Capstone Paper
Capstone Paper
Capstone Paper
Kelsey Baker
Abstract
This paper explores the meaning of clinical nursing judgement, identifies the importance of
clinical nursing judgement, and includes a personal experience of a time that I have used clinical
nursing judgement. Three different research articles are discussed in the paper. The first article
mentioned is written by Paneuf (2008) and it discusses the definition of clinical nursing
judgement. Another article included in the paper written by Graan, Williams, and Koen (2016)
discusses the publics understanding of clinical nursing judgement versus reality, and lack of
clinical nursing judgement in new graduates. The last article discussed is written by Kyung Oh
(2016), which will explain strategies to improve nursing students clinical nursing judgment.
CLINICAL NURSING JUDGEMENT 3
several different ways. There is no right or wrong way to define clinical nursing judgement,
because it is just that, a judgement. I however agree with the following definition of clinical
nursing judgement. Le Grand Robert, a 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. In particular, it requires the ability to pay attention, to
reason and to summarize in order to achieve logical deduction. Clinical judgement is complex
because the nurse is required to have prior training in order to develop further understanding of
the subject. It depends on her ability to observe, to identify relevant information, to identify the
relationships among given elements and to reason. Clinical judgement in itself encompasses a
cycle of sensory activities which begins with perceptions and which is followed by cognitive
functions associated with the intellectual processing of information through the mental
judgement is a very complex and may vary from nurse to nurse. For example, a nurse that has
twenty-five years of bedside nursing experience will most likely have better clinical judgement
than the new graduate nurse simply because of experience. On the other hand, some may argue
that a new graduate has better clinical judgement because new graduates are typically nervous to
mess up, resulting in more thorough assessments and documentation than an older, experienced
nurse would provide. Overall, clinical judgment focuses on the patients. Having good clinical
judgement means that the nurse is advocating for their patients, improving quality of life for their
patients, and alleviating stress and anxiety that their patients may be experiencing.
CLINICAL NURSING JUDGEMENT 4
Clinical nursing judgment is important for the doctors, nurses, patients, and families. It
affects everyone involved with the patient, which is why it is so important. Studies have shown
that clinical nursing judgement leads to, The identification and logical interpretation of
symptoms; the planning of care to alleviate or prevent complications or relapses; the nurse is
doing what the patient would do for himself if he had the required strength or knowledge;
helping the patient satisfy his physical, psychological and spiritual needs at the same time; and
assisting the patient in passing away with dignity, if necessary (Phaneuf, 2008). It is important to
evaluation. Graan, Williams, and Koen (2016) have found that many of the public view nursing
as a profession that simply keeps sick people safe, comfortable and clean and helps carry out the
tasks requested by the doctors. While those assumptions are true, there is more to nursing than
comfort provided at the bedside. The difference between a skilled professional nurse, and a non-
professional caregiver is the ability to assess, diagnose, implement, and evaluate the patient. In
todays environment, patients are more critical and more complex. Clinical nursing judgement is
more important than it ever has been. The patients and institutions need their nurses to be
competent and capable of critical thinking skills. According to research by Graan et als. (2016),
newly qualified nurses are not meeting the expectations for entry level clinical judgement.
Clinical judgement no longer includes following the process, analyzing the data and performing
prescribed techniques. If a nurse is going through the motions, that cannot guarantee good
clinical judgement that will solve the patient's problems. It is important for clinical judgement to
include the nurse determining appropriate nursing interventions when planning the patients care
in order to receive good outcomes. Good clinical nursing judgement starts developing in the
classrooms and clinical. Unfortunately, research is determining that one of the reasons that new
CLINICAL NURSING JUDGEMENT 5
nurses are not meeting the expectations for entry level positions falls back on insufficient use of
time in clinical teaching. Research provided by Kyung Oh (2016), concluded that structuralized
debriefing processes that utilize the clinical judgment rubric improved nursing students clinical
judgment and communication scores and impacted their skill performance. The use of structured
clinical judgment rubric debriefing can be used as an effective teaching and learning strategy to
achieve learning goals related to clinical judgment, communication, and skill performance which
nurse, and have quickly realized that I will be using clinical nursing judgement every day in this
career. Already, as a student nurse, I have used clinical nursing judgement which has helped me
prepare learn and develop critical thinking skills to prepare me to be the best nurse that I can
possibly be. A specific situation that sticks out to me when I used clinical nursing judgement was
a couple of weeks ago while I was precepting. My precepting nurse and I were floated down to
the Emergency Deparmtent to triage patients. My nurse was allowing me to do the initial
assessments on the patients and then she would verify after I was finished. A sixteen-year-old
boy can in from his work because he felt extremely weak, he had a headache and he had no
energy. He had a low-grade fever, the chills, and was very achy. His blood pressure, pulse, and
respiratory rate was all within normal limits. After his assessment, I noted that his throat was red,
with swollen tonsils. I immediately thought that we should do a rapid strep test on the patient.
My precepting nurse agreed with my assessment and decision to do the strep test. I swabbed the
patients throat, and within two minutes the strep test came back positive. This is a perfect
example where I used clinical nursing judgment during my assessment, implementation and
References
Graan, A. C., Williams, M. & Koen, M. P. (2016). Professional nurses' understanding of clinical
Kyung oh, H. (2016). Effects on Nursing Students Clinical Judgment, Communication, and
http://www.sersc.org/journals/IJBSBT/vol8_no1/27.pdf
Paneuf, M. (2008). Clinical Judgement An Essential Tool in the Nursing Profession. Retrieved
from http://www.infiressources.ca/fer/Depotdocument_anglais/Clinical_Judgement
%E2%80%93An_Essential_Tool_in_the_Nursing_Profession.pdf