Clinical Judgment – The Role of Intuition and Its Greatest Influences

Clinical Judgment – The Role of Intuition and Its Greatest Influences

“Thinking Like a Nurse: A Research-Based Model of Clinical Judgement in Nursing”

What do you feel are the greatest influences on clinical judgment? Is it experience, knowledge, or a combination of those things?

In the article “Thinking Like a Nurse: A Research-Based Model of Clinical Judgement in Nursing,” Tanner (2006) viewed clinical judgment as a major part of professional practice and a factor in developing and improving a professional identity. There are various influences on clinical judgment in nursing. From a personal perspective, I feel that no single factor can be attributed to clinical judgment. Therefore, a number of factors affect nurses’ clinical judgments. By definition, clinical judgment involves the acquisition of the required knowledge and skills over a period of time for nurses to be able to analyze patient symptoms and presentations of both objective and subjective data to aid in making decisions for diagnosis and evidence-based nursing interventions to improve patient outcomes (Embler, 2021). Based on this description, I believe clinical judgment is majorly influenced by experience and knowledge. This is the same view Tanner (2006) holds on the influences of clinical judgment. Both experience and knowledge give the health decision maker, such as a nurse, the ability to notice, identify, and synthesize the major elements of health issues as presented by a client and interpret the presented objective and subjective data in order to make a good clinical judgment that guides their actions.

Knowledge in nursing is acquired and developed throughout their education and training and through their experiences while interacting with their patients. Education and training equip the nurses or health care professionals with theoretical and practical knowledge and critical thinking skills that can help them determine the existence of a health problem and how best to solve it. Through education and training, the nurses develop the needed knowledge to understand the pathophysiology of diseases and the diagnostic processes that can help the nurse deduce the client’s health condition based on their presentation. By interacting with various clients and practicing over time, the nurses gain enough experience to exercise when faced with complicated situations. Tanner (2006) notes that reflection on practice triggered by a clinical judgment is important for developing clinical knowledge and reasoning. Besides having the knowledge and experience to understand disease processes, nurses use client symptom presentations to determine the patient’s situation. According to Tanner (2006), their knowledge and experience will help them understand how to integrate the client’s health history, family history, and other social, environmental, and economic aspects of the patient and how they influence the development of the diseases.

As presented by Tanner (2006), clinical judgment is complex as the decision is expected to determine cases and interventions in the face of ambiguity, conflicting morals, values, and ethics. This includes making decisions on care that have competing interests from the patient’s side with an impact on the patient’s health that the nurse has no control over, such as their age, racial and ethnic background, mental state, and financial well-being. These factors of the patient’s health create a contextual situation that requires the personalization of care as per these individual aspects. From the author’s perspective, clinical judgments can be influenced by the context of the situation on the basis of how and where it occurs and the culture of the nursing unit in which it occurs. However, to base their decisions on the contextual aspects of the situation and culture of the nursing unit, the decision maker will still have to make such choices by referring to their knowledge and experience from related situations.

In your opinion, what part does intuition play in clinical judgment? How do you think you’ll be able to develop nursing intuition?

Tanner (2006) argues that clinical knowledge goes beyond the nurses’ knowledge and experience to include the nurse’s reasoning, intuition, clinical thinking, and evidence-based practice skills. Intuition plays a critical part in clinical judgment as it, to some extent, influences individuals’ decisions. In various situations, nurses will be required to apply their intuition to their clinical thinking, evidence-based practice skills, and nurses’ reasoning to make clinical decisions. For instance, a nurse working in the emergency department will be required to use her intuitive thinking. In some emergency cases, first aid care will be needed to support the patients in pain or those having a cardiac attack at the ER. As such care cases are undetermined, the nurse must use intuition to decide on the emergency medications to use to support the patient before they can be admitted and a conclusive objective diagnosis is made.

Intuition in nursing goes beyond having a gut feeling about something. It is based on knowledge and experiences to interpret a patient’s case, either from physical observation and examination or a health history review. I will focus on various approaches that can help develop more in-practice knowledge by engaging in practices that give me substantial exposure and experiences to support my intuition. This includes learning from senior nurses and physicians through observation and asking them questions. I can also learn how to interpret responses, body language, and physical manifestations of various diseases. I can also ensure that I continuously reflect on my experiences when interacting with patients.

 References

Embler, P. (2021, March 9). Imparting clinical judgment leads to sound clinical decision-making and patient advocacy. Wolters Kluwer. https://www.wolterskluwer.com/en/expert-insights/imparting-clinical-judgement

Tanner, C. A. (2006). Thinking like a nurse: a research-based model of clinical judgment in nursing. The Journal of Nursing Education, 45(6), 204–211. https://doi.org/10.3928/01484834-20060601-04

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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

Link to article

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 please cite them in APA format if they are used.