Tara Amero
Clinical judgment is a term commonly used in the medical field. Nurses, doctors,
and other healthcare workers are always being told to use clinical judgment with their
patients. As we hear this term so often, does anyone truly know what it means? Such an
important term is not so easy to define, as there is no set in stone definition. Does clinical
judgment define if a nurse is good or not? Does clinical judgment come with time and
experience within a field? Or are some people more knowledgeable than others, which
gives them better clinical judgment? Clinical judgment requires knowledge of various
The term clinical judgment can be broken down into numerous parts. According
disease, but also requires an understanding of the physical and emotional strength of the
patient and their family. Also, an understanding of how the disease is affecting the patient
is crucial. While clinical judgment is extremely important from the disease aspect,
knowing the patient is equally as important. Knowing the patient and the response to the
disease and treatments can provide nurses more knowledge and help assist with their
clinical judgment towards that individual. Most new nurses take time to analyze and
reason with the situation, which helps them grow and recognize these situations when
they happen again. After so much experience, they begin to feel familiar with different
types of situations, and can act quickly with their clinical judgment.
Clinical judgment is not only knowing how and why to perform an intervention,
but also being able to explain and defend why the judgment for it be done was made.
(Standing. 2008). Nurses are constantly doing those steps, without even knowing.
According to the article, the usual response to uncertainty is to seek more information.
This can easily be applied to nursing and when making clinical judgments. Nurses are
always seeking more information, whether it is from the patient or family member, or
searching through the charts for labs and previous doctors notes. Any additional
Depending on what type of unit a nurse is on, they could be making clinical
judgment decisions every 10 minutes (Thompson, Aitken, Doran, Dowding, 2013). Their
research shows that nurses working in acute care make decisions every 10 minutes and
critical care nurses can make them every 30 seconds. Regardless of the type of healthcare
system, all nurses have to make clinical judgment choices. Patients are putting their
complete trust in the nurse to make these decisions in the best interest for their health. A
study showed that when nurses were given the same information, different judgments and
decisions were made (Thompson, et al. 2013). This was related back to what nurses do
with the information and how they translate it. More experienced nurses are quicker to
act, while novice nurses, every choice made is thoroughly though out before being acted
upon.
A few years ago, my dad came home from work because he didnt feel well. After
convincing him to go to the doctor, they diagnosed with a urinary tract infection, and sent
him home with antibiotics. Thinking nothing much of it, my mom and I went along with
our day. Later that night, my mom came into my room, said my dad was actin odd, and
wanted me to go to their room and check on him. He was lying in bed, shivering under a
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blanket, while profusely sweating. I asked him what he was feeling and all he kept saying
how freezing the room felt. I went over and felt his head, which was burning up. While
talking with my dad, he seemed very dazed, confused, and was not answering my
question properly. As Tanner says, knowing the patient is extremely important and I knew
this patient better than most. Just within the first 30 seconds of interacting with him, I
knew this was not his normal behavior. I used my clinical judgment, adding together the
symptoms of fever, chills, confusion, and told my mom we needed to call an ambulance.
The ambulance came and took him to St. Elizabeths in Boardman. After doing cultures
and tests, they found that his UTI had spread to the blood, and he had sepsis. Using my
judgment and paying attention to the signs, my mother and I made the right choice by
bringing him to the hospital. After learning about Tanners theory regarding clinical
judgment, I realized how important it really is. Knowing the patient and their background
References
Standing, M. (2008). Clinical judgement and decision-making in nursing nine modes of practice
in a revised cognitive continuum. Journal Of Advanced Nursing, 62(1), 124-134.
http://dx.doi.org/10.1111/j.1365-2648.2007.04583.x
Thompson, C., Aitken, L., Doran, D., & Dowding, D. (2013). An agenda for clinical decision
making and judgement in nursing research and education. International Journal Of Nursing
Studies, 50(12), 1720-1726. http://dx.doi.org/10.1016/j.ijnurstu.2013.05.003