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Clinical Nursing Judgement as a Nursing Student
Josie L Preski
Centofanti School of Nursing, Youngstown State University
NURS: 4852 Senior Capstone Seminar
Dr. Kim Ballone
March 13, 2023
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Clinical Nursing Judgement as a Nursing Student
Clinical nursing judgement can be referred to as “the process by which nurses make
decisions based on nursing knowledge (evidence, theories, ways/patterns of knowing), other
disciplinary knowledge, critical thinking, and clinical reasoning” (American Association of
Colleges of Nursing). There are many components that make up the definition of clinical nursing
judgment. The research and practice behind clinical nursing judgement is constantly changing. It
is important to know and understand the changes in nursing as it will affect our actions and
decisions through clinical judgment. Nurses, nursing students, nursing aides, PT, OT, dieticians
and many other clinical related positions all use clinical nursing judgment without being aware
they are doing it. Clinical nursing judgement is not a nurse’s opinions on how we view the
patient. For example, if the patient has poor hygiene or how their hair is done, how we treat them
will not be dictated by their personal hygiene. Clinical judgment is extremely necessary to
perform proper care to patients. In a recent study, clinical judgment was described as “a crucial
skill necessary for nurses to practice safely and support positive patient outcomes” (Zebler &
Severi, 2022). If our clinical nursing judgement is negative, poor patient outcomes will occur. As
nurses, it is our job to help and care for patients in a direct manor.
Clinical nursing judgment is so important because it shapes how a nurse takes care of
their patient. Nurses use critical thinking and clinical reasoning to reach clinical judgment.
Clinical nursing judgment helps nurses in how to respond to a situation. There are many
examples that can prove the importance of clinical nursing judgment in nursing practice. For
example, a patient resenting to the emergency room with symptoms of fever, confusion, +1
peripheral radial and pedal pulses bilaterally, cardiac rhythm sinus tachycardia, capillary refill of
4 seconds, mucous membranes dry, and tenting turgor. A nurse uses clinical judgment and can
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diagnose this patient with sepsis. With these classic symptoms of sepsis, many nursing diagnoses
can be given. Before doing any other further tests or labs, she knows what this patient needs.
A personal experience I can share about my use of clinical nursing judgment involves a
patient with diagnosis of a gunshot wound. Patient was a 26-year-old female with a gunshot
wound in her buttocks and abdomen. She was quiet, liked the door shut and lights off. This
experience was during my precepting clinical shift. My assigned nurse, occupational therapy,
and I were in the patient’s room. She had surgery a couple days prior and had many drains and
surgery incisions around her perineum and abdomen. The patient was consistently in a lot of
pain. My nurse and I were getting her medicine while the therapist was getting the patient up to
the bathroom to get cleaned up for the day. We all noticed that when the patient got up, there was
bright red blood on the chuck pad on her bad and on her mesh pull ups. A possible cause of the
bleeding could have been her menstruation cycle starting again or she was bleeding from the
inside as a complication from the gunshot wound or previous surgery. We all knew this was a
concerning problem as “uncontrolled, life-threatening bleeding is the primary preventable cause
of trauma-associated death in the world” (Jones, et al., 2020). My nurse then messaged the
patient’s surgeon to make the team aware of the situation. We continued to monitor how much
blood and the color of blood, as the blood color can tell you whether the bleeding is new or old.
A couple minutes the later, the patient’s trauma surgery team was on the unit in her room
performing stitches to where they thought the blood was coming from. They quickly learned
those stitches were not helping. Our patient was then scheduled for an emergency surgery. The
did not take her right away so we had to still monitor very closely until transport came up to get
her. Me, my nurse, and the occupational therapist used clinical judgement to help ensure the
greatest care for our patient, which could have possibly saved her life.
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References
Clinical Judgement Concept. American Association of Colleges of Nursing: The Voice of
Academic Nursing. (n.d.). Retrieved February 13, 2023, from
https://www.aacnnursing.org/Essentials/Concepts/Clinical-Judgement
Jones AR, Hallman MG, Heaton K. Application of Bleeding Control Training in Occupational
Settings. Workplace Health & Safety. 2020;68(5):209-213.
doi:10.1177/2165079919883240
Zehler, A., & Severi, E. (2022). Enhancing Clinical Judgment in Managing Postpartum
Hemorrhage: A Replication Study. The Journal of Continuing Education in Nursing,
53(11), 500+. https://link-gale-com.eps.cc.ysu.edu/apps/doc/A726485014/PPNU?
u=ohlink104&sid=bookmark-PPNU&xid=faeb73b5
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4852 Capstone
Scholarly Paper Rubric
Scholarly Capstone Paper
A component of the capstone course, worth 20% of the final grade
An in-depth exploration on the topic “Clinical Nursing Judgment”
3-page paper
APA format
Minimum of 3 references citing recent Nursing Journals
Define the concept, identify the importance of clinical nursing judgment, and then discuss
a personal experience where you used “clinical nursing judgment” in a specific situation.
Requirements: Possible Points Achieved
Points
1. organization and clarity of topic present 20 _________
2. content quality 20 _________
3. reflection of topic 20 _________
4. APA format and correct grammar 20 _________
5. Cited References 20 _________
Final Grade
________/100 points
_________/20%
4852 capstone paperubric 2023 Heasley/Ballone
