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Clinical reasoning is the process by which nurses observe patients status, process the information, come to an understanding of the patient problem, plan and implement interventions, evaluate outcomes, with reflection and learning from the process (Levett-Jones et al, 2010).At all times, nurses are responsible for their actions and are accountable for nursing judgment and action or inaction.As a future nurse you have probably heard about the intensity of nursing courses, if not yet experienced it firsthand.
In order to acquire such skills, students need to develop critical thinking ability, as well as an understanding of how judgements and decisions are reached in complex healthcare environments. Journal of Clinical Nursing, 21(23–24), 3451–3465 Thompson, C., Aitken, l., Doran, D., Dowing, D. An agenda for clinical decision making and judgement in nursing research and education.
As lifelong learners, nurses are constantly accumulating more knowledge, expertise, and experience, and it’s a rare nurse indeed who chooses to not apply his or her mind towards the goal of constant learning and professional growth. International Journal of Nursing Studies, 50 (12), 1720 - 1726 Tomlinson, J. Using clinical supervision to improve the quality and safety of patient care: a response to Berwick and Francis.
The focus of the nurse clinical judgement has to be on quality evidence based care delivery, therefore, observational and reasoning skills will result in sound, reliable, clinical judgements.
Clinical judgement, a concept which is critical to the nursing can be complex, because the nurse is required to use observation skills, identify relevant information, to identify the relationships among given elements through reasoning and judgement.
As you can see, there’s a lot more that goes into critical thinking than one might think.
It’s a transferrable skill that can be leveraged in several facets of your life.
Institute of Medicine (IOM) report on the Future of Nursing, stated, that nurses must continue their education and engage in lifelong learning to gain the needed competencies for practice. NMC (2010) New Standards for Pre-Registration Nursing.
American Nurses Association (ANA), Scope and Standards of Practice requires a nurse to remain involved in continuous learning and strengthening individual practice (p.26) Alfaro-Le Fevre, R. Critical thinking and clinical judgement: A practical approach to outcome-focused thinking. St Louis: Elsevier The future of nursing: Leading change, advancing health, (2010). Jeong, S., Noble, D., Norton, C., Roche, J., & Hickey, N. The ‘five rights’ of clinical reasoning: an educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients.
But why is critical thinking in nursing so critical? You’ll notice in the list above that critical thinking is embedded in a nurse’s everyday routine.
You’ll learn all sorts of practical skills in nursing school that you’ll put to use at the clinic, but without the ability to think clearly and make rational decisions; those skills alone won’t get you very far.