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Nursing Process and Clinical Decision Making

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Nursing Process and Clinical Decision Making
Janet
NUR/300
Kimberly Tomsai
October 12, 2011

Nursing Process and Clinical Decision Making Not all nurses have the same knowledge and experience therefore nurses need to understand clinical judgment, decision making, and the nursing process to administer the best nursing care regardless of personal skill level. Nurses make clinical decisions based on knowledge and experience. A variety of theories and conceptual frameworks have developed to explain the science of nursing and clinical judgment, one of the most notable is that of Patricia Benner. Benner’s theory presents that nurses operate in five stages of clinical judgment from novice to expert (Bias, Hayes, Kozier, & Erb, 2011). The novice is the student nurse who has very little or no knowledge whose main concern is with rules and guidelines to complete tasks. Next is the advanced beginner or the graduate nurse who understands the concepts of nursing but sees difficult situations as more difficult tasks to complete and more rules to learn and often feels overwhelmed frequently consulting with more experienced nurses. For example a new patient arrives to the unit the nurse has not completed the tasks for the patients she already has becomes overwhelmed with how to prioritize and meet each patient’s needs. At the competent stage the nurse no longer functions entirely within a set of rules. Organizational and technical skills have improved the nurse is adaptive able determine what is important and what is not, and is comfortable with nursing care. For example she has five patients calling for assistance this nurse determines what can be delegated to others and what is a priority for her nursing abilities. A proficient nurse has developed a more intuitive understanding of situations relying less on rules and guidelines able to anticipate what

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