Critical Thinking and Clinical Judgment Skills - Essay Example

? Critical Thinking and Clinical Judgment Skills Number: Introduction In itself, critical thinking isa process is logical tool by which an individual or a group can arrive at reasoned conclusions, based on a reasoned process. Conversely, critical thinking can also be described as an intellectually disciplined process of skillfully and actively conceptualizing, analyzing, synthesizing, evaluating and applying information that has been gathered from or generated from experience, observation, communication or reasoning, as a guide to an action or a belief. Thus, critical thinking surpasses the provision of a way of ascertaining veracity, partial veracity or falsehood of a claim, to embrace and encompass the passing of judgment not just in academic fields, but in practical ventures as well. Nursing is one of these many ventures in which critical thinking is greatly applied. As a matter of fact, critical thinking and nursing are mutually inclusive of each other that any nurse devoid of critical thinking skills seldom succeeds. That critical thinking in nursing is indispensible is a matter which is underscored by the fact that it [critical thinking] helps nurses carry out the assessment process, question, evaluate, analyze and reconstruct the process of delivering nursing care, by logically and systematically challenging the established nursing theories and practices. The magnitude of critical thinking may therefore be seen in light of the discussion which ensues forthwith. Critical Thinking and Decision-Making in Patient Care In the first place, when going about the nursing process or duty, it will behoove the nurse to decide [by critically thinking through] the pieces of patient information which is critical, from those that are not. Those that have been determined as important may then be analyzed. After the analysis, the nurse may need to work closely and in consultation with the patient, so as to form a consensus, which is a mutually agreed upon care goals. In this case, the nurse will need to use sound judgment to arrive at key decisions, when and by studying a wide variety of sources and by making personal observations about the patient, in relation to his medical records. In this case, the nurse will need to incorporate and use a reflective component in decision-making. Herein, the reflective component is essentially a review of the judgements and the validation of these judgments’ appropriateness (Alfaro-Lefevre, 2009). Critical Thinking in Reconciling Nursing Practices and Ethical Issues When Administering Patient-Based Care Above all the needs of critical thinking in nursing, is the application of critical thinking in the delivery of patient-based care. Since patient-based supports the active participation of patients and their families in decision-making about individual options for a patient’s treatment and designing new care models for the patient’s treatment. This means that in administering patient-based care, the nurse will administer care which is responsive and respectful to an individual patient’s needs, values and preferences, and making sure that patient values are the rallying points to all clinical decisions. Herein, critical thinking will be critically applicable, since the administration of patient-based care sometimes seems constrained by, and to fundamentally clash with the dictates of medical and clinical rules and guidelines (Mann, 2012). Thus, Bowles (2000) observes that when administering patient-based care, the nurse will have to: appreciate the importance of nursing guidelines and rules of medical care; factor the patient’s preferences, values and needs; and establish the status of the patient spelled out in his medical records; think through the options needed to strike the delicate balance among delivering patient-based care, not breaching nursing and medical guidelines and not subjecting the medical institution to legal liabilities. An instance which expressly exemplifies the situation above took place on December 12th, 2012. In this instance, a patient checked in to the hospital I was working in, with a deep cut in his eyebrow. He had been happened upon malefactors who attacked and robbed him, at 8:00 PM, on his way from work. When he checked in to my custody, he requested to have a surgery, to close the wound. On one hand, the crux of the matter herein is that the patient slept with his wound, meaning that it was not fresh enough for surgical stitching. Medical laws needed that wounds for surgical intervention be fresh. This is because stitching a wound that is not as fresh is in potential danger of becoming gangrenous from within. On the other hand, the patient pleaded earnestly on surgical stitching, since leaving the wound to heal and seal up on its own would leave the patient’s face with a large scar. In respect to the foregoing, I decided to think of the best way of providing the patient with patient-based care. I: analyzed the patient’s health record to ascertain his vulnerability to infections and illnesses; factored the client’s age; and having ascertained that he was above the legal age [or the age of consent], was compos mentis [having a sound mind], not allergic to the type of anesthesia available [Local 20] and able to meet the financial obligations of the surgical procedure, I deemed the procedure tenable. The next was to carefully examine the state of the wound. From examination, it was apparent that although the wound had been being exposed for 12 hours, yet it was still fresh. I decided to administer surgical stringing, after cleaning the wound and before bandaging it. The wound claimed 20 stitches. The bandage was changed and the surface of the wound cleaned in the hospital after every 2 days. When the patient checked in a week later for the removal of surgical stitches, the wound had healed just well, much to my joyful satisfaction and the patient’s delight. Just as Lisko and O’Dell, V. (2010) observe, the situation above had compelled me to utilize critical thinking and clinical judgment skills. This is because failing to use critical thinking could have made me to stick only within the guidelines of medical or clinical ethics, but the patient’s best interests may not have been served. Conversely, attempting to pursue the patient’s request as a way of administering patient-based care might have subjected me and the medical institution to a legal liability. This is because, analyzing the patient’s health record to ascertain his vulnerability to infections and illnesses lessened chances for the internal formation of gangrene after the surgery; factoring the client’s age and state of mind ensured that he was able to make a legal decision all by himself; and checking against allergy to the type of anesthesia available ensured that the surgical procedure was done in light of all safety measures. The need to ensure that the interests of the hospital I was working for were taken care of and to allay risks in this high-risk affair compelled me to ensure that the patient was able to meet the financial obligations of the surgical procedure. Conclusion In regard to the foregoing, it is clear that critical thinking and clinical judgment skills relate to nursing practice by fostering key decision-making exercises; solving ethical issues which may impede the delivery of quality and patient-based medical services and clinical care; and perpetuating the interests of clinicians, healthcare practitioners and the medical institution in operation. In my case, the use of critical thinking and clinical judgment has been instrumental in improving my patient outcomes by allowing me to exercise discretion in factoring medical ethics and laws and the wishes, values and needs of my patients. References Alfaro-Lefevre, R. (2009). Critical Thinking and Clinical Judgment: A Practical Approach to Outcome-Focused Thinking, 4th Edition. St. Louis, MO: W.B. Saunders Company. Bowles, K. (2000). The Relationship of Critical-Thinking Skills and the Clinical-Judgement Skills of Baccalaureate Nursing Students. The Journal of Nursing Education, 39 (8), 373. Lisko, S. & O’Dell, V. (2010). Integration of Theory and Practice: Experiential Learning Theory and Nursing Education. Nursing Education Perspectives, 31 (2), 106. Mann, J. (2012). Critical Thinking and Clinical Judgement Skill Development in Baccalaureate Nursing Students. Kansas Nurse, 87 (1), 26. Read More