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Nursing Judgement
Emily Shields
Clinical Judgement
CLINICAL JUDGEMENT 2
Introduction
Throughout the course of nursing school we are loaded with an innumerable amount of
information, constantly probed by our instructors to think through patient scenarios critically.
However, to be a competent nurse it cannot stop there. Beyond critical thinking a nurse must
assessing the needs of the patients and deciding about the continuance or adjustment in taking
care of them in a cognitive and reasoning thinking process” (2017 pg. 1). It is a basic nursing
skill (Pouralizdah 2017). Nursing judgment includes the use of the nurses knowledge, intuition,
critical thinking, and critical reasoning to interpret the data and achieve the best evaluation of the
patients’ conditions (Pouralizdah 2017). It is important to note that clinical judgement and
critical thinking, although overlap in some ways, are defined differently but used tandemly. Mary
Cazzell argues in that, “critical thinking and clinical judgement are two separate concepts and
require separate, concise definitions to guide nurses and nurse educators” (2016 no pg.). Critical
thinking is tool used to make a final nursing judgement. Additionally, critical thinking also does
not happen alone. First, the nurse must gain a range of knowledge on the patients she is caring
for in order to even begin implementing critical thinking and nursing judgement. According to
Robert J. Evans, “skills in themselves do not contribute to the development of the profession but
that the knowledge base and clinical judgement has to be developed in tandem with the skill in
order for nurses to play a meaningful role within the healthcare system” (2006 pg. 156). Many
times throughout nursing school we have heard the phrase, “listen to your gut.” This does not
mean to throw out the text books and do whatever you “feel” is best. It does however press us to
be aware of our patients’ situations and remember that our intuition and “gut feelings” need to be
CLINICAL JUDGEMENT 3
listened to. A nurse can make a huge impact on the outcome of a patient and using her clinical
judgement is what facilitates the opportunity to improve the status of her patient.
Body
A nurse is a vital component to the management and success of the patients care. The
nurse many times will be the one spending the most amount of time with the patient,
implementing most of the doctors’ orders, assessing the patient, monitoring the patient, and
caring for the patient. Their input is crucial and their competency is necessary. To be clinically
competent it is required that the nurse have knowledge, skill and judgment inherent in the
practice of the profession (Evans 2006). Without it, the trust and desire needed to work together
is not possible (Evans 2006). This is why the development of nursing judgment is so important.
According to Moluk Pouralizdeh, “With the development of clinical judgement, the nursing care
competence. It can lead to creating effective health care interventions and promotion of the
health in patients” (2017 pg. 3). So one reason why clinical judgement is so important is that it
There are many things that are involved in obtaining proper clinical judgement and
becoming clinically competent. One study reported that only twenty four percent of new nursing
graduates meet clinical judgement expectations (Pouralizdeh 2017). So what can nursing
educators do to accelerate the nursing students’ development of clinical judgement and prepare
them to be competent in their field? Mary Cazzell would suggest to make more use of simulation
as a strategy to facilitate deductive skills (2016 pg. 89). Along with this the literature mentions
multiple times about the importance of learning “therapeutic communication” and “proper
interaction with patient” while developing clinical judgement (Pouralizdeh 2017). According to
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staff and patients in the development of students’ clinical judgement” (2017 pg. 6). And of
course, clinical judgement is also grown in a nurse by gaining more experiences. The nurses
knowledge level, experience, and skill at integrating these factors determine their level of
judgement in the healthcare setting (Evans 2006 pg. 154). Gaining clinical judgement as a nurse
should be a focus in both nursing schools and hospitals for the improvement of patient care.
Conclusion
critical thinking to make a proper evaluation of the patient’s status and make a decision for their
care. Clinical judgement is vitally important for the nurse to have, to participate in the
management of care effectively, improve the quality of care, and become competent in their
profession. Nurses can gain clinical judgement in many ways. They can participate in different
simulations to promote awareness of certain scenarios. They can learn how to effectively
communicate with their patient and the healthcare team involved in the care. They can continue
to grow in their knowledge and understanding of certain disease processes by completed the
required continuing education hours. They also will need to gain experiences by practicing as a
nurse for an extended amount of time and then learn to integrate their knowledge and experience
to make appropriate judgements. Overall, defining what clinical judgment is, understanding why
it is so important and learning how to gain it is a very important thing for the newly graduating
nurse to know.
References
Cazzell, Mary, and Mindi Anderson. “The Impact of Critical Thinking on Clinical Judgement
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Evans, Robin J., and Glenn W. Donnelly. “A Model to Describe the Relationship Between
Knowledge, Skill, and Judgment in Nursing Practice.” Nursing Forum, vol. 41, no. 4,
Pouralizadeh, M., Khankeh, H. R., Ebadi, A., & Dalvandi, A. (2017). Concept Analysis of
Clinical Judgment in Nursing Students: A Hybrid Model. Iranian Red Crescent Medical