Reflective
Clinical decision making is a complex task that requires high-quality clinical knowledge, critical thinking, and problem-solving skills to achieve positive patient outcomes (Levett-Jones, 2018; Liou et al., 2018). This essay will apply eight stages of the clinical reasoning cycle (CRC) to discuss and reflect on a clinical decision that I made during clinical placement. SMART goals framework and Gibbs reflective cycle will be incorporated effectively within stage five and stage eight, respectively, of the CRC for my chosen decision. Furthermore, this essay will also discuss three of the Nursing and Midwifery Board of Australia (NMBA) competency standards for registered nurses concerning the decision-making process.
Considering the patient
The first stage in the CRC is to consider the presenting problem and start to gain an initial impression (Levett-Jones, 2018). In this stage, it is paramount to note the prior preconceptions, assumptions and bias that may influence the nurses’ ability to collect information (Levett-Jones, 2018; FitzGerald & Hurst, 2017). Patient ‘Z’ was a 61-year-old male who was brought in by ambulance to the emergency department (ED) after suffering an acute onset of chest pain post heavy lifting in his garage. On admission, the patient complained of 9/10 central chest pain with some radiation to his teeth and associated nausea. The patient was admitted to the ED for the management and treatment of his chest pain.
Collect cues/information
The second stage in the CRC involves collecting and reviewing current information, patient history, patient charts, nursing notes, investigation results, and previous medical and nursing assessments (Levett-Jones, 2018). Further Alfaro-LeFevre (2017) recommended the importance of gathering new information by undertaking patient assessment and recalling some knowledge from the law, therapeutic, cultural context, pathophysiology, and physiology to establish the context of care for the patient.
