Running head: CLINICAL REASONING AND THE NURSING PROCESS 1

Clinical Reasoning and The Nursing Process

Carlie Eaves

Brigham Young University-Idaho

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Clinical Reasoning and The Nursing Process

Clinical reasoning, as it pertains to nursing practice, is essential for providing high-

quality patient-centered care. According to The Journal of Nursing Education, “Clinical

reasoning is the process whereby nurses use clinical judgment and critical thinking to make

decisions based on both knowledge and experience,” (Herron & Sudia, 2016, p.329). Critical

thinking is employed as nurses analyze patient situations and use observations to create the best

treatments for them. Nurses, as they incorporate critical thinking abilities into every facet of the

nursing process, are practicing clinical reasoning, and are able to provide the best care to their

patients.

Clinical reasoning also includes, “reflective, concurrent, creative and critical thinking,” (Foote,

2016, p.19). Reflective thinking is essential in analyzing patient care and creating new solutions

to difficult problems, creative thinking is necessary for planning innovative methods of care,

critical thinking is important for confronting new situations and concurrent thinking is imperative

as nurses understand each patient’s needs and plan for them. Each of these forms of thinking is

combined to create clinical reasoning skills in the nurse.

Clinical reasoning is manifested as nurses, “gather and analyze patient information,

evaluate it significance, and weigh alternative actions,” (Hunter &Arthur, 2016, p.1). These key

components of the nursing process are the foundation for understanding patient concerns and

conditions, alleviating symptoms, and promoting continued wellness and health across the

lifespan. Nurses who are proficient in clinical reasoning are more likely than novice nurses to

“recognize relevant information…predict a patient complication and recognize an emergent

patient situation,” (Stec, 2014, p.4). Experienced nurses also analyze details, such as patient

symptoms and concerns, that new nurses may overlook or see as irrelevant. The extra attention to
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detail, employed by the nurse who employs clinical reasoning, prevents complications and

problems before they arise instead of after they cause distress to the patient. The proficient nurse

prevents problems instead of simply treating them when they occur. This will ensure that patients

receive the best care available to them.

Novice nurses enter the clinical setting with much to learn, including the essential skill of

clinical reasoning. According the journal, Nurse Education Today, applying the clinical

reasoning skill “will allow students to move from simple to complex thinking which will

positively impact care delivery and patient outcomes,” (Giuliano & Von Colln-Appling, 2017,

p.107). Nursing practice is centered on the patient. Applying clinical reasoning in every setting

will help novice nurses prevent mistakes, increase awareness of the patient’s needs and create a

safe environment conducive to healing. Recently graduated nursing students have had several

opportunities to practice clinical reasoning by way of simulations, clinicals, and problem-solving

activities. When they enter the hospital or nursing home or other clinical setting, they will have

the opportunity to practice clinical reasoning through trial and error. With this improvement in

clinical reasoning skills, each novice nurse will become more proficient and be able to make a

difference in the lives of their patients and eventually, change the face of nursing altogether.
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References

Foote, J. M. (2013). Time is the essence: A grounded theory study of registered nurse's

experiences with clinical reasoning (Ed.D.). Available from ProQuest Dissertations &

Theses Global. (1412355436). Retrieved from https://search-proquest-

com.byui.idm.oclc.org/docview/1412355436?accountid=9817

Giuliano, D., & Von Colln-Appling, C. (2017). A concept analysis of critical thinking: A guide

for nurse educators. Nurse Education Today, 49, 106-109.

doi:10.1016/j.nedt.2016.11.007

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.

doi://dx.doi.org.byui.idm.oclc.org/10.3928/01484834-20160516-05

Hunter, S., & Arthur, C. (2016). Clinical reasoning of nursing students on clinical placement:

Clinical educators' perceptions. Nurse Education in Practice, 18, 73-79.

doi://dx.doi.org.byui.idm.oclc.org/10.1016/j.nepr.2016.03.002

Stec, M. W. (2014). Health as expanding consciousness: Patterns of clinical reasoning in senior

baccalaureate nursing students (Ph.D.). Available from ProQuest Dissertations & Theses

Global. (1543816177). Retrieved from https://search-proquest-

com.byui.idm.oclc.org/docview/1543816177?accountid=9817