Clinical Reasoning Cycle

Experienced nurses engage in various clinical reasoning cycles during clinical practice. This paper uses the critical reasoning cycle 1-3 and then 8 phases to apply to a specific clinical decision during my clinical placement.

Running head: CLINICAL REASONING CYCLE 1
Clinical Reasoning Cycle
Name
Institution

CLINICAL REASONING CYCLE 2
Introduction
Experienced nurses engage in various clinical reasoning cycles during clinical
practice. An experienced nurse will have no difficulty taking notes of the significant data
when she gets into the ward and make deductions regarding the patient as well as instigate
suitable care. Such a process is called critical reason (Cooper & Frain, 2017). This paper uses
the critical reasoning cycle 1-3 and then 8 phases to apply to a specific clinical decision
during my clinical placement. The clinical decision encompassed reacting to a change in the
patient’s condition.
Clinical Reasoning Cycle
According to Kozier at al. (2014), a clinical reasoning cycle is a process via which
health practitioner and specifically a nurse, collect cues, interpret the data, comprehend the
situation or problem a patient, and perform an intervention, assess the results, and reflect on
the entire process.
CRC1: Considering Situation
Stage 1 of CRC encompasses the consideration of the facts or situation of the patient.
This stage is where a nurse is introduced to a clinical scenario (Dalton, Gee & Levett-Jones,
2015). During my clinical placement, I interviewed a 67-year-old woman called Mrs. Jamie.
She was brought to our ED and complained of pain (back and shoulder), nausea, dizziness,
and discomfort in her chest. She reported to have been working at her garden earlier in the
day and also attended a family picnic. To facilitate data collection, I ensured that I used
therapeutic communication including both verbal and non-verbal cues. I gave her ample time
to think over when I asked her a question. I also assured her the privacy and confidentiality of
the information she was given me.
CRC2: Collecting Cues

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Phase 2 in the CRC is the collection of the information of the patient. It is mainly an
assessment of Mrs. Jamie’s current situation, collecting fresh data, and recalling knowledge.
(Dalton, Gee & Levett-Jones, 2015). In the case of Mrs. Jamie, I realized that her previous
medical history entailed HBP, elevated total serum cholesterol, coronary artery disease as
well as angina. Based on her records, Mrs. Jamie took one aspirin every day and had also
been put on the nitroglycerin tables for the angina management. At that time, the physicians
ordered for the ECG and there were negative results. However, I was sure I had to undertake
additional cardiac testing since Mrs. Jamie’s symptoms signaled a myocardial infection.
CRC3: Informational Processing
Phase three of the Clinical Reasoning Cycle entails the information processing
which I had gathered from Mrs. Jamie medical records and fresh assessments. Here,
processed her present status in respect of both pathophysiological and pharmacological
patterns, establishes appropriate details, as well as determines the feasible results for the
decisions which I had to make (Koivisto et al., 2016). At the point Mrs. Jamie was admitted,
she had stated that she had been involved in certain activities and chores early the same
morning. Specifically, she mentioned to have performed some gardening, and thus, I was sure
there could be feasibility that Mrs. Jamie’s symptoms stood linked to acid reflux as well as
strained muscles. Nonetheless, I realized that I had to be worried since Mrs. Jamie had a past
medical record of angina and coronary heart disease. Thus, I made a decision to monitor the
cardiac markers of my patient. When Mrs. Jamie’s heart got damaged, the level of cardiac
markers would rise over a period, and this is the reason blood tests for Mrs. Jamie were taken
over the one-day duration (Zhu et al., 2017; Sweeting et al., 2016). The pain at both shoulder
and chest could also have been indicators of Mrs. Jamie having suffered a heart attack. It was
imperative for me to note that the enzymes levels never rise immediately after the myocardial
infection (Chew et al., 2016). Based on this, I made a decision to treat Mrs. Jamie while

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assuming that a heart attack had taken place and subsequently assessed her for a more precise
diagnosis. On that note, I decided to treat Mrs. K with the assumption that a heart attack had
occurred and then assessed for a more precise diagnosis.
CRC8: Reflection
In this stage, the main focus is the reflection on the effectiveness of the course of
action I have undertaken. This is an effective and desired stage which enable a nurse to
determine whether she could have done other things differently and also shows the new
insights or lessons learned in the same line of actions already being undertaken. As seen in
the above scenario, I was able to correctly assess the situation of my patient and recommend
the correct form of treatment that led to managing her condition well. The problem was
correctly identified with my patient by establishing the reasons for her current status (Dalton,
Gee & Levett-Jones, 2015).
I was able to synthesize the deductions as well as facts and subsequently using those
to make an eventual diagnosis of Mrs. Jamie’s problem which was making her suffer. I was
also able drawn upon the informed I had earlier processed in phase three and correctly
deduced that she had suffered a heart attack because the level of enzymes always does not
surge instantly. Also, I was also able to set up the desired objectives in dealing with Mrs.
Jamie and came up with suitable goals of treatment (Daly, 2018).
Also, I realized that I took the desired actions to save Mrs. Jamie by executing the
actions steps needed to meet the treatment objectives I had set for my patient (Delany &
Golding, 2014). I learned about the significance of bringing on board other members of our
healthcare team and giving each of them the desired updates about the treatment goals for
Mrs. Jamie worked. Finally, I was happy to have realized the significant improvement of
Mrs. Jamie’s condition following my interventions because she had stopped complaining
about any pain or discomfort at the chest or back and she had as well reported no dizziness.

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Conclusion
Nurses with efficient skills in clinical reasoning cycle definitely end up significantly
impacting positive patient outcomes. However, nurse without such clinical reasoning
competencies will always fail in the identification of the impending deteriorations of patient
conditions leading to the “failure of rescue.” Based on the above encounter with Mrs. Jamie,
it is evident that I was an effective nurse, and I could deter the health deteriorations or worsen
of my patient by correctly applying my CRC 1-3 and CRC8 phases to make useful and
working clinical decisions. I hence purpose to continue being determined as well as engage
actively in the deliberate practice of this clinical reasoning cycle skills to help save my
patients.

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References
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