This article discusses the clinical reasoning cycle and its steps in making clinical decisions. It explores the process of assessing patient situations, collecting cues and information, and processing information for effective care. The article also provides examples and resources for further understanding.
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CLINICAL REASONING CYCLE2 CLINICAL REASONING CYCLE Introduction My care situation involved caring for Mr. Smith who was a sixty-year-old patient waiting for AAA surgery. I was tasked to assess his current health status. Because I was a nurse professional nurse first year student, I went via daily interview period which entailed processes of making decision. My assignment and instruction was to consider using a CRC3. Thus I will show the steps I took to achieve my goals under the supervision of a nurse I worked in handy with. Consider the patient situation (CRC 1) For the practical and precise decision on the present health condition, it is essential that I considered all the necessary data about the condition. These include data on the effects, how the condition appeared and other data. As a professional nurse first year student, I needed to make some decisions taking into account my judgment and knowledge during several conditions that can never be sorted with the textbook or research knowledge. The clinical reasoning session which I went through entail moral reasoning sessions that ultimately helped me consider the condition of the patient alongside health status before advancing with the process of decisions making. I generated my clinical reasoning from a caring and concerned position which I developed to take desired care of my patient alongside advancing my career (Forsberg, Ziegert, Hult & Fors, 2016). To facilitate data collection, I first developed a rapport with Mr. Smith, and we became friends. I empathized with his situation, and he got to be open with me and told me all the things I wanted to know without a challenge. In the case where he could not talk to explain, I provided him with a paper and a pen to write down. This helped me gather the required information from the interviews when I realized he had difficulties explaining his conditions.
CLINICAL REASONING CYCLE3 The 61-year-old man was in the ward waiting to undergo AAA (adnominal aortic aneurysm) surgical treatment the following day. Collect cues and information (CRC 2) Mr. Smith was a 61-year-old patient who had a history of hypertension and under the beta-blockers in his past life. He was an ordinarily hypertensive individual condition that required strong consideration. In the course of my session with him, I was mandated to appraise the collected information and data which included the medical history of Mr. Smith, handover reports, past investigations reports as well as any previous medical or nursing assessment which have been carried out. Mr. Smith had a history of hypertension. Mr. Smith also previously used beta-blockers. His blood pressure (BP) was 141/181 thirty minutes ago. I undertook a new patient assessment of my patient to gather potential changes which could have taken place. The fresh data gathered through Mr. Smith’s evaluation showed a BP at 111/61 while his epidural streaming stood at 10ml per hour. The ultimate task within this specific step was for me to recall knowledge that encompasses recalling past phases and steps my patient had to go through (Hunter & Arthur, 2016). Here, I evoked knowledge like therapeutics, ethics, culture, law, pharmacology, and pathophysiology because Mr. Smith’s BP is linked to his fluid status. His epidurals could drop the blood pressure as they result in vasodilation. Within the ward, I got standing instructions relevant to running epidural (Koivisto, Multisilta, Niemi, Katajisto & Eriksson, 2016). Process information (CRC 3) In processing the information, I used several steps under the instruction and supervision ofnursethatentailedinterpretation,discrimination,relation,acombinationofinferring, matching and prediction session. Under interpretation, I analyzed the information I had gathered
CLINICAL REASONING CYCLE4 to understand the signs and symptoms of Mr. Smith and stimulated a comparison between the abnormality and normality. Under discrimination, I refined the useful information from the irrelevant ones, and recognized any possible inconsistencies and finally extracted the most significant disparities within the cues I had gathered. Mr. Smith’s temperature was somewhat high; however, I was never concerned in this regard. My main concern regarded Mr. Smith’s pulse and blood pressure. I would check Mr. Smith’s oxygen sat alongside urine output. I then related to and realized that hypertension and tachycardia could be imminent shock symptoms. Mr. Smith’s blood pressure dropped following his epidural raising. Under relation, I discovered the new association or patterns whereby I Mr. Smith’s blood pressure stayed down, for a person who is especially usual hypertensive.Under the combination of inferring, I inferred that Mr. Smith’s blood pressure might drop when taking to surgery the next day due to loss of blood during the operation. I matched and predicted the information by making some deductions and considering options or alternatives alongside consequences (Levett-Jones et al., 2010). Here, I was aware that AAA often has hypotension after the operation, and thus I predicted that if Mr. Smith were not given additional fluids after the surgery, he would get into shock (Daly, 2018). Under the matching step, I compared past and present health condition of Mr. Smith. From this step, I was able to note the possibility of Mr. Smith’s blood pressure to get down. Under predict session, I went through the expert critical reasoning process to predict the likely outcomes. For this part, I anticipated the need to ensure that Mr. Smith is given more fluids the following day in the post operations (Wong, Chandra, VanDeBogart, Lu & Yee, 2015). This will help ensure the safety of Mr. Smith because it is expected that he will lose much blood throughout his intended surgery (Dalton Gee & Levett-Jones, 2015). In general, I realized some facilitators and barriers to health for Mr. Smith’s relative lifespan phase. The facilitators included the existence of Mr.
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CLINICAL REASONING CYCLE5 Smith’s medical history which availed desired information which helped me know exactly what I needed to support Mr. Smith. Conclusion As a first-year student professional nurse, I was presented with a 61-year-old patient who had a history of hypertension and under the beta-blockers in his past life. He was a normally hypertensive individual. I have used the CRC3 to demonstrate the steps I took to making clinical decisions to help Mr. Smith deal with his condition.
CLINICAL REASONING CYCLE6 References Dalton, L., Gee, T., & Levett-Jones, T. (2015). Using clinical reasoning and simulation-based education to'flip'the Enrolled Nurse curriculum.Australian Journal of Advanced Nursing, The,33(2), 29. Daly, P. (2018). A conciseguide to clinicalreasoning.Journal of evaluationin clinical practice,24(5), 966-972. Forsberg, E., Ziegert, K., Hult, H., & Fors, U. (2016). Assessing progression of clinical reasoningthroughvirtualpatients:Anexploratorystudy.Nurseeducationin practice,16(1), 97-103. Hunter, S., & Arthur, C. (2016). Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.Nurse education in practice,18, 73-79. Koivisto, J. M., Multisilta, J., Niemi, H., Katajisto, J., & Eriksson, E. (2016). Learning by playing: A cross-sectional descriptive study of nursing students' experiences of learning clinical reasoning.Nurse education today,45, 22-28. Levett-Jones, T., Sundin, D., Bagnall, M., Hague, K., Schumann, W., Taylor, C., & Wink, J. (2010). Learning to think like a nurse.HNE, 15 (1), 23-176. Wong, J. M., Chandra, M., VanDeBogart, R., Lu, B., & Yee, A. H. (2015). Clinical Reasoning: A 27-year-old man with rapidly progressive coma.Neurology,85(9), e74-e78.