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Making Decisions in Nursing Practice

Introduction

Nursing decision-making depends on numerous factors to take into account to provide patients with qualified and ethical care. These factors include effective communication, the sustainability of leadership practices, teamwork success, employee personal readiness, and some other aspects. In conditions of constant interaction with the population, nurses should be aware of different approaches and principles of providing assistance to those in need, and in my practice, I have always tried to develop individual skills and expand knowledge. Meeting the results of the passed course has become a priority for me, and I paid much attention to those criteria that influenced my decision-making.

Decision-Making in Relation to Client-Centered Care

During the course, I have learned many aspects of client-centered care as one of the key principles of skilled nursing. This approach dictates the specific conditions of interaction with target patients and determines the nature of decision-making, which concerns many aspects of each case. According to Sanerma et al. (2020), in an individualized care plan, the patient-nurse relationship includes ethical, cultural, spiritual, and some other factors to take into account.

For instance, over the course of my practice, I have learned how important it is to consider the patient personal background to provide the most effective care, both from a clinical and a moral standpoint. From a decision-making perspective, patients’ religious beliefs or other cultural criteria may be constraining factors for individual care interventions. In this regard, a client-centered approach allows addressing such barriers, and I have realized how valuable it is to follow these practices from an ethical standpoint.

Decision-making from a client-centered perspective can have not only clinical consequences, such as the rate of recovery but also political implications. Introducing dedicated funding programs can be effective in improving the quality of nursing care and enhancing nursing service coordination and delivery (Sanerma et al., 2020). The timely replenishment of the resource base eliminates any challenges associated with addressing patients’ individual problems, whether they are physical or psychological disorders. As a result, a client-centered approach is a practice that greatly influences decision-making and correlates with different individual factors of care, which explains the value of this technique in dealing with complex cases.

Intentional Learning and Decision-Making

In the context of nursing education, the concept of intentional learning plays an essential role. During the course, I have tried to develop this skill and realized that such an approach reflects an intrinsic motivation based on ultimate goals that, in turn, are significa0nt to pursue. The particular value of this type of learning lies in the ability to hone decision-making attainments and make nursing work more credible from a reliability perspective.

Epp et al. (2021) emphasize that sometimes, students in this field have “insufficient foundational knowledge to inform clinical judgements” (p. 805). In other words, the lack of theoretical background influences work outcomes negatively and can affect the quality of interaction with patients. Intentional learning, in my case, has become a driver to strengthen my decision-making skills and give me the understanding of how to operate with sufficient evidence for credible and ethically correct nursing practice.

Due to intentional learning, I have managed to build a clear model of my professional development and identify those areas in which I need to improve my knowledge. This, in turn, has given me an opportunity to approach decision-making more responsibly because I understand that, at the current stage, my qualifications may not be sufficient to make unconditionally accurate predictions and nursing diagnoses. Any form of interaction with patients, whether direct communication or care programs evaluation, requires commitment and responsibility. Therefore, intentional learning has become a concept for me to move forward so as to minimize mistakes at any of the interaction levels.

Processes of Making Decisions in Nursing

During the course, I have studied a wide list of processes and approaches to decision-making. This experience is valuable to me because the ability to apply different analytical techniques helps minimize errors and accelerate patient recovery through effective care interventions. In particular, a large volume of the theoretical base has improved my skills in analytical decision-making. According to Nibbelink and Brewer (2018), this process is reliable and efficient due to the logical comparison of specific data and their objective assessment. In other words, no personal beliefs and opinions affect decision-making.

Another process that I have also encountered during the course is based on the intuitive practice. Nibbelink and Brewer (2018) describe it as the technique of identifying specific causal relationships based on individual experiences and similarities, which resembles a deductive method. However, I am aware that the latter process is not reliable for me because I do not have sufficient experiences to draw conclusions regarding patient outcomes based on my intuition and referring to individual views on care outcomes.

One of the crucial concepts I have studied is naturalistic decision-making. In my practice, this framework is based on stimulating rapid responses to different situations, including emergencies (Nibbelink & Brewer, 2018). I am aware that medical employees often face situations when much depends on the speed of making the right decision, up to the patient’s life. Therefore, such a process is a valuable practice to develop so that to learn how to work in different conditions and be able to quickly address potential challenges.

Decision-Making in Relation to Clinical Reasoning and Critical Thinking

Any issue related to patient care requires professional judgment in line with clear rationales for a specific solution. In this regard, decision-making is associated with clinical reasoning as a concept that Macauley et al. (2017) define as “a process of balancing patient interactions, health systems, clinical data, judgment, and knowledge” (p. 64).

By combining different aspects of care, including both individual patient data and related circumstances, nurses can achieve high efficiency and the rational use of available resources and intervention techniques. Clinical reasoning corresponds to various manifestations of decision-making, whether it is either an analytical practice with clear reasoning or an intuitive approach based on practical experiences. As a result, nursing diagnostics, selecting communication strategies, and other relevant tasks are successfully solved due to the search for adequate justifications based on clinically reasonable features of each individual case.

The concept of critical thinking is another approach that also intersects with decision-making in nursing. According to Macauley et al. (2017), this practice is rather individual than group, but it is valuable since its basis is a “purposeful self-regulatory judgment that results in interpretation, analysis, evaluation, and inference” (p. 64). Decision-making can be complicated by circumstances that require a quick response, a combination of theoretical and practical skills, and other conditions. Critical thinking helps nurses quickly find an approach to each case by assessing such situations adequately. In my practice, both concepts are relevant to develop to achieve professional success and recognition from patients and colleagues.

Decision-Making and Leadership

Despite the fact that honing decision-making skills as important attainments acquired during education is a critical aspect of nursing staff training, the effective application of these skills is largely controlled by department heads. After studying a number of leadership theories and strategies during the course, I have realized that the task of a competent leader is to stimulate colleagues’ productive work but not just communicate relevant tasks to them and ensure that they are completed timely. Moreover, for productive decision-making, working at different levels should be taken into account. For instance, Salvage and White (2019) state that many leadership promotion programs focus primarily on organizational management. This means that, at the clinic level, relevant proposals are accepted to improve work performance and stimulate employee initiative, and I have studied different approaches to such work, including collaborative activities and individual incentive practices.

At the same time, leadership in local environments addresses broader issues that, nevertheless, also concern decision-making but at a more general level. Salvage and White (2019) provide an example of local campaigns aimed at educating nurse leaders, thereby creating a background for productive leadership at the organizational level. In a global context, leadership concepts are conveyed by international agencies, such as the World Health Organization (WHO), whose purpose is to promote policy decisions and then disseminate them to lower levels. Ultimately, in all environments, decision-making is one of the fundamental concepts to drive through actionable leadership practices.

Use of Technology in Decision-Making

While discussing effective communication, which is an important aspect of productive decision-making, one should also mention the tools used to interact with different stakeholders in the care process. During the course, I learned in what ways communication could be carried out and what trends existed in the nursing environment. McDonald et al. (2018) consider different remote communication tools, for instance, through social media, to deliver information to target patients timely and clearly. This practice is particularly valuable in the current context of the COVID-19 pandemic, when, due to social constraints, communication with patients is often remote.

Nevertheless, despite the value of technological solutions, I understand that even in the absence of such developments, the task of the professional nurse is to communicate regardless of the channels and methods of interaction.

In order for target patients to understand the essence of care principles and the importance of appropriate interventions, during the course, we were shown potential challenges associated with interaction with the population, as well as the ways to overcome them. Regardless of the technology available, patients have the right to understandable and accessible explanations of diagnoses and care courses. In relation to communication with colleagues, decision-making can be based on teamwork, which also implies productive interaction. I have become familiar with the mechanisms of conflict prevention in the workplace, numerous theories of effective interaction, and algorithms for group practice in a multitasking environment. All these aspects of learning have helped me better understand the principles of communication with the public and colleagues and assess how distinctive these approaches can be.

Quality Improvement and Error Prevention Practices

In a multitasking and dynamic work environment, establishing an efficient and error-free nursing process is a challenging task to implement in nursing practice. During the course, I got acquainted with relevant approaches to evidence-based and culturally competent practices and made relevant conclusions. One of the important topics was medication management and creating conditions for patient safety.

According to Kavanagh (2017), an effective care plan with error and hazard prevention strategies inherently includes “preparing, calculating, checking and administering medications,” as well as “educating patients about their medications” (p. 159). In addition, to meet all cultural competencies, nurses should address the aforementioned principles of client-centered care and promote participation and empathy as the essential aspects of skilled care, including psychological support. I have found that such an environment is conducive to recovery and enhances productive patient-provider interaction.

From a quality improvement perspective, the course materials have helped me explore a wide range of competencies required to improve individual nursing skills and address different care outcomes. Phillips et al. (2018) argue that quality improvement, which is the constant development of professional capacity and the creation of conditions for optimizing the care process, is one of the six core competencies.

They are quality improvement, client-centered care, collaboration and teamwork, safety, evidence-based practice, and informatics (technologies) (Phillips et al., 2018). Combining all these conditions is a powerful approach to create a safe care environment in which the problems of the target audience are addressed through adequate interventions and effective intra-team communication mechanisms. All these nuances have become valuable knowledge for me and allowed learning more about the principles of effective work with the population.

Team Collaboration as Part of Decision-Making

As mentioned, team collaboration is essential to an effective decision-making process. As I have learned during the course, in a nursing environment, colleagues’ help and support are highly valued. Moreover, as a member of the group, I realized that collaboration was a factor that not only brought the team together but also had a positive effect on the quality of care. According to Emich (2018), “positive consequences of collaboration in nursing include improvements in patient safety, patient satisfaction, patient care, and decreases in error rates, patient mortality, patient length of stay, and healthcare staff turnover rates” (p. 569). All these benefits are direct evidence of the important role of team communication.

I need to mention health promotion among the population as one of the critical advantages of working in a nursing team. As a member of the group, I participated in collective assistance programs aimed at engaging with target communities and integrating modern care approaches. Alone, these tasks would be impossible to accomplish due to the limited workforce. Moreover, from a decision-making perspective, individual solutions may be biased. Teamwork, conversely, reduces the risk of misjudgment of challenges and facilitates the search for adequate solutions designed to address different patient problems and gaps in care.

Conclusion

When evaluating the outcomes of the passed course, I can note that the topics studied have allowed me to get much new information about making decisions in nursing and the factors that influence this process. I have managed to learn about the principles of client-centered care, hone skills in research work, establish productive communication with colleagues, assess the merits of modern technologies in this industry, and gain much valuable knowledge. Given the breadth of the concepts discussed, I am confident that I will be able to better navigate the basics of decision-making as I have met the course outcomes and confirmed my willingness to learn.

References

Emich, C. (2018). Conceptualizing collaboration in nursing. Nursing Forum, 53(4), 567-573. Web.

Epp, S., Reekie, M., Denison, J., de Bosch Kemper, N., Willson, M., & Marck, P. (2021). Radical transformation: Embracing constructivism and pedagogy for an innovative nursing curriculum. Journal of Professional Nursing, 37(5), 804-809. Web.

Kavanagh, C. (2017). Medication governance: Preventing errors and promoting patient safety. British Journal of Nursing, 26(3), 159-165. Web.

Macauley, K., Brudvig, T. J., Kadakia, M., & Bonneville, M. (2017). Systematic review of assessments that evaluate clinical decision making, clinical reasoning, and critical thinking changes after simulation participation. Journal of Physical Therapy Education, 31(4), 64-75. Web.

McDonald, E. W., Boulton, J. L., & Davis, J. L. (2018). E-learning and nursing assessment skills and knowledge – An integrative review. Nurse Education Today, 66, 166-174. Web.

Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917-928. Web.

Phillips, J. M., Stalter, A. M., Winegardner, S., Wiggs, C., & Jauch, A. (2018). Systems thinking and incivility in nursing practice: An integrative review. Nursing Forum, 53(3), 286-298. Web.

Salvage, J., & White, J. (2019). Nursing leadership and health policy: Everybody’s business. International Nursing Review, 66(2), 147-150. Web.

Sanerma, P., Miettinen, S., Paavilainen, E., & Åstedt-Kurki, P. (2020). A client-centered approach in home care for older persons–an integrative review. Scandinavian Journal of Primary Health Care, 38(4), 369-380. Web.

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OctoStudy. 2022. "Making Decisions in Nursing Practice." October 24, 2022. https://octostudy.com/making-decisions-in-nursing-practice/.

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