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Dr. Ballone
three nursing research articles. A “clinical nursing judgement” can be defined as the conclusion
expertise, and analysis of observable or available information or data. The first nursing research
article by Pouralizadeh, Khankeh, Ebadi, and Dalvandi (2017) that I used conducted a research
project on different factors that influence nursing students to develop a nursing clinical
judgement. The second research article by Wane and Lotz (2013) that I researched is about how
simulations help student nurses refine critical thinking in order to develop a sound nursing
clinical judgement through various scenarios. The third nursing research article I found by
Shelestak, Meyers, Jarzembak, and Bradley (2015) researched nursing clinical judgement
through a human patient simulation (HPS) to identify cues, judgements, decisions, and outcomes.
In the first article I research by Pouralizadeh, Khankeh, Ebadi, and Dalvandi (2017) they
set up a qualitative research study that looked at the many different factors that influence a
nursing students’ clinical judgement. The factors this study found and concluded are,
“thoughtful behavior, professional ethics, use of evidence based care, the context of learning
Khankeh, Ebadi, and Dalvandi, 2017). In the study thoughtful behavior is described more into
detail by also including assessment, critical thinking, intuition, and clinical reasoning. This is
huge in my opinion because assessment is everything in order to know what is going on with
your patient and every nurse or student nurse needs to assess the situation appropriately. That
also includes the critical thinking aspect along with the clinical reasoning behind your
assessment and the actions that are needed to be taken to assure that every patient is getting the
best holistic care possible. This helps round out clinical judgement based off of the nurses’
assessment on what is the main problem and what steps need to be taken next based on that
pertinent information. It really pulls in the application of information learned from nursing
On the next nursing research article I researched by Wane and Lotz (2013) it looked at
providing clinical simulations relevant to clinical experiences in order to enhance that critical
thinking in nursing students to start developing that important clinical nursing judgment. Using
a simulation to help develop nursing clinical judgement is very helpful and also a safe
environment for students to really take over and start to use that critical nursing judgement based
off of variables such as an assessment, medical history, lab results, and diagnostics. Wane and
Lotz (2013) explained that, “by delving into the client’s medical history and providing pertinent
background materials, the students voiced that they had an appreciation for the amount of detail
necessary to critically analyze a medical situation”. This helped the students comprehensively
put all of the pieces together in order to make a sound nursing judgement based on the patient
individually. Therefore, creating a simulation helps facilitate that critical thinking in nursing
The final research article I found was by Shelestak, Meyers, Jarzembak, and Bradley
(2015) that also conducted a simulation for nursing students but focused on American Cardiac
Life Support guidelines for bradycardia and pulseless ventricular algorithms. This research
study used a human patient simulation and looked at four phases of noticing the problem,
interpreting the data, responding appropriately using nursing judgement, and then reflecting on
the situation. One human patient simulation the students were introduced to was a vagal
response from a patient that was straining during a bowel movement. This led to a drop in heart
rate and blood pressure that was detected by the EKG reading that was available to all students.
The researchers then stopped the simulation in order for the students to write down all of the
information and what steps they thought would need to be taken next. The researchers then had
the students hand in their answers to record and grade their work. At the end they did go over
the correct steps to take based on evidence-based nursing research for bradycardia. In my
opinion as a nursing student myself nothing is better than learning in a simulation because you
are now in charge and have to really develop that critical thinking aspect of nursing in order to
care for your patients. It gives all nursing students an excellent opportunity to learn in a
simulation so when it comes time that they have graduated and are working on the floor they
have that simulation experience to benefit from in order to take the needed actions to care for
their patients.
order to care for all of your patients. I remember going through different simulations throughout
nursing school and it really makes you realize that you need to have that knowledge base and
critical thinking in order to work efficiently to diagnose the problem and correct it. For example,
I had a patient who was in a lot of pain post-op that had a heart rate of over 200 beats per minute.
I was a student and started to get overwhelmed, but I needed to focus for my patient, so I got a
set of vitals, assessed the surgical site, assessed lung sounds for a possible pulmonary embolus
and called the doctor stat. I stayed with my patient and made sure he didn’t get worse until
further testing was done to figure out why he became very tachycardic. The patient is relying on
you to care for their health while in the hospital so having that clinical nursing judgement is very
Pouralizadeh, M., Khankeh, H., Ebadi, A., & Dalvandi, A. (2017). Factors
analysis in an Iranian context. Journal Of Clinical & Diagnostic Research, 11(5), 1-4.
doi:10.7860/JCDR/2017/25753.9822
Shelestak, D. S., Meyers, T. W., Jarzembak, J. M., & Bradley, E. (2015). A process to
185-187. doi:10.5480/13-1107.1
Wane, D., & Lotz, K. (2013). The simulated clinical environment as a platform for