Running Head: CLINICAL NURSING JUDGMENT

Tayona Johnson
Clinical Nursing Judgment
Youngstown State University
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Clinical Nursing Judgment

Nursing is a very important and vital career to take on within a hospital setting or even in

the community. Nurses are responsible for many things, all to help benefit the patients’ health

care, safety, and well-being. Nurses must be very knowledgeable in their field and be able to step

in when they see something is not right, such as if a physician were to prescribe an inappropriate

medication or give an order that would harm the patient. Although physicians are the ones who

make all orders, the nurse must know when not to carry out an order and when it is appropriate to

call the physician with a patient’s status.

“Nursing is a practice based discipline and one of the basic objectives of nursing

education is to achieve clinical judgment. Clinical judgment is essential for decision making and

is considered an inseparable part of a high quality nursing care” (Pouralizadeh, Khankeh, Ebadi,

& Dalvandi 2017). One of the main responsibilities of a nurse whether in a hospital setting or in

the community is to use good, proper judgment. Nursing judgment is very vital and can in fact

save a person’s life when done. Nurses’ decision making can improve the quality of health care

being provided to patients.

“Healthcare organizations expect new nurses to join the workforce with excellent clinical

decision-making skills; one such skill is the ability to manage rapidly deteriorating patients”

(Lindsey, & Jenkins 2013). Even as a new nurse it is important to have good judgment skills. In

an emergency one must know how to act fast and know the appropriate steps to take in order to

save a patient’s life. Without good judgment skills a patient can deteriorate very rapidly which

can even lead to death. The nurse is ultimately responsible for the care of the patient. Although

some things are out of the nurse’s hands, all care should be done properly and with sound

judgment. The nurse is usually with their patients multiple times a day and make many
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assessments. The nurse should know their patients baseline assessment so that they can quickly

determine when a patients deviates from their base. Sometimes patients can deteriorate very

rapidly so the nurse must act quickly when emergencies arise.

New nurses take time and practice to be able to build up their clinical judgment skills.

Simulations are a great way for new nurses to learn and put themselves in critical situations

without harming any patients. “Nursing students need the experience of confronting challenges

in the care of patients they will undoubtedly confront in real-world health care settings. Clinical

simulations that mimic the real world with real obstacles provide a safe environment in which to

learn and apply theoretical principles of nursing care” (Bambini, Washburn, & Perkins 2009).

Although simulations aren’t real life, they give a good depiction of something that can go wrong

in the real world and can prepare you if the situation ever does occur. Simulations are a good

way to build judgment and give nurses more confidence if the situations were to occur.

Although the situations was not very critical, I had to make a nursing judgment about

pulmonary embolism prophylaxis with a patient. The physician ordered the patient to be on a

sequential compression device (SCD) as a means to prevent blood clots to the patient. The

physician made this order without assessing the patient prior to the order. Upon assessment, the

patient exhibited bilateral edema in the lower legs with redness, warmth, and cracked skin. I had

to make the judgement that the SCD’s may not have been the best idea for this patient because he

seemed to have some kind of peripheral vascular issues, and maybe even a blood clot. The SCD

could of made the patient’s condition even dislodged a potential clot. Although the order was for

the SCD to be applies, I had to make my own nursing judgment that they may not have been

appropriate for this patient.

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It is very important to utilize good clinical judgment and even question some of the

orders the physicians may place. Nurses must be aware of the effects that different things can

have on their specific patient and make sure that what is ordered is appropriate. Using clinical

nursing judgment usually get better with time and experience.

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References

Bambini, D., Washburn, J, & Perkins, R (2010). Outcomes of Clinical Simulation for Novice

Nursing Students: Communication, Confidence, Clinical Judgment.

Lindsey, P. & Jenkins, S. (2013). Nursing Students’ Clinical Judgment Regarding Rapid

Response: The Influence of a Clinical Simulation Education Intervention

Pouralizadeh, M., khankeh, H., Ebadi, A, & Dalvandi, A. (2017) Factors Influencing Nursing

Students’ Clinical Judgment: A Qualitative Directed Content Analysis in an Iranian

Context