American Sentinel University The Use of Clinical Reasoning in Advanced Physical Assessment The advancement of medicine, complexity of diseases, and the nurses’ ability in becoming increasingly autonomous, requires nurses to be prompt in solving problems. The expectations of the health care industry and society of shortened hospital stay, the need for nurses to do more in less time, and the overall intensity of the nursing care provided to patients continues to affect how nurses think and deliver patient care. The constantly changing world of health care mandates nurses to utilize clinical reasoning to guide their practice. The purpose of this paper is to discuss the relationship between clinical reasoning and clinical decision making, consider clinical reasoning in advance physical assessment and identify the nurses’ use of critical thinking, clinical reasoning, and clinical judgment.…
Nurses must also be able to critically think through each situation and make a clinical judgement when it comes time to activate…
The nursing process follows five chronological steps. The steps are assessment, nursing diagnosis, planning, implementation, and evaluation. These steps are necessary for nurses to follow…
If a nursing intervention follows the nursing process, e.g., assess, diagnose, plan, implement, and evaluate – it demonstrates the clinical reasoning that supports the patient care. As cited by Alfaro-Lefevre (2012) Skip the principles of assessment and diagnosis and it’s easy to jump to conclusions, miss risks, and give care based on assumptions rather than evidence. Assessment errors and omissions are a major cause of adverse outcomes. If you fail to plan before implementation, the risk of adverse outcomes also increases. Skip evaluation, and reflective nursing practice (not to mention patient safety) goes out the door (p. 1).…
The six stages of ASPIRE involve a problem solving approach that helps nurses to identify patient’s problems and nursing diagnosis. Yura and Walsh (1967) present the nursing process that comprise the four stages which are assessment, planning, implementation and evaluation (APIE). The nursing process was presented as is a systematic method of planning and delivering care to patient. (McCormack and McCance, 2010). It also a process by which nurses obtain information, then record the information in order to evaluate whether the care implemented is proving successful (Barrett, Wilson and Woollands, 2012).…
The nursing process has six steps assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It is focused on patient centered care using critical thinking. My role as a RN will be different than my role as an LPN because, the RN has to be accountable by making sure the full plan of care is executed to provide quality patient care. When you conduct a assessment as a RN the information you collect must be well written, organized and clear. You will use objective and subjective data when you do a patient assessment.…
This journey is meaningful to my nursing practice because it has ensured my success in clinical placements. Also, through the development of this skill, I am confident to say that I am ready for the transition to professional practice and I understand that critical thinking is not a standard nursing competency but a recurring theme that runs through various competencies. For my future practice, I hope to utilize critical thinking to study ad pass my NCLEX examination. Using this strategy will provide a framework for thinking through test questions and picking out correct choices (Ward & Morris,…
21). The purpose of critical thinking in nursing arises from the complex nature of client care; often the client is unable to articulate the underlying reason of their condition, which will require the nurse to provide a solution with limited information (Coutts, 2014). The rise in patient complexities presents increasing pressure and accountability for nurses to make informed decisions (Coutts, 2014; Lauri & Salantera, 1995). Due to the ambiguous nature of nursing and complex client diagnoses, nurses must apply insightful reasoning, intuition, theoretical knowledge, and previous experiences as their guide to making a decision (Banning, 2008; Blum, 2010; Coutts, 2014; Gillespie & Paterson, 2009; Lauri & Salantera, 1995; Payne, 2015; Tanner,…
Effective clinical reasoning skills are essential in nursing; an estimated half of all clinical adverse events are attributed to errors in clinical decision-making (Levett-Jones et al., 2013). Tanner (2006) defined clinical reasoning as the process via which nurses arrive at clinical decisions by weighing evidence, pattern recognition, using intuition, selecting from alternatives and patient safety. This clinical reasoning cycle (CRC) consists of 8 cyclical steps namely, consideration of the patient’s situation; collecting of cues and information; processing of information; identification of problems and issues; establishing objectives; taking action; evaluation of outcomes; and reflecting on processes and new learning (Levett-Jones, et al.,…
Research, Roles, and Values in Nursing Nurses perform many roles as they provide care on any given day. Nurses are educators, leaders, managers, providers of care, and members of a profession. They use the latest research and evidence-based practice to provide care to their patients. Nursing theories are also incorporated into the daily routines of nursing. A theory is “a method of perceiving reality and mapping the complex processes of human action and interaction that affect nursing care” (Houser, 2012, p. 135).…
Critical thinkers in nursing exhibit these habits of the mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open-mindedness, perseverance, and reflection. Critical thinkers in nursing practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge. Based on Benner’s theory, every nurse should be a critical thinker. The theory also helps nurses understand to solve the critical problems with smartly.…
Critical thinking involves identifying the problem, determining the solution and the best way to reach that solution. So a person who thinks critically concern about an event that was it effective and might have done in a better way. However as a nurse, should have the ability to make clear and correct decisions even at an immediate situation. Therefore it is vital to develop those skills in nurse’s education where some critical thinking skills come naturally. For instance when a nurse undergoing with a treatment of patient, wound treatment nurses are able to make instant decisions under pressure.…
Critical thinking skills are important in nursing as it allows appropriate triage, treatment options and the appropriate disposition of the…
Decision-making involves critical thinking and critical analysis they are important as they make the nurses into competent management skills Jones (1996). In my practise setting I was given the…
As the theory is evolving the nursing discipline is also changing or upgrading. Nursing theories are able to predict the future in nursing practice, more so, caring is difficult to measure, but theories and principles can analyze and explain the level of care that nurses can give. The complexity of nursing practice is also simplified by appreciating or relating to the theories where nursing situations are explained (Smith & Parker, 2015). Most importantly, theories act as one of the most important basis for decision…