Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings.
Keeping that in mind, answer the following scenario:
You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include:
- RN with 12 years of Trauma ED experience
- New RN with 6 months ED experience
- RN from the Medical Surgical floor with 8 years of experience
The following patients are in the ED, which patient will you give to each of the nurses and why?
- A 76-year-old client who was involved in a motor vehicle accident and has hematuria.
- A 38-year-old client with kidney stones complaining of severe pain.
- A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.
- An 80-year-old client that has not had a bowel movement for 4 days.
Clinical judgment is a vital skill that every nurse should possess to provide safe, effective, and quality patient care. In the given scenario, as the Charge Nurse in a large urban Emergency Department (ED), assigning patients to the nursing staff requires clinical judgment based on their knowledge, skills, attitudes, and experience in the ED setting. The nursing staff includes an RN with 12 years of Trauma ED experience, a new RN with six months of ED experience, and an RN from the Medical Surgical floor with eight years of experience.
The first patient is a 76-year-old client who was involved in a motor vehicle accident and has hematuria. The RN with 12 years of Trauma ED experience should be assigned to this patient. The experienced nurse has the knowledge and skills to assess and manage trauma patients, including patients with hematuria. The nurse will conduct a thorough assessment, provide interventions to stabilize the patient’s condition, and collaborate with the healthcare team to ensure timely and appropriate care.
The second patient is a 38-year-old client with kidney stones complaining of severe pain. The new RN with six months of ED experience should be assigned to this patient. The patient’s condition is stable, but the pain requires immediate intervention. The new RN will have the opportunity to practice and apply their knowledge and skills in pain management, including administering pain medications, assessing pain levels, and monitoring the patient’s response to interventions. The experienced nurses will be available to provide support and guidance as needed.
The third patient is a 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching. The RN from the Medical Surgical floor with eight years of experience should be assigned to this patient. The patient’s condition is stable, and the focus is on providing education and discharge planning. The nurse has experience in providing education to patients with chronic conditions, including diabetes, and can ensure that the patient receives appropriate education and resources to manage their condition at home.
The fourth patient is an 80-year-old client who has not had a bowel movement for four days. The RN with 12 years of Trauma ED experience should be assigned to this patient. The patient’s condition is unstable, and constipation can lead to serious complications in the elderly. The experienced nurse has the knowledge and skills to assess and manage patients with bowel obstructions and will collaborate with the healthcare team to provide appropriate interventions, including medication administration, enemas, or other bowel management strategies.
In conclusion, clinical judgment is a crucial skill that nurses should possess to provide safe, effective, and quality patient care. In the given scenario, assigning patients to the nursing staff requires clinical judgment based on their knowledge, skills, attitudes, and experience in the ED setting. By assigning patients based on their individual needs and the nursing staff’s experience, the patients can receive appropriate and timely care, leading to better outcomes.