Clinical Judgment and Intuition
Clinical judgment is difficult to define as a formalized process. Many nurses would not be able to verbalize their own process of clinical judgment. Different theories have been presented to define the process and put it into steps to teach new nurses how to develop their own clinical judgment. Not only is this challenging, but it often does not translate well to the clinical setting. There are varying opinions about how much clinical judgment is based on experience versus knowledge. The evidence points towards a combination of the two. Intuition is also a part of the discussion, and defining it has its own challenges. The evidence shows that intuition is based on well-developed clinical judgment. Hire our assignment writing services if your assignment is devastating you.
The article Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing by Christina A. Tanner, Ph.D., RN (2006) defines clinical judgment as “a problem-solving activity, beginning with assessment and nursing diagnosis, proceeding with planning and implementing nursing interventions directed towards the resolution of the diagnosed problems, and culminating in the evaluation of the effectiveness of the interventions.” She reviews this traditional way of defining clinical judgment by summarizing previous studies and articles. She further goes on to propose a new model for viewing and teaching clinical judgment with four steps: noticing, interpreting, responding, and reflecting.
The traditional way of defining clinical judgment relies heavily on knowledge. It is a very formal approach that is cumbersome in the clinical setting but works well in written literature. Dr. Tanner’s new approach to defining and using clinical judgment seems more practical for use in the clinical setting. It takes into account the experience a nurse uses when they notice a problem. It then moves on to knowledge in the interpreting step when the nurse uses knowledge of the problem, such as specific clinical manifestations that correspond with specific conditions. The next step, responding, is a combination of experience and knowledge where the nurse uses experience gained by interactions with previous patients and knowledge about specific treatments or approaches to the problem. The last step, reflecting, may use both knowledge and experience to interpret any outcomes.
Dr. Tanner’s definition of clinical judgment makes the most sense to me. I believe that experience can only get a healthcare worker so far without knowledge. The same thing can be said for knowledge. The new grad may be able to have rudimentary clinical judgment, but the experience will help them to develop a strong clinical judgment that they can rely on to lead them to the right decisions. For example, I was able to use some therapeutic communication with the clients I worked with before beginning nursing school, but the outcomes were not always favorable, and I would be unsure how to proceed in some situations. The more I progressed through nursing school, the more I used the techniques that were being taught to me. Now, I can walk into a room and quickly know how to respond to clients in emotional distress. Outcomes have improved, and I am more confident in my approach. The knowledge and experience together have given me an ever-growing strength in clinical judgment for therapeutic communication.
According to Dr. Tanner (2006), intuition has been “characterized by immediate apprehension of a clinical situation and is a function of experience with similar situations.” Intuition, therefore, is the result of experience. This is what nurses mean when they tell new nurses to listen to what their gut is telling them. Intuition, to me, is the ability to walk into a situation, know the problem, and react accordingly with the need for little to no reasoning. Later, when asked, the nurse may be unable to put their action into formal language or reasoning processes but will simply state they just knew what to do.
In my opinion, intuition is the result of practiced clinical judgment. As a new nurse, I will not expect to have intuition. I will remind myself to be patient with my reasoning and rely on other nurse’s intuition. As I use clinical judgment, my own intuition will grow from that. For example, if I walk into a room and a client is exhibiting a specific symptom, I may need to asses, then think about what these clinical manifestations would mean, then implement a plan and later evaluate its effectiveness. After walking into various rooms and seeing the same specific symptoms, I would rely on my clinical judgment and know what the problem might be I would conduct a focused assessment and implement care sooner, followed by an evaluation of the outcome. As I continue to see this condition, I would rely on intuition and be able to walk in and start treatment while conducting an assessment.
This type of thought process can be applied to most situations and can help to identify problems sooner, notice when a client needs assistance sooner, and know when to call for backup. These skills will come with time and exposure to various problems that clients might have. I will not rely on intuition too soon. By relying on undeveloped intuition, I may assume I know what the problem is and overlook the real problem. Caution is the key when a new nurse is considering using intuition. When first starting to work in the clinical setting, I will take my cues from more experienced nurses and rely on their intuition to help me develop my own.
After reading this article, I conclude that clinical judgment is indeed based on experience and knowledge. I also believe that intuition is developed over time by using clinical judgment. Nursing school gives us the knowledge that we base our clinical judgment on, and we will add to our experience that began with our practical education at clinical sites with our future positions as nurses in the clinical setting.
References
Tanner, C. (2006). Thinking like a nurse: a research-based model of clinical judgment in nursing. Journal Of Nursing Education, 45(6), 204-211.
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Question 
Module 05 Written Assignment – Concepts for Clinical Judgment
Module 05 Content
Read the article “Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing” by Christine Tanner, which is linked below:
Clinical Judgment and Intuition
In at least three pages, answer the following questions:
What do you feel are the greatest influences on clinical judgment? Is it experience, knowledge, or a combination of those things?
In your opinion, what part does intuition play in clinical judgment? How do you think you’ll be able to develop nursing intuition?
Additional sources are not required, but if they are used, please cite them in APA format.
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