Clinical Reasoning and Its Effectiveness in the Nursing Career - Article Example

CLINICAL REASONING AND ITS EFFECTIVENESS IN THE NURSING CAREER Clinical Reasoning and Its Effectiveness in the Nursing Career Customer Inserts His/Her Name Customer Inserts Grade Course Customer Inserts Tutor’s Name 02, 04, 2011 Clinical reasoning is a wide field that involves various aspects. These aspects include the following: application of various cues by nurses to enhance clinical reasoning, how to rescue a patient in critical conditions and use of the Situation Background Assessment and recommendation tool in clinical reasoning. The various cues used in nursing include the think aloud analysis and also use of the proactive and reactive approach in performance of tasks. The SBAR tool shows the procedure a nurse should follow when handling a patient in a critical condition. If the above factors are put into practise then it is evident that clinical reasoning is enhanced in nursing a career that is majorly geared towards achieving optimistic patient outcomes despite the patient’s condition. An example of a critical patient’s condition will enhance the actual basis on which a nurse will react with regards to clinical reasoning (Aiken et al. 2008). There are various types of cues used by nurses in clinical reasoning. These include; think aloud analysis especially in surgical operations to avoid danger and also ensure successful patient outcome, proactive or reactive approach in tasks (Banning 2008,). The above cues were meant to enable the nurses to: assess the patient’s status, make appropriate judgement with regards to the patient status, follow the correct procedures in treating the patient and acquire/get the patient’s history and relate it to the present condition of the patient thus being able to make realistic and applicable measures during the treatment of the patient. Studies using the think aloud analysis focus on the cognitive processes that are to be followed to give a solution. It is also used to rate the reasoning skills of qualified nurses in a variety of clinical settings. In this case, it assessed the nursing care offered, evaluation of the particular care offered, planning and implementation of that particular nursing care (Kendall-Gallagher & Blegen 2009). Protocol analysis which is used along the think aloud approach is effective as it enables nurses to be quick in reviewing and analysing a patients situation. Clinical reasoning in this case is evident when the nurse uses his/her career experience and knowledge to relate and merge the incidences in the information gathered and make a decision (Hoffman, Aitken & Duffield 2009). Failure to rescue involves evaluation of the different healthcare offered to patients and the patient outcomes whether good or bad. This evaluation is basically centred on the nurse’s approach towards a certain patient scenario. It focuses majorly on whether nurses are able to deeply harness how their knowledge and skills application deeply influences the patient outcomes. With reference to nursing, the nurses majorly concentrate on whether the details of nursing care have been attended to their expectation on the patient, whether good or bad and maybe their level of unsettledness in case of bad outcomes. In the case of rescue nurses are viewed as beginners of the rescue process and so they should avoid any slight mistakes if there should be successful patient outcomes (Brown & Edwards 2008). To avoid unsuccessful patient outcomes, nurses should carefully interpret clinical data before carrying out any procedures on a patient. The models of care used in a facility determine greatly if a nurse will effectively apply their career knowledge so as to realise a successful patient outcome. The major nurse role in a rescue situation is bravery and quality leadership which are clearly depicted through procedures taken in a patient rescue situation (Clarke 2004). The nursing intervention would be to frequently and at close intervals study the vital signs of Mr. Smith’s condition. In Mr. Smith’s case, the vital signs were: heavy chest pain, shortness of breath in him, nausea and weakness. The nurse would then assess his weight and check if his current weight actually does correspond to the weight that he should medically possess because he seemed an obese case. The nurse would then check for the blood pressure of the patient and try to regulate it with respect to directions from the physician. The nurse would then administer drugs prescribed and actually check on the patient’s reactions to the drugs prescribed by the physician. This enables the nurse to make a conclusive care treatment with regards to Mr. Smith’s condition after administration of the prescribed treatment (Brown, D and Edwards, H, 2008). This is actually a practise of what the Situation Background Assessment Recommendation tool suggests; where one is expected to assess the patient’s condition, alert the physician about the situation, administer the physicians recommendation after a deep analysis of the patient’s condition and then evaluate the patient’s condition after giving treatment and send feedback to the physician about the patient’s response. The SBAR tool aimed at ensuring safety of the patient thus leading to higher cases of successful patient outcome. This method also enables the nurse to easily review the patient’s records. It also ensures effective communication between the nurse and the interdisciplinary team. The members of the interdisciplinary team are knowledgeable about the care to be given to the patient and this also ensures implementation of the tool. The effectiveness of the SBAR tool is greatly aided by the use of technology which ensures speedy and conclusive feedback to the nurse who then acts in accordance with the feedback received (Haig, Sutton & Whittington 2006). Another way nurses can effectively implement clinical reasoning is by implementing clinical reasoning is by use of the five rights in the medical fraternity to enhance medical safety. This is practicable in the sense that any time medication is given to patient it must be reviewed by nurse of a physician. The medication should be availed in single doses to the patient. These five rights encourage nurses to intervene in serious injury in patience thus saving the lives in great danger (Levett-Jones et al. 2010). This is because it helps the nurses to plan, implement and carry out the rescue process. Nurses can increase the optimal wellness of their patience in the following ways: ensuring a well spaced and comfortable environment for the patient, proper interaction between the nurse and interdisciplinary committee to avoid any further complications to the patient and speed up the patient’s recovery process and recommendation of emotional support and proper care of the patient while at home by the relatives of the patient. In conclusion, nursing as a career delicate as it requires the implementation of key and rightful procedures during operation hence the need for reasoning and in particular clinical reasoning. This is basically to ensure successful patient outcomes and also encourage an optimistic attitude in the patient during the treatment and also as they recover. From the analysed literature it is evident that when effective cues and tools like the SBAR tool are used then the nurse is able to save the patient’s life with ease as in cases of emergency (Woodhall et al. 2008). Clinical reasoning also ensures that the nurse is alert at all times thus able to give better quality services to the patient with regards to the code of ethics of his career. References Aiken , L., Cheung, R., Clarke, S., & Sloane, D 2008, ‘Nursing care and patient outcomes: international evidence’, Enferm Clin, vol. 18, no. 1, pp. 35–40. Banning, M 2008, ‘Clinical reasoning and its application to nursing: Concepts and research studies’, Nurse Education in Practice, vol. 8, no.3, pp. 177–183. Brown, D & Edwards, H 2008, Lewis' medical-surgical nursing, 2nd edn, Elsevier Mosby, Sydney. Clarke, S 2004, ‘Failure to rescue: lessons from missed opportunities in care’, Nursing Inquiry, vol.11, no. 2, pp. 67–71. Haig, K, Sutton, S & Whittington, J 2006 , ‘SBAR: A shared mental model for improving communication between clinicians’, Joint Commission Journal on Quality and Patient Safety, vol. 32, no. 6, pp.167- 175. Hoffman, K, Aitken , L & Duffield, C 2009, ‘A comparison of novice and expert nurses’ cue collection decision-making: Verbal protocol analysis’, International Journal of Nursing Studies, vol. 46, no. 10, pp. 1335–1344. Kendall-Gallagher, D, & Blegen, M 2009, ‘Competence and Certification of Registered Nurses and Safety of Patients in Intensive Care Units’, Am J Crit Care, vol. 18, no.7, pp.106-113. Levett-Jones, T, Hoffma, K, Dempsey, J, Jeong, S, Noble, D, Norton, C, Roche, J & Hickey, N 2010, ‘The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients’, Nurse Education Today, vol. 30, no.6 pp. 515–520. Woodhall et al. 2008, ‘IMPLEMENTATION OF THE SBAR COMMUNICATION TECHNIQUE IN A TERTIARY CENTER’, J Emerg Nurs, vol. 34, no. 4, pp. 314–317. Read More