Nursing Process and Clinical Decision-Making

Nursing Process and Clinical Decision-Making

The nursing process and Benner's stages of clinical judgment have major roles in the nursing profession as well as nursing students. The nursing process serves as a guide or foundation for nurses and students alike to help formulate clinical decision-making. The Benner's stages of clinical judgment illustrate the different levels of proficiencies in both nursing students and licensed nurses. Both nursing process and Benner's stages have five progressive levels, which will help nurses have a solid foundation in making effective clinical decision-making.

Clinical decision-making involves accurate assessments, using available resources for valuable information, and evaluating and incorporating knowledge and information to formulate clinical judgments (Duncan, G., & René DePew, R. p. 60). The nursing process is a method nurses use to formulate clinical judgments for caring patients. There are five steps in the nursing process. The first step in the nursing process is assessment. In this step, the nurse will assess the patient by collecting specific data related to the patient's health needs. When the assessment is completed, the nurse will then identify either an actual, potential, or possible nursing diagnoses specific for the patient. In the third step of the nursing process is planning. The nurse sets up nursing interventions to achieve goals for the patient's problem. The fourth step in the nursing process is implementing the planned interventions-based on scientific knowledge. The fifth step is evaluating the care plan. For example, did the nurse reach his or her desired goal or outcome for the patient? Or how is the patient reacting or adjusting? However, if the goal for the patient was not achieved, then the nurse will repeat the nursing process as many times possible until the desired goal or outcome is achieved.

The nursing process is very effective in clinical decision making. The nursing process is a method, which nurses use in the clinical setting to formulate nursing plans or goals step-by-step for individual patients. The nursing process is unique and individualize for each patient. The nursing process method also helps the nurses focus or pinpoint the main problem or idea in which needs to be addressed. Although each patient is different to one another, the nursing process follows the same methods or steps. The nursing process also determines nursing actions that are appropriate for each patient. Each step of the nursing process involves the use of knowledge and available information to formulate clinical judgments specifically for the patient's problems, diagnosis, and/or needs.

The Benner's stages of clinical judgment describes five levels of proficiency in nursing – novice, advanced beginner, competent practitioner, and proficient practitioner (Koernig Blais et al., p. 22). The first level of Benner's stages is known as novice. The novice stage is where an individual have no experience of the situations in which he or she are expected to perform. For example, nursing students are considered to be in the novice stage. Their planning for the provision of nursing care at this stage is limited and inflexible because of lack experience. Their performance and clinical judgments are also limited and inflexible. They are not yet able to perceive any given situation as a whole. They are also governed by context-free rules and regulations rather than experience. Stage two is known as the advanced beginner. At this stage, the nurse is able to demonstrate marginally acceptable performance. Unlike novice individuals, the advance beginners have experienced enough real situations to make clinical judgments about them. For example, a nursing student who has some prior work experience in the field may be able to use his or her experience to plan their nursing care in the clinical setting. At this stage, principles-based on experience are formulated to guide clinical actions. The