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Scholarly Capstone Paper
Scholarly Capstone Paper
Scholarly Capstone Paper
Brandon Reyes
This paper is focusing on how us nurses make, “clinical nursing judgment” in the
clinical field of practice. To define clinical nursing judgment means, “the process by
which the nurse decides on data to be collected about a client, makes an interpretation of
the data, arrives at a nursing diagnoses, and identifies appropriate nursing actions; this
2003). As a nurse, it is our priority to make logical, rational decisions and determine
whether a given action is right or wrong. Clinical nursing judgment is applied while the
patient is still alive, and the critical decisions are made based on scientific observations,
along with the added skill provided by a long understanding due to similar experiences.
evaluation.” (“Van Graan,” 2016). It is important to have critical thinking and clinical
judgment as necessary skills when caring for a patient in an everyday nursing practice.
Without clinical practice, we would have limited exposure to real life scenarios. This
would negatively benefit us in accomplishing the part of developing the “role taking”
skill as a nurse in different patient scenarios. Having such opportunities will give us
nursing students a deeper understanding of the clinical situation and ethical values for
Running head: Clinical Nursing Judgment 3
care. The nursing process has dominated nursing education since the 1960's as theorists
tried to link their theories with the clinical judgment process and to link nursing theory
The personal experience I would like to share where all medical personnel’s used
clinical judgment, including nurses, was my first patient code. I was in the Medical
Intensive Care Unit (MICU) at downtown St. E’s for an offsite clinical last semester for
critical care class. I was helping admit a patient who coded on a previous unit while
receiving dialysis. He was very unstable and this was the second time he coded within 4
hours. Another nurse and I were hooking him up to an EKG, drawing blood from a
femoral line, and the next thing you know, he starts to seize and his blood pressure drops!
Respirations are decreasing with each breath and then no pulse! The nurse hit the code
button on the wall and a code team of about 14 medical personnel’s rushed in. It caught
me off guard and I was in complete shock. I stood off to the side and watched these
heroes do everything they can to save this person’s life. It was amazing to see how each
department had their own required task in bringing this guy back to life. He was a full
code patient. Nurses were doing chest compressions and helping the doctors by pushing
the medications like Atropine to raise the patient’s heart rate. Respiratory watched vitals
and bagged the patient, while the doctors were giving instruction by telling everyone
what to do/look for, etc. Seeing how everyone used clinical judgment in such an intense
moment made everything come together on the outlook of medical professionals by how
they used problem solving, decision-making, and critical thinking in this specific
Running head: Clinical Nursing Judgment 4
scenario. It became reality when the one male nurse demanded me to hop in and due
chest compressions on the patient. I was completely caught off-guard and hesitated for a
brief second before taking action. In that moment, my heart was beating out of my chest
and I had to make clinical judgment on remembering the proper technique of giving chest
compressions by hand placement, locking the arms, exerting pressure by using body
weight, and pressing hard enough to penetrate 2 inches into the chest wall at a rate of 100
compressions a minute. After about 5 minutes into the code and while I was doing chest
compressions, the nurse exclaimed, “We have a pulse!” I was in complete relief and the
adrenaline rush I experienced was amazing. After this experience is when I knew the
Intensive Care Unit was where I wanted to specialize in the field of nursing.
evidence based care delivery, therefore, observational and reasoning skills will result in
sound, reliable, clinical judgments. Clinical judgment, a concept which is critical to the
nursing can be complex, because the nurse is required to use observation skills, identify
reasoning and judgment” (“McCartney,” 2017). Nursing school, along with the clinical
experience, definitely helps us nursing students develop clinical judgment and critical
thinking skills in the time of need. I am pleased to have chosen nursing as my career and
profession. Everything I have learned and will continue to learn will only further benefit
the people around me and myself. Having the knowledge and clinical experience of being
able to help save a patients life is the most rewarding gift of all!
Running head: Clinical Nursing Judgment 5
Reference Page
Nursing, and Allied Health, Seventh Edition. (2003). Retrieved March 14 2018
from
https://medical-dictionary.thefreedictionary.com/clinical+judgment
McCartney, M. (Ed.). (2017, March 28). Margaret mccartney: Nurses must be allowed to
http://www.bmj.com/content/356/bmj.j1548/rr-0
Van Graan, A. C., Williams, M. J.S., & Koen, M. P. (Eds.). (2016, December).
https://www.sciencedirect.com/science/article/pii/S1025984816300047