Decision-Making In Nursing Practice -

Decision-Making In Nursing Practice

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Nursing Question

Discuss three theories/models of decision making used in nursing practice. Critically analyse  these theories and explain which theory will be applied during PEP with a clear rationale  supporting this.

Nursing Solution

Introduction

Advanced decision making in nursing practice requires critical thinking by the nurse professionals while applying the conventions of decision-making theories with the core objective of effectively resolving the complex ethical and legal issues arising during the patient encounter in the clinical setting. Indeed, nurse professionals need to analyse public policy considerations advocated by advanced nursing theories while evaluating patients in the context of improving their wellness outcomes following the healthcare interventions. Clinical judgement in nursing practice is usually based on the personal choice of the nurse practitioner and undertaken under the influence of professional experience and the types of nursing theories applied while extending care and treatment to the patient population. The clinical decision making by the nurse professionals during their professional deployment is a self-reflective process that considerably influences the quality of administered healthcare interventions as well as the length of the treated patients in the hospital setting. Nurse professionals require applying scientific and evidence-based approaches while applying their clinical reasoning for effectively resolving complex patient scenarios. They require developing attention to detail in relation to the application of key concepts advocated by evidence-based decision making theories with the objective of appropriately treating the disease manifestations of patients of various age groups in the clinical setting. Nurse professionals also require developing an effective therapeutic relationship with treated patients with the objective of elevating their trust and confidence in the administered clinical interventions. The enhancement of trust of patients on the proposed nursing interventions improves their compliance with the treatment strategies that reciprocally improve their treatment outcomes. The objective of the utilisation of advanced decision making approaches in nursing practice attributes to the administration of patient-centred, holistic and ethically justified healthcare interventions to the patient population. This essay effectively discusses the application of the decision-making theories attributing to intuitive humanistic theory, information processing theory and social judgement theory in clinical practice. The paper analyses the inconsistencies, contradictions, complexities and pros and cons associated with each of 77the selected decision making theories and compares them with several other advanced decision-making theories for systematically identifying their effectiveness, requirement and advantages in nursing practice. 

Intuitive Humanistic Theory

The intuitive humanistic theory advocates the utilisation of intuition while undertaking judgements and decisions related to the treatment planning of patients in the clinical setting (Blum, 2010). Nurse professionals utilise their practical knowledge gained from their previous experiences in the context of making informed decisions for the treated patients. The intuitive humanistic theory of clinical decision making evidentially follows the concept advocated by Benner for dealing with complex real-life scenarios (Bjørk& Hamilton, 2011). The nurse professionals do not explore the rationale of their understanding of the clinical situation during decision making and attempt to utilise their insight for analysing a range of possibilities and meanings related to the treatment scenario in the context of resolving problems arising after the administration of nursing care and treatment to the patients in the hospital setting. However, less experienced nurse professionals fail to apply more pragmatic approaches following the conventions of the intuitive humanistic model while dealing with various patient situations. The humanistic model of decision making focuses on the existential approaches that require subjective implementation in accordance with the choice and pattern of self-awareness experienced by nurse professionals. The intuitive knowledge of the nurse professionals in relation to the clinical decision making is derived from the gut feeling that convinces them in taking subjective decisions about handling any clinical scenario. Nurse professionals while systematically utilising their intuitive approaches analyse the possible outcomes of a complex clinical situation and eventually undertake calculated decisions for effectively surpassing the state of crisis that might place the treated patient at high risk of experiencing an untoward event of adverse healthcare outcomes. However, the pattern of intuitive decision making in nursing practice is not effectively substantiated in critically ill patients across the emergency room setting (Hassani, et al., 2016). Indeed, a blend of theoretical knowledge and clinical experience of the nurses helps them in handling the critically ill patients with the implementation of evidence-based intuitive healthcare approaches. The nursing curriculum does not provide a well-defined methodology for teaching the principles of intuitive humanistic approaches to the nurse professionals, and therefore nurses require utilising the pattern of their self-perception while dealing with the patient scenarios in the clinical setting. Evidence-based findings advocated by (Payne, 2015) reveal the development of the somatic state among nursing professionals that assist in the systematic generation and transfer of physiological biasing signal and skin conductive responses following a patient encounter. Resultantly, the nurse professionals acquire the confidence of taking an advantageous decision that effectively improves the patient outcomes. Indeed, the intuitive method of dealing with various patient conditions remains questionable in the absence of a concrete rationale for their justification in the evidence-based research literature (Hassani, et al., 2016a). The concept of intuition in nursing practice is based on the insightful utilisation of the attributes of clarity, visibility and presence of mind by the nurse professionals. Humanistic intuitive capacity originates from the frontal cortex of the human brain. Nurse professionals, while utilising this capacity, judge the level of threat and risk associated with various patient conditions. Additionally, they require legitimately utilising their nursing knowledge, clinical skills and experience along with their intuition for subjectively undertaking empirical decisions for the benefit of the treated patients. The findings of the research study undertaken by (Pretz&Folse, 2011) advocate the effectiveness of intuition in clinical judgement in terms of acquiring favourable patient outcomes. The findings also reveal the enhancement of intuitive skills of nurse professionals following the acquisition of self-confidence derived from nursing experience. The findings in evidence-based research literature advocate the acquisition of greater precision in clinical decision-making derived from the pattern of intuitive humanistic approaches by the nurse professionals in the clinical setting (Payne, 2015). This evidentially reveals the significance of intuitive humanistic theory in acquiring precise clinical decisions by the nurse professionals in the context of resolving the complex patient situations in the clinical setting.

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