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CLINICAL NURSING JUDGEMENT

Scholarly Paper: Clinical Nursing Judgement

Chaylee Bentley

Nursing Department – Youngstown State University

NURS4852: Senior Capstone

Professor Ballone and Professor Thomas

March 15th, 2021

What is Clinical Nursing Judgement? “Historically, nursing clinical judgment has been

described as a process by which a nurse decides on the data to be collected about clients,

interprets the data, arrives at a nursing diagnosis, and identifies appropriate nursing actions

(Martin et al., 2020). This is a very good explanation of what Clinical Nursing Judgment is and

how it is used by nurses everywhere. As a nurse, you take on the role of being a master problem

solver. This means that “Nursing clinical judgment involves problem solving, decision making,

and critical thinking”. Wendy Manetti wrote that another published article defined clinical

judgment as “an interpretation or conclusion about a patient’s needs, concerns, or health

problems, and/or the decision to take action (or not), use or modify standard approaches, or

improvise new ones as deemed appropriate by the patient’s response.” (2018). Humans are like

snowflakes. We are all so very different in so many ways such as our genetic makeups, responses

to treatments, responses to medication, and how illnesses or injuries affect us. This means each

patient we encounter is like a brand-new case. We have to be the ones to figure out what will

work best for each specific patient and meet those different needs accordingly.

This is important because nurses can encounter a wide variety of problems on a shift to

shift basis. So, through the use of Clinical Nursing Judgment a nurse can make informed,

reasoned, and sound decisions and choices to help provide the best care possible to each patient

that they encounter. Nurses tend to often work as a team so again if each of them uses proper

and safe Clinical Nursing Judgement this means that as a team they can be more productive as

well. Along with having the ability to help each other provide safe and effective care while at

work. One decision can change the outcome of patient’s situation or illness. So, this is a big coat

to carry. Making the right decisions for each patient is vital in providing quality nursing care. It

was stated by (Herron et al., 2016) “Safe and effective provision of patient care is an essential
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goal of nursing (American Association of Colleges of Nursing, 2008). Positive patient care

outcomes result from well-educated nurses who have the ability to clinically reason through both

emergent and nonemergent patient care situations and make sound clinical judgments (American

Association of Colleges of Nursing, 2008)”. Essentially, this becomes the job of the Nursing

Program to give their students a good foundation of Clinical Nursing judgment and then the

hospitals must also be responsible in making sure they provide their staff with effective and safe

Clinical Nursing Judgment education as well.

I have had the opportunity to put my skill set and nursing knowledge to the test in many

different settings while in Nursing School. Youngstown State University’s nursing program has

provided me with the fundamentals of providing competent Clinical Nursing Judgement. Being

that graduation is only a few short weeks away, I’d like to use a scenario from the beginning of

my program. The scenario that I would like to share and my most memorable scenario took place

at our very first clinical rotation. We had been spending time at a nursing home. I had been

taking care of my patient on this particular day. One of the nursing home residents sitting in a

wheelchair in the dining room had appeared to be in distress and agitated. As a fresh nursing

student in the clinical setting it was scary for me to know what I was allowed to do and what I

wasn’t allowed to do. I had seen staff get frustrated with this patient and put her in her room

alone. I decided to walk up the hallway of this patient room. I wanted to get a feel for the

situation myself to see if there was anything that I could do to help this patient and meet their

needs. I come to find out that this patient could not communicate with me. The patient was alert

but not oriented to person, place, or time. So, I see that I hit a roadblock and I had to find a new

way to communicate with this patient. I chose to point at different objects or options with short

simple phrasing and words. The patient had been yelling and tugging on her bottoms. So, my
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first thought was that she was uncomfortable and wanted to change. Then I thought ok maybe the

patient needs to use the restroom. So, since this patient could not communicate with me and she

wasn’t the patient I was assigned to me had to find a staff member who knows this patient and

how this patient goes to the bathroom. This shows that I made a wise decision to check with a

staff member on how this patient ambulates for the patient’s safety instead of just getting her up

on my own and taking her to the bathroom without knowing her medical conditions. She had not

even been an assigned patient on the day of care. One of the staff members came in to show me

that the patient uses a bedside commode and needed assistance getting out of bed. The patient

refused to cooperate with transferring to the bedside commode until the staff member left the

room. She wanted me to help her use the bathroom. After I got her cleaned up and back in bed,

she grabbed my hand and said, “thank you”. Each time I went back to the nursing home that

semester she made sure she got to see me. This was such a rewarding experience and it made me

feel like I did something right even though I was brand new to the nursing world.

Not only have I gotten to use Clinical Judgement in the nursing world I have also carried

it outside of the clinical setting and into my daily life and my part time job as well. An example

of this is that I work for an eye doctor. So, when patients come in for their exams before they

enter or leave a room I always make sure that the exam chair is in the lowest position. This is to

ensure their safety when sitting or rising from the chair and prevent injuries or falls. Another

example is that I have a sister who is physically disabled. I help in her daily care routine. One

example of an important judgement call in her daily care is having to decide how to safely

transfer her from one location to another, whether it be from the wheelchair to the bathroom, or

from the bed to the wheelchair. She must also be watched going from room to room around the

house. This is important because it also keeps her safe and free from injury. It always prevents
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injuries to those who are transferring her. So, as you can see from reading this paper. Providing

competent and safe Clinical Nursing Judgement is a really important factor and part of a nurse’s

job.
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References

Herron, E. K., Sudia, T., Kimble, L. P., & Davis, A. H. (2016). Prelicensure Baccalaureate
Nursing Students' Perceptions of Their Development of Clinical Reasoning. Journal of
Nursing Education, 55(6), 329–335. https://doi.org/10.3928/01484834-20160516-05

(Herron et al., 2016)

Martin, B., Greenawalt, J. A., Palmer, E., & Edwards, T. (2020). Teaching circle to improve
nursing clinical judgment in an undergraduate nursing program. Journal of Nursing
Education, 59(4), 218–221. https://doi.org/10.3928/01484834-20200323-08

` (Martin et al., 2020)

Manetti, W. (2018). Sound clinical judgment in nursing: A concept analysis. Nursing Forum,
54(1), 102–110. https://doi.org/10.1111/nuf.12303

(Manetti, 2018)