients and other colleagues got better, my judgment and reasoning regarding health were more accurate and sound, and I was able to implement an integrated clinical performance. I would however also say that there were other things that I learned from this subject that were not among the set learning outcomes. All these were very helpful in my practice as a health practitioner. Below I will discuss some of the things that I learned which were not part of the predetermined learning outcomes.
I learned that decision making is in most cases related to the field of practice. For example, I realized that nurses in the coronary care unit preferred the use of intuitive decision-making when compared to their counterparts from the general unit. This is so because the patients in the coronary care unit normally experience sudden shifts in their health conditions and this may necessitate the application of sound clinical judgment and good decision making.
I also learned that not every patient would always be satisfied with your decisions and judgments as a nurse. Some of the decisions may be influenced by the knowledge taken from physical examination and the history of the health condition. Therefore, every nurse should apply an evidence-based approach to aid in making the right clinical judgments and decisions that may prove to be crucial to an individual’s health condition (Howick, 2011). This approach is necessary regardless of a nurse’s longevity in the nursing g profession. I additionally learned the importance of promoting a healthy workplace culture. This kind of culture is useful in developing the confidence of a nurse and motivating them to improve their nursing skills and knowledge.
I would like to take the initiative of furthering my learning and sufficiently pursue some aspects that I was unable to cover within the confines of the subject. I would like to use a computer-based cognitive representation approach to improve my clinical judgment and decision-making skills. This approach normally involves the mapping of an argument in order to externalize to the process of problem-solving and thus revealing the knowledge created from the problems (Gerdeman, Lux & Jacko, 2013). It is important to note that this subject is difficult to learn since it involves complex processes used to collect all the pieces of evidence regarding a problem, evaluating the collected data and formulating a reasonable hypothesis. However, the use of computer-based cognitive representation approach helps in effectively fostering system thinking and reasoning when it comes to making decisions about crucial health conditions.
I would also like to pursue some other aspects of clinical judgment and reasoning that were not covered in class. This pursuit would further aid me in developing most of the necessary skills that I would require to effectively practice as a nurse. Some of the aspects that I would like to pursue include standards of care, patient-nurse relationships, and clinical deterioration among others. Understanding the standards of care is useful in providing quality care practice for the patients. It is also useful in understanding care priorities and the levels of care to improve the quality of care and guarantee patient safety. Additionally, understanding the patient-nurse relationship is useful in knowing how to relate to patients and gain their trust. Once a patient trusts you then it becomes easy for them to believe in your clinical judgments (Layne, Steinberg & Steinberg, 2014). Finally, it is important to learn and understand the factors that influence patient deterioration so that I can apply the skills of clinical judgment and decision making to make swift clinical decisions that can help in improving the patient’s health and preventing deterioration.
In conclusion, I can with confidence say that clinical judgment and decision-making is a very important aspect of the nursing profession. It helps in making informed judgments through critical thinking to aid in improving the quality of health. Every nurse should be able this skill when making clinical decisions that could directly impact the health of the patient, their families and the community at large.
Alfaro-LeFevre, R. (2015). Critical Thinking, Clinical Reasoning, and Clinical Judgment E-Book: A Practical Approach. Elsevier Health Sciences.
Cappelletti, A., Engel, J. K., & Prentice, D. (2014). Systematic review of clinical judgment and reasoning in nursing. Journal of Nursing Education, 53(8), 453-458.
Gerdeman, J. L., Lux, K., & Jacko, J. (2013). Using concept mapping to build clinical judgment skills. Nurse Education in Practice, 13(1), 11-17.
Howick, J. (2011). The philosophy of evidence-based medicine.
Layne, C. M., Steinberg, J. R., & Steinberg, A. M. (2014). Causal reasoning skills training for mental health practitioners: Promoting sound clinical judgment in evidence-based practice. Training and Education in Professional Psychology, 8(4), 292.