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Alyssa Streb
Nurses deal with a broad range of issues related to the conditions of each patient and their
nursing judgment is one of the most important things to determine the patient’s outcomes.
Nurses are always with the patient seeing their improvements and complications, so being
observational and having good reasoning skills helps the nurse make sound, reliable clinical
judgments. Nurses must have great hands on skill’s, but they also need the knowledge to make
decisions for their patients. Every nurse has a different mindset, so they are going to have a
different clinical nursing judgment. Some nurses will have a list of complications that is going on
with their patient and a lot of information, whereas an emergency room nurse may only have a
little bit of information on the patient which makes it difficult for sound nursing judgment.
Nursing clinical judgement allows the nurse to analyze information they see, review it, and
analyze the data from a nursing perspective. For example, if there is a patient who is bedridden
and who eats few proteins, the nurse is going to conclude that the patient is at risk for developing
Clinical nursing judgement can be defined in many ways. Clinical nursing judgment is
when the nurse decides on data to be collected about a client that may be experiencing a
interventions to take place. Clinical nursing judgment involves problem solving, decision
making, and critical thinking. A nurse who is prepared and trained will have the ultimate skills of
problem solving, decision making, and critical thinking thus using clinical nursing judgment and
protecting their patients from injury. The nurses experience plays a big role in the speed and
ability that a nurse can make sound clinical judgment. Technology is a big factor on nurses for
using nursing judgment when they should just be able to identify problems with their own skills.
We have a sepsis risk assessment tool. It’s helpful if a patient is truly septic, but
sometimes those measurable values are normal or baseline. I think it’s helpful for
when it’s busy, and you might overlook an abnormal value. But I still use my
nursing judgment in the end. Have we come to rely on technology so much that
decisions that can impact a patient’s life forever. Acute care nurses face a judgment every ten
minutes, critical care nurses every thirty seconds, and family or public health nurses make up to
ten judgments for every contact they have with new mothers (Thompson, 2013, p. 1721). Also,
around one and a thousand patient encounters result in fatality (Thompson, 2013, p. 1721). From
these statistics, you can tell that what nurses do really affect their patient’s life and how
Clinical nursing judgment is one of the key factors of education in nursing students and
we use it almost every day as well in our clinical experiences and transitions. One study reported
that only 24% of new nursing graduates meet clinical judgment expectations (Pouralizadeh,
Ebadi, Khankeh, & Dalvandi, 2017). As such, it is the role of teachers and educators to continue
to convey the merits of clinical judgement. Their influence may allow new nurses to think of
prevention of complications, to focus on what is really happening with their patient and
As a nursing student, I have used clinical judgment almost every day during clinical and
during my preceptorship hours. During my clinical hours on the MICU floor at Saint Elizabeth’s
downtown, I had a patient in acute respiratory failure. I did my head to toe assessment and I
noticed while listening to their lung sounds that I heard crackles bilaterally in both lobes. I also
Running Head: Clinical Nursing Judgment
saw on the ventilator settings that the Fio2 was set a lot different than what the patient was
doing. Obviously, that is something that you do not want to hear and see so I went up to my
clinical instructor and she asked me what I can do as a nurse to help with the crackles and the
Fio2. During this time, I thought hard and used my clinical nursing judgment. I told my
instructor we could either elevate the head of the bed and that may help, or we could suction the
patient and get all those secretions out of the patient and see if they would start breathing better.
We suctioned the patient and then I listened to the lung sounds and they were clear and the Fio2
improved as well. I thought to myself that if I didn’t hear those lung sounds and suction properly,
the patient would be in distress. Another time I used clinical nursing judgment is when I was
precepting on the epilepsy monitoring unit floor at The Cleveland Clinic. My doctor told me that
he wanted the patient to have a seizure, so they could see what part of the brain was causing her
seizures and to come up with some ways that may induce a seizure. I had my patient walk a
couple laps around the unit and got the recumbent bike out because I thought that stress on the
body and exercise may cause a seizure. Another thing I did was tell my patient to stay up as late
as they can because being sleep deprived could also cause a seizure. She rode the recumbent bike
for twenty minutes and then ten minutes later she ended up having a seizure. I was so happy with
what I had accomplished, and I hoped that what I did would help the patients diagnosis.
Clinical nursing judgment is a hard topic to discuss. Every nurse and nursing student uses
it differently, but everyone should acquire the skill and knowledge to use it appropriately.
Clinical nursing judgment can help save a life one day if used properly and it should be
something that is taught in school so each new nurse understands what is expected of them.
Running Head: Clinical Nursing Judgment
Works Cited
Pouralizadeh, M., Khankeh, H. R., Ebadi, A., & Dalvandi, A. (2017). Concept Analysis
Thompson, C., Aitken, L., Doran, D., & Dowding, D. (2013). An agenda for clinical
decision making and judgement in nursing research and education. International Journal
Risk Tools vs. Nurse Perception : AJN The American Journal of Nursing. (2017, June &
https://journals.lww.com/ajnonline/Fulltext/2017/07000/Risk_Tools_vs__Nurse_Percepti
on.7.aspx
Running Head: Clinical Nursing Judgment
Running Head: Clinical Nursing Judgment