Running head: THE IMPORTANCE OF CLINICAL JUDGEMENT IN NURSING 1

The Importance of Clinical Judgement in Nursing

Madison Hefner

Youngstown State University

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Abstract

This paper talks about the importance of clinical judgement in the nursing field. Three articles

were used to better help understand what “clinical judgement” truly means, and how important/

prominent it is to have while working as a nurse. Clinical judgement is used on a day to day basis

for practicing registered nurses.

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The Importance of Clinical Judgement in Nursing

Nurses have the best job in the world and the most challenging. So many pieces of

information go into caring for patients. Nurses look at individualized patient history, lab data,

urine results, medication history, current medications, vital signs, and the current overall

appearance of their patients; and those few things are considered subjective and objective data

which is all just one part of what nurses call an “assessment”. The acronym ADPIE is used for

all patients, aside from just assessment nurses then have to diagnose, plan, implement

interventions/treatments, and evaluate (ADPIE). So much goes into taking care of patients and

putting together the “whole picture”. When a nurse is able to see how certain things affect

patients health status and how each link goes into another is considered good clinical judgement.

Clinical judgement is done by using what you think is the best technique to care for a patient and

doing it in a timely manner. Clinical judgement may be need to be quick depending on the

stability of the patient. In the following three articles clinical judgement is defined, analyzed, and

tested.

Clinical judgement is a very difficult thing to define says, Phaneuf,M. (2016), so she

decided to break it down. “The French dictionary defines judgement as having an idea, a clear

opinion following a period of reflexion whereas the term clinical indicates that it is related to the

patient. A difficult task for nurses is making a clinical judgement. It requires both intellectual

and professional maturity.” With clinical judgement being defined by Phaneuf, M.(2016) as a

clear opinion of a patient she also states that it can be both taught (intellectually) and acquired

(professional maturity). This made me want to look more into how clinical judgement differs

between new student nurses that have graduated with little floor experience verses nurses that
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have been in the field for many years. According to a article by Tanner, C. A. (2014) it was said

that “Clinical judgements are more influenced by what nurses bring to the situation than the

objective data about the situation at hand.” She is suggesting that the more experience a nurse

has with different patients and situations, the better clinical judgement she has as well. Which

would make sense because we are human and learn through trial and error. Practicing as a nurse

for a longer amount of time allows you to experience more errors therefore preparing you to

make better judgement from past failures. Tanner later backs up this statement in her article by

saying, “For the experience nurse encountering a familiar situation, the needed knowledge is

readily solicited; the nurse is able to respond intuitively, based on an immediate clinical grasp

and just “knowing what to do”. However the beginning nurse must reason things through

analytically;he or she must learn how to recognize a situation in which a particular aspect of

theoretical knowledge applies and begin to develop a practical knowledge that allows

refinement, extensions, and adjustment of textbook knowledge.” Therefore, from Tanner’s

standpoint, more experienced nurses will have better clinical judgement because it is more than

something that can be taught in a classroom.

A study done by Hallin, K., ect al. (2016) looks at the best way to teach students learning

styles to have better clinical judgement. They stated “High fidelity patient simulation (HFS) is

one of only few learning strategies in nursing education where students can demonstrate skills in

complex care situations without harming the patient.” Even though simulation labs are

considered a good way of learning it is not the only way. “Learning style theories assume that all

humans beings learn in different ways and at different levels,”(Hallin, K., ect al. 2016) with that
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being said it is great that YSU offers simulation labs along with classes, tudors, and real life in

hospital experiences (clinicals).

One experience of mine where I used good clinical judgement was at downtown St. E’s

in the ICU unit. My patient was a 74 year old female that went to get an EGD for a bleeding

stomach ulcer. She was stable pre-op and intra-op but once in PACU she began to arrest. My

patient was unconscious with PEA for twenty minutes. Two days after this incident I was

assigned to take care of her. She was still completely unresponsive due to hypoxemia to her

brain during the twenty minutes of cardiac arrest. She was on a sedatives because she had an

endo tube in therefore she was being pushed further into unresponsive/unconsciousness. From

learning in class that it is crucial to give patients a sedation vacation when they are on IV

sedatives I suggested this to my nurse. My nurse told me there is no point because she thought

personally that the patient would remain unconscious for the rest of her life. So I suggested that

we try, and miracuously once we took her off of her sedation she opened her eyes for the first

time she has since she lost consciousness. Although some people may suggest that more

experience leads to better clinical judgement I believe that what you learn in class should never

be forgotten.

It is very important as a working nurse to have good clinical judgement. As nurses we

make the decisions that affect the lives of others. Yes, over the years clinical judgement can

become perfected but the basic fundamentals of what we learn in school all factor into good

clinical judgment and must be utilized working as a nurse.

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References

Hallin, K., Haggstrom, M., Backstrom, B., & Kristiansen, L. P. (2016). Correlations Between
Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room.
Retrieved March 15, 2018, from
http://www.ccsenet.org/journal/index.php/gjhs/article/view/49841

Phaneuf, M., R.N. (2016). Clinical Judgement-An Essential Tool in the Nursing Profession.
Retrieved March 15, 2018, from
http://www.infiressources.ca/fer/Depotdocument_anglais/Clinical_Judgement–An_Essential_To
ol_in_the_Nursing_Profession.pdf

Tanner, C. A., PhD, RN. (2014). Thinking Like a Nurse: A Research-Based Model of Clinical ...
Retrieved March 15, 2018, from
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EDF65760AFA41A9AF70641F&rd=1&h=LB-Nfdr3vaIC9VI8NwF1QAtTwrQD8PX0ePb5IcG
XR3s&v=1&r=http://www.mccc.edu/nursing/documents/Thinking_Like_A_Nurse_Tanner.pdf&
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