The following articulation of practical reasoning in nursing illustrates the social, dialogical nature of clinical reasoning and addresses the centrality of perception and understanding to good clinical reasoning, judgment and intervention. Simulations cannot have the sub-cultures formed in practice settings that set the social mood of trust, distrust, competency, limited resources, or other forms of situated possibilities.
The scientist is always situated in past and immediate scientific history, preferring to evaluate static and predetermined points in time e. Bourdieu 29 calls the recognition of the situation central to practical reasoning.
Aristotle recognized that when knowledge is underdetermined, changeable, and particular, it cannot be turned into the universal or standardized. This is a skill of foregrounding attention accurately and effectively in response to the nature of situational demands.
Thus, RCTs are generalizable i. The clinician must act in the particular situation and time with the best clinical and scientific knowledge available. As noted earlier, a central characteristic of a practice Clinical nursing essay is that a self-improving practice requires ongoing experiential learning.
In these cases, the latest basic science about cellular and genomic functioning may be the most relevant science, or by default, guestimation. Course work or ethical experiences should provide the graduate with the knowledge and skills to: The ability to think critically uses reflection, induction, deduction, analysis, challenging assumptions, and evaluation of data and information to guide decisionmaking.
In clinical practice, the particular is examined in relation to the established generalizations of science. Why am I doing this procedure for this particular patient? This implies that evidence-based practice, indicative of expertise in practice, appropriately applies evidence to the specific situations and unique needs of patients.
To recognize this is of course also to recognize the existence of an additional virtue, one whose importance is perhaps most obvious when it is least present, the virtue of having an adequate sense of the traditions to which one belongs or which confront one.
To do so, clinicians must select the best scientific evidence relevant to particular patients—a complex process that involves intuition to apply the evidence. The student first asked her teacher about the unusually high dosage.
Clinical experience is good, but not everybody has it. Recognizing Changing Clinical Relevance The meanings of signs and symptoms are changed by sequencing and history.
The challenge for nurses was that rigid adherence to checklists, guidelines, and standardized documentation, 62 ignored the benefits of intuition.
The changing relevance entailed in a patient transitioning from primarily curative care to primarily palliative care is a dramatic example, where symptoms literally take on new meanings and require new treatments. Expert clinical reasoning is socially engaged with the relationships and concerns of those who are affected by the caregiving situation, and when certain circumstances are present, the adverse event.
Evidence-Based Practice Clinical nursing essay concept of evidence-based practice is dependent upon synthesizing evidence from the variety of sources and applying it appropriately to the care needs of populations and individuals. Developing Clinical Knowledge in Specific Patient Populations Extensive experience with a specific patient population or patients with particular injuries or diseases allows the clinician to develop comparisons, distinctions, and nuanced differences within the population.
Four aspects of clinical grasp, which are described in the following paragraphs, include 1 making qualitative distinctions, 2 engaging in detective work, 3 recognizing changing relevance, and 4 developing clinical knowledge in specific patient populations.
Available research is based upon multiple, taken-for-granted starting points about the general nature of the circulatory system. Get Full Essay Get access to this section to get all help you need with your essay and educational issues. He had a [nasogastric] tube, and knew pretty much about that and I think at the time it was clamped.
Alterations from implicit or explicit expectations set the stage for experiential learning, depending on the openness of the learner. In nursing and medicine, perceptual acuity in physical assessment and clinical judgment i.
The accrediting bodies and nursing scholars have included decisionmaking and action-oriented, practical, ethical, and clinical reasoning in the rubric of critical reflection and thinking. For example, when the background rhythm of a cardiac monitor changes, the nurse notices, and what had been background tacit awareness becomes the foreground of attention.
The context and sequence of events are essential for making qualitative distinctions; therefore, the clinician must pay attention to transitions in the situation and judgment. The transition from advanced beginners to competent practitioners began when they first had experience with actual clinical situations and could benefit from the knowledge gained from the mistakes of their colleagues.
Descartes codified this preference for formal logic and rational calculation. Yet many nurses do not perceive that they have the education, tools, or resources to use evidence appropriately in practice. This virtue is not to be confused with any form of conservative antiquarianism; I am not praising those who choose the conventional conservative role of laudator temporis acti.Associate Degree Nursing as Compared to Baccalaureate Degree Nursing Essay - Since the inception of the Associate Degree in Nursing there has been research and discussion as to whether this degree should continue.
REFLECTIVE ACCOUNT OF A CLINICAL SCENARIO ~ (AN ASPECT OF NURSING CARE) Reflection on Clinical Practice – First Placement (Year 1) The following essay is a reflective account on an event that I, a student nurse encountered whilst on my first clinical placement in my first year of study.
year nursing students demonstrated appropriate clinical reasoning and critical thinking skills during clinical competency assessment. The reasons for this are multidimensional. Clinical nursing and nursing education Essay Sample Why does funding have a lot to do with the comparisons of Quantitative Clinical Nursing and Nursing Education Articles?
Nursing education research, an inclusive science in which both qualitative and quantitative approaches are used and accepted. Each are utilized daily in clinical practice to provide the best patient care.
The rationale for considering the middle range theories is an important factor when considering a care plan, which requires the use of the nursing process.
Chapter 6 Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. Patricia Benner; presenting, and evaluating information that is both factually and belief based.
This is demonstrated in nursing by clinical judgment, which includes Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and.Download