RUNNING HEAD: CLINICAL NURSING JUDGMENT 1

Scholarly Paper over the Topic Clinical Nursing Judgment

Sydny Paul

Youngstown State Nursing

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When defining clinical nurse judgment, one must look at the steps that are used to make

a clinical nursing judgment. The medical dictionary defines clinical nursing judgment as “the

process by which the nurse decides on data to be collected about a client, makes an interpretation

of the data, arrives at a nursing diagnosis, and identifies appropriate nursing actions; this

involves problem solving, decision making, and critical thinking” (Medical Dictionary for the

Health Professions and Nursing 2012). According to the US National Library of Medicine and

National Institutes of Health and authors Gunver Kienle MD and Helmut Kiene MD, clinical

judgment can be defined as a “central element of the medical profession, essential for the

performance of the medical staff, and potentially generating information also for other clinicians

and for scientists and health care managers. It is believed that this is primarily engaged with its

role in communication, diagnosis and decision making” (2011). This “central element” can be

found embedded into the culture of nursing and can be a vital lesson that needs to be established

early in the educational tract of nursing. As stated in the nursing journal The Use of Emotional

Intelligence Capabilities in Clinical Reasoning and Decision‐Making: A Qualitative,

Exploratory Study, “developing decision making and judgment skills is a growing area of nurse

educational activity and one that attracts a variety of educational approaches” (Hutchinson,

Hurley, Kozlowski, & Whitehair, 2017). Interventions used by educators to develop nursing

judgment and decision making are many and varied. The evidence suggests that “interventions

work only some of the time, only in some circumstances, and with no consistently positive

results” (Hutchinson, Hurley, Kozlowski, & Whitehair, 2017). Many researches believe that the

ability to make strong clinical judgments comes through experience actually working within the

hospital. Through the research of Mary Cazzell and Mindi Anderson, “the gap between nursing
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education and practice will not be bridged until baccalaureate curricula address the complexities

and rapid changes in nursing practice” (2016).

Through my experience over the last three years of nursing school, I find that the concept

of nursing clinical judgment is something that is built upon. The building blocks of this skill

would consist of educational backgrounds, experience and confidence. An experience I has

recently working with in the hospital I am employed at really tested my clinical judgment skills

and forced me to think quickly, efficiently, and effectively. During a typically shift, I found a

child face down in a hallway that was not commonly traveled in by patients. The child was

unresponsive with cyanotic features primarily around the lips. When finding the child, I found

myself acting, stopping in my tracts to say “well what would a nurse do?” I began with calling

for help, checking for pulses and respirations, and then establishing an open air way to instantly

begin giving rescue breaths. I promptly scooped the child up from the floor, supporting the head

and neck with one arm while pinching the child’s nose and giving rescue breaths while running

to the trauma bay. Once reaching the trauma bay, I instantly opened the airway for the doctor and

experience nurses to begin bagging and rattled off quickly what I had stumbled upon. When

reflecting on this critical moment, I found myself in awe over what I had just done. It all seemed

like such a blur but when recollecting that truly happened, I subconsciously made all the

decisions I did on my own, without asking someone else if I was right. What I had just done was

made a clinical judgment that saved a child’s life.

Although some researchers believe that nursing clinical judgment is established through

experience, I personally believe that clinical judgment is established through confidence along

with experience. The confidence of clinical nursing judgment would be through the educational

aspect of nursing school, along with clinical experience to apply the knowledge. Also, through
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the support of educators, we as students can ask the questions needed to reassure or correct our

actions. Without the strong background that I have worked hard to establish, I don’t think I

would have been able to respond in the way that I did. Without my educational background, I

believe that I would have allowed emotions to cloud my judgment. In the article written by

Hutchinson, Hurley, Kozlowski, & Whitehair, they stated that “at the heart of clinical practice is

the ability to reason carefully and make decisions, often in difficult or emotionally charged

situations” (2017). “Nurses’ clinical decisions are often made in contexts in which emotional

triggers are bound. These situations entail significant emotional labor, are emotionally

challenging and require clinicians to actively manage their own and others’ emotions”

(Hutchinson, Hurley, Kozlowski, & Whitehair, 2017).

In conclusion, without clinical nursing judgment, patient safety would be become a huge

issue within all clinical settings. Without nurses having an strong base knowledge on how to care

for ill patients, have the confidence to execute what is the correct care for the patient, and using

critical thinking skills to recognize that an issue is occurring and acting before a potential life

threatening event occurs, more people would pass away from events that were completely

preventable. Clinical nursing judgment is the foundation to saving lives and healing those that

need it the most.

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References

Cazzell, M., & Anderson, M. (2016). The Impact of Critical Thinking on Clinical Judgment

During Simulation With Senior Nursing Students. Nursing Education Perspectives

(National League for Nursing), 37(2), 83–90. https://doi.org/10.5480/15-1553

Clinical judgment. (n.d.) Medical Dictionary for the Health Professions and Nursing. (2012).

Retrieved March 3 2019 from https://medical-

dictionary.thefreedictionary.com/clinical+judgment

Hutchinson, M., PhD, RN, RM, Hurley, J., PhD, RN, Kozlowski, D., PhD, Psych Hons, &

Whitehair, L., RN, BHSc, MN. (2018). The use of emotional intelligence capabilities in

clinical reasoning and decision?making: A qualitative, exploratory study. Journal of

Clinical Nursing, 27(3-4), e600-e610. doi:10.1111/JOCN.14106

Kienle GS, Kiene H. Clinical judgement and the medical profession. J Eval Clin Pract.

2011;17(4):621-7.