Nursing Process and Clinical Decision Making in Practice
This paper examines clinical decision making within the nursing process, beginning with a definition drawn from Higuchi and Donald's framework of thinking processes — description, representation, inference, synthesis, and verification. It then outlines Benner's five stages of clinical competence, from novice to expert, explaining how nurses develop intuitive judgment and problem-solving ability over time. The paper also discusses how critical thinking contributes to effective clinical decision making and illustrates how nursing care provision differs at each stage of Benner's model. The paper concludes by emphasizing that experiential learning, combined with formal education, enables nurses to grow into confident, expert practitioners capable of meaningful collaboration in clinical settings.
- Defining Clinical Decision Making: Definition and theoretical framework for nursing decision making
- Benner's Five Stages of Clinical Competence: Novice through expert stages of nursing judgment
- How the Nursing Process Supports Effective Clinical Decision Making: Critical thinking components that enhance nursing decisions
- Differences in Nursing Care Across Stages of Clinical Judgment: Contrasting novice and expert nursing care provision
- Conclusion: Experience and education shape expert nursing practice
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What makes this paper effective
- The paper integrates multiple authoritative sources — Higuchi and Donald, Benner via Saver, and a critical thinking framework — to build a coherent argument about nursing judgment development.
- It uses a clear enumerated structure for Benner's five stages, making complex developmental concepts easy to follow and compare.
- The contrast drawn in Section IV between expert and novice nurses grounds the theoretical framework in practical, clinical terms.
Key academic technique demonstrated
The paper demonstrates synthesis across sources: rather than summarizing each source in isolation, it connects definitions of clinical decision making with a developmental competency model and a critical thinking framework to show how they collectively explain nursing practice. This layered citation approach strengthens the argument that clinical expertise is both experiential and knowledge-driven.
Structure breakdown
The paper is organized into five sections. It opens with a definition and theoretical framework for clinical decision making, moves into Benner's staged competency model, then links those stages to the broader nursing process and critical thinking skills. A focused comparison of expert versus novice care follows, and the paper closes with a brief integrative conclusion. This progression from definition to theory to application is characteristic of a well-organized nursing education essay.
Defining Clinical Decision Making
Clinical decision making is defined in the work of Higuchi and Donald (2002), "Thinking Processes Used by Nurses in Clinical Decision Making," as "a problem-solving activity that focuses on defining patient problems and selecting appropriate treatment interventions" (p. 145). Clinical decision making is further described as that which "forms the basis of expert clinical practice" (Higuchi & Donald, 2002, p. 145). The nurse works in clinical practice settings as a member of a healthcare team, which requires communicating decisions to other team members "to ensure the continuity and coordination of patient care" (Higuchi & Donald, 2002, p. 145). The nurse is also required to document clinical decisions in the patient's charts and plans for care.
Clinical decision making, according to Higuchi and Donald, has been studied using the theoretical perspectives of decision theory and information processing. They identify five major thinking processes:
(1) Description — the delineation or definition of a situation or the form of a thing;
(2) Representation — depiction or portrayal through enactive, iconic, or symbolic means;
(3) Inference — the act or process of drawing conclusions from premises or evidence;
(4) Synthesis — composition of parts or elements into a complex whole;
(5) Verification — confirmation of accuracy, coherence, consistency, or correspondence. (Higuchi & Donald, 2002)
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