Running head: CLINICAL NURSING JUDGEMENT 1

Clinical Nursing Judgment

Michael Audi

Senior Capstone

Youngstown State University

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Clinical Nursing Judgement

Clinical nursing judgement is an extremely important part of being an effective, reliable

registered nurse. Without adequate clinical judgement, nurses can make detrimental mistakes

while caring for patients and fail to recognize opportunities to promote the health of their

patients. It would be near impossible to act as a patient advocate, a key component of effective

nursing, without possessing adequate clinical judgement abilities. Clinical nursing judgment is

an extremely extensive topic and encompasses many different skills.

Defining the term clinical nursing judgement can be complicated, and many sources have

different theories and philosophies on the subject. After reviewing multiple different nursing

journals, I have concluded that the concept of clinical nursing judgement comprises of the

clinical decisions and assumptions that nurses make after evaluating all patient data available,

using a wholistic approach, and acting as a patient advocate. Making correct clinical decisions

while acting as a practicing nurse ensures that adequate patient care is being provided. According

to Chalmers et al. (2001):

Clinical decisions are an integral part of nursing practice. Nursing literature indicates two

main phases: (a) a diagnostic phase in which observation of a patient situation, data

collection, and data processing lead to identification of problems or decisions about

diagnosis, and (b) a management phase in which plans of action and treatment options

lead to nursing interventions. (p. 83)

In the diagnostic phase of making clinical decisions, nurses gather information about their

patients and identify problems and areas of focus. This information can come from patient

history, assessments, and many other sources. If a nurse does not gather enough information
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about their patients, they are in no position to make decisions surrounding their care. In the

management phase of clinical decision making, nurses use the information they have gathered to

make informed decisions about how to care for each individual patient.

The importance of clinical nursing judgement cannot be overstated. Nurses are put into a

position of extreme responsibility every day they show up to work and it is crucial to have

appropriate judgement. In the opinion of Dowding & Thompson (2003):

The increasingly blurred boundaries between health care professions mean that nurses’

judgements and decisions have more potential than ever to impact on patients’ lives and

experiences. How we measure the accuracy or ‘goodness’ of nurses’ judgements and

decisions is therefore of prime importance. (p. 49)

As registered nurses increasingly gain more responsibility in healthcare, the importance of

having competency in a wide range of nursing skills increases as well. Registered nurses are now

viewed as having an active role in maintaining or improving the health of all patients, and they

must be prepared to make informed decisions on their own. Possessing satisfactory clinical

nursing judgement requires sufficient nursing education and extensive clinical experience. To

ensure enough nursing education, it is important that nurses attend reputable nursing programs

that will prepare them for all aspects of patient care. Nursing instructors that have extensive

knowledge provide students with the information needed to have appropriate clinical nursing

judgment. Clinical experience can come from participating in specific clinicals while in nursing

programs and practicing as a registered nurse. Throughout nursing school, nursing students are

exposed to professional nursing in many different environments that will give them a solid base

of knowledge to build from. Although in multiple different nursing research studies, it is shown

that nurses do not truly possess peak clinical nursing judgement skills until they have extensively
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practiced as a registered nurse in a professional setting. Clinical nursing judgement is necessary

to provide effective nursing care, and practicing nurses are always evolving and improving in

this area.

Throughout my experience as a student nurse, my clinical nursing judgment has

constantly evolved and my ability to use inductive reasoning to make decisions has improved.

Taylor (2000) states the importance of inductive reasoning:

It is evident from what is known about clinical problem-solving, that the process involved

in decision making is one of inductive reasoning (p. 848)

One specific example of when I used inductive reasoning in my clinical nursing judgment was

during the Nursing Care of Children and Families clinical. A patient that I was caring for was a

young boy who was diagnosed with asthma, but he was admitted for a reason completely

unrelated to his asthma. After observing this diagnosis of asthma in the patient’s chart, I made

sure to make frequent respiratory assessments including SpO2 checks. During one of my

assessments, I realized that the patient’s SpO2 level was below normal. After this discovery, I

reported the finding to the nurse, and we provided the patient with supplemental oxygenation

before any complications arose.

In conclusion, clinical nursing judgment is a vital tool in practicing as a registered nurse.

This concept involves a wide-range of knowledge in the field of nursing and the ability to make

responsible, appropriate decisions while caring for patients. My nursing skills and knowledge

have greatly improved throughout my experiences, and the YSU Nursing Program has given me

the skills to practice as a nurse with excellent clinical nursing judgement.

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References

Chalmers, K., Ekman, S., Käppeli, S., Kim, H. S., Lauri, S., Macleod, & M., Salanterä, S.

(2001). An Exploratory Study of Clinical Decision-Making in Five Countries. Journal of

Nursing Scholarship, 33(1), 83-90. Retrieved from

https://sigmapubs.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1547-

5069.2001.00083.x?r3_referer=wol.

Dowding, D., & Thompson, C. (2003). Measuring the quality of judgement and decision-making

in nursing. Journal of Advanced Nursing, 44(1), 49–57. Retrieved from

https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1365-

2648.2003.02770.x?r3_referer=wol.

Taylor, C. (2000). Clinical problem-solving in nursing: insights from the literature. Journal of

Advanced Nursing, 31(4), 842-849. Retrieved from

https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1365-

2648.2000.01342.x?r3_referer=wol.