Nursing Process and Clinical Decision Making

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Nursing Process and Clinical Decision-Making
The nursing professional faces a myriad of decisions on a daily basis. The effectiveness of the decision-making process is crucial to ensuring positive outcomes in the clinical setting. If the nursing process is misunderstood or misapplied to the decision-making process by a failure to use critical thinking skills, the results can be catastrophic to the anticipated outcomes. Furthermore, an immaturity in critical thinking may influence decisions because of insufficient knowledge and experience. This paper will explore the role of critical thinking and the nursing process in making clinical decisions. Additionally, clinical maturity will be addressed as a key component of critical thinking and making-clinical decisions. Finally, these elements will be applied to a case scenario to demonstrate the progression of clinical decision-making by applying critical thinking skills through the nursing process. When faced with a clinical problem, the nurse must go through an ordered series of steps to arrive at a sound clinical decision. While there are many versions of these steps, they can be summarized as follows. First, the problem must be identified and stated (e.g., the patient is bleeding from a laceration). Second, the goal must be stated. This many be multi-tiered (e.g., the goals would be to stop the bleeding and prevent shock). Third, the goals must be prioritized (e.g., stopping the bleeding must take precedence over preventing shock). Fourth, interventions must be developed to accomplish the goals (e.g., direct pressure, elevation, arterial pressure, and tourniquet). Fifth, the interventions must be evaluated and ranked according to recognized standards of care (e.g., direct pressure is first, then elevation, then arterial pressure, and as a last resort, a tourniquet). Sixth, the interventions must be evaluated as to any negative effect that may arise in the situation and appropriate steps determined to...
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