Wednesday, October 16, 2019

Clinical Decision-making in complex care i.e Identify a clinicaL Essay

Clinical Decision-making in complex care i.e Identify a clinicaL decision that you have been involved in - Essay Example The family had a hard time to decide on the removal of life-support systems and the changeover to palliative sedation. The nurse manager advised me to empower the family to make the decision required of them. When I told her that I had never before handled this situation, she advised me on how to do it and convinced me that I would be able to achieve the target and that my few years of experience were sufficient. My feelings The message that I received today was that this situation was a common occurrence and I had to be prepared. I was feeling unhappy that I was not competent enough to handle the situation. It was the nurse’s duty to empower the family in times of crises. With the intention of redeeming myself, I needed to use evidence-informed decision-making in this frequently occurring situation in my practice (Brown et al, 2009). This day had been conducive to my learning a new experience which had stimulated me to further my comprehension of bioethics and empowerment of family members of end-of-life patients. Evaluation This often-occurring situation in the nursing profession and its solution was revealed to me today. That I needed to learn much more to become competent was another revelation. Both of these appeared good to me as I could learn from experience. Another good thing was that I had the support of my seniors. The fact that I was not confident enough to handle this crisis was the bad part but I take this as an opportunity to think positively and find ways to solve this problem so that I am equipped to cope with it at any moment in my profession. Analysis Clinical decision-making could also be termed clinical reasoning, judgment, inference or diagnostic reasoning (Hardy and Smith, 2008). Clinical decision-making could be defined as the process of making an informed judgment over the treatment necessary for patients. Intuition as a form of reasoning had been associated with clinical decision-making (Nyatanga and De Vocht, 2008). Clinical de cision is a type of informal decision-making that combines clinical expertise, patient concerns, and evidence gathered from scientific literature to arrive at a diagnosis and treatment recommendation. Participants, process, an outcome and setting formed a major portion of the nurses’ clinical decisions (Gurbutt, 2006). Clinical reasoning was the process by which the judgments were made. The judgments were difficult propositions and could be managed only if the nurse could understand the salient details and difficulties of a situation (Tanner, 2006). She should also be able to interpret and respond accordingly. In today’s situation, I should have been able to understand the illness and end-of-life experiences of the family when I reached my station, much before the actual situation arose. Their emotional strengths, physical health, social well-being and coping mechanisms should have been gauged before the crisis (Tanner, 2006). Clinical decision-making affected the qual ity of care for the patient and his safety. In fact it had been described as the essential component for professional nursing care (White, 2003 in Hagbaghery, 2004). The resolution of family conflicts and the provision of information on care provider services were also a part of the decision-making. The decision- making performance of the nurse and her capability of reaching heights were hindered by various interruptions expected in a hospital atmosphere (Ebright et

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