Clinical judgment
Clinical judgment is a complex process of navigating a nurse’s medical knowledge in situations that require their assessment and subsequent actions. Critical thinking and decision-making are the two vital parts of that process (NCSBN, 2019). The former is responsible for correctly assessing the patient’s condition using evidence-based theories and facts and establishing what needs to be done to resolve the issue and help the patient. Decision-making is the next step in solving the problem – the nurse performs the necessary actions based on their assumptions and knowledge. I believe that clinical judgment is crucial in nursing care, as it allows nurses to make informed and educated decisions that impact patient outcomes significantly.
The video by NCSBN (2019) advocates clinical judgment and how to develop it through tailored exams. I think that I would like to take these exams to evaluate my clinical judgment skills and see what areas I would need to educate myself in further. After learning about the clinical judgment concept, I am now determined to fully employ it in my own nursing care processes and actively use it every time I interact with a patient.
Clinical Judgement in My Clinical Experience
Around 2 months ago, I was tasked with administering COVID-19 Pfizer vaccine shots to incoming patients. One woman began experiencing severe adverse effects in the form of a strong headache and nausea, accompanied by feelings of dread, hindered breath, and skin irritation, which is located at and around the vaccine injection site. The symptoms began to manifest 15 minutes after the injection of the vaccine. The patient showed an increase in breath hindrance severity, as well as in nausea feeling. I prompted her to lie down and decided to observe her symptoms further. The patient stated that standing up and moving makes it more difficult to breathe while lying down gives relief from nausea. Still, her other symptoms persisted, and I had to provide medical care for her.
I critically reviewed all of the patient’s symptoms and visible signs and related them to the vaccine injection – the evidence pointed towards either anaphylactic shock or myocardial infarction. The symptoms manifested shortly after the vaccine injection, which was more characteristic of an allergic reaction, and the patient did not experience any chest pain that is usually present in myocardial infarction. Moreover, skin irritation and shortness of breath also indicated the anaphylactic reaction. Thus, I concluded that the patient was experiencing anaphylactic shock, and proceeded with the necessary treatment.
Reflection on the First-Year Nursing Experience
My first-year nursing experience has provided me with many insights, especially regarding my future work as a registered nurse. Prior to working in a real clinical setting, I perceived the impact nursing care has on patients and their outcomes as something more abstract, as I have not yet experienced this connection. After I began my first year as a nurse in training and saw firsthand how close nurses are to patients and how important nursing care is in the whole treatment process, I finally understood it. The value and complexity of the nurses’ job was the most important insight that I gained by working as a nurse.
This experience also made me think a lot about my future career and how I want to continue it. I still want to be a nurse because I have seen the impact nurses make on patients and their outcomes. Without nurses, the whole treatment process is impossible – people would suffer greatly if there is a shortage of capable and educated nurses who can provide qualified care.
If I want to remain successful in nursing school, I must dedicate effort and time to educate myself – both in my area of expertise and adjacent fields. It is crucial for a medical professional to always stay up to date with the latest developments in medicine and related technology, and continuously develop their knowledge. Thus, I would try to take on different additional courses to learn more, read books and scientific articles, and engage with fellow nurses and doctors.
Reference
NCSBN. (2019). The right decisions come from the right questions. YouTube. Web.