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In nursing, we define nursing clinical judgement as, having an idea or clear opinion

following a period of reflexion that is related to the patient ( Cazzell, Anderson, 2016). While

working in our scope of practice of nursing, one must be able to use both clinical reasoning and

judgement to care for their patients. We have learned since the first year of nursing how to

clinically judge scenarios and how to use the clinical judgement to properly take care of our

patients on a daily basis. Beyond critical judgement, nurses most also poses the ability to

critically think. According to the article “ The Impact of critical thinking on clinical judgement

during simulation with senior nursing students”, critical thinking is thinking based on reflection.

To me this means that when we enter patients rooms each day we must use our own personal gut

feelings on what we think is right for our patients because we, the nurses, are with the patients

most throughout the day. By critically thinking we must reflect on what we know and do what

we feel is right even if others are telling us we may be wrong.If one has a gut feeling that the

care needed to be given is what they're doing, they need to not stray from giving that care.

Clinical Judgment involves noticing, interpreting, responding, and reflecting ( Cazzell,

Anderson, 2016). During our days in the hospital we must notice things going on with our

patients, we need to understand why their here and their plan of care. Next, we must interpret the

information we have on the patient using the assessment skills we have learned. Responding

involves, once we get all the information we need and see the doctors orders for the patient we

must respond to those orders and give the care we need to the patient. Finally, we must reflect on

how the patient responded to the care given, and we as nurses must reflect on our own care we

gave and was that enough for the patient. On a daily basis nurses must make clinical judgements

on multiple patients and multitask with giving care. We are the eyes and ears for these patients in

order for them to get the care they need. We advocate for the patients by making our own clinical

judgements and give our own feedback to doctors so that our patient gets the best care while in

the hospital. “Stacking” involves organizing, prioritizing, and decision-making about patient care

on a daily basis ( Manetti, 2019.) Nurses must be able to understand the context of each patient

situation and develop a nurse-patient relationship in order to give the best care for each

individual. The attitude of a nurse can either be positive or negative to a patients outcome. That

is why clinical judgement comes into play into everything we, as nurses do. Reflection-on-action

is something nurses do to evaluate effectiveness of interventions used on patients to either

continue with what they're doing or re-evaluate ( Manetti, 2019.)

In order to provide safe and effective care to patients, we as nurses must continually

adapt and change our skills with the fast evolving ways to give care in the hospital systems.

Thats why using our clinical judgement always comes into play. When we sit back and evaluate

each patients situation we can competently care for them by using the skills we have learned in

our practice through the years. In recent years, clinical judgement in nursing has become

synonymous with the nursing process model of practice viewed as a problem solving activity (

van Graan, Williams, Koen, 2016.) In order for nurses to adapt to the ever changing health care

environment, nurses must critical think everyday in order to give the appropriate interventions

needed for each patients situation. Going through the motions, taking assessments, and

performing interventions is not enough in the evolving, high tech health care world. Nurses need

to adapt to these changes and do more. Going through the motions of standard care doesn’t

always guarantee proficient and good clinical judgement ( van Graan, Williams, Koen, 2016.)

Going through nursing school it is believed that once we graduate we aren’t as competent in

clinical nursing judgement and thinking because we are not exposed to as many real life patients.

That is why the Department of Health, 2011 demanded nursing students go from 3000 clinical

hours to 4000 hours.

In my own experience with clinical judgement in our clinical is that we do get practice

with utilizing our own clinical judgement and thinking. We as the nursing students are doing our

own assessments on patients and are with one patient throughout the whole day so it allows us to

competently analyze and evaluate the individual patient’s situation,. I feel as if we do see enough

real life patients where we can start to obtain the proper clinical judgment nurses need in order to

care for patients in the hospitals. We are able to work with the nurse that is assigned to the

patient and our clinical instructor to learn how they clinically judged the situation and they

explain to us how they got to that conclusion., This helps us as students start to think in the way

they do.

In conclusion. Clinical judgment uses both the nursing process and clinical thinking to

fully care for and treat each patient the right way. It involves noticing the patients situation,

interpreting the data collected on a patient, evaluating the interventions given, and finally

reflecting on the whole scenario. We as nurses must constantly adapt to the changing health care

systems and fully utilize our nursing judgement in order to give our patients the best care they

can get. Nurses need to be confident in what they feel is right for the patient y using their

“nursing gut” . This allows us to utilize our critical thinking skills we have gained while in

nursing school.