Decision Making in Nursing Practice - Importance, Core Principles, Framework and Theories

This article discusses the importance of decision making in nursing practice, core principles, decision making framework, and theories like information processing theory and social judgment theory. It emphasizes the need for effective decision making in critical situations and the importance of maintaining ethical codes. The article also highlights the decision making tools that can be used by nurses to provide quality services and manage risks. The theories discussed in the article can help nurses identify risks and find solutions to problems.

Running head: DECISION MAKING IN NURSING PRACTICE
Decision Making in Nursing Practice
Name of the Student
Name of the University
Author Note

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Introduction
The nursing practice is considered to be one of the most important health sector practices
in the society. This is why the communication skills will have to be proper and one of the major
aspects will be the effective decision making. Effective decision making is indeed very important
since the nurses may have to take sudden decisions in many cases. The focus of the nursing
practice is on serving the human beings in their most critical conditions. The interpersonal
communication is one of the most important aspects in the nursing practice. It is to mention that
the decision making really has a big issue in the successful nursing practice. The decisions have
to be made very suddenly as the conditions of the patients can turn out to be very much critical.
It is indeed very important for the nurses to take the proper actions in certain cases (Lachman
2012).
The purpose of this paper is to identify the sections where the nurses will have to
problems. Then only they can find some solutions to these problems indeed. Uncertainty is one
of the biggest risks in every scenario, especially if it is regarding the life of the human beings.
Their sole purpose of the profession is to save the lives of the human beings from all angles.
These are the very reasons why the nurses must be very much cautious about their works. They
must always create an environment that should be constructive enough (Lachman 2012). They
always have to remember that the critical situations do not come beforehand. They have to be
prepared for all the consequences. They have to analyze the critical aspect of all the situations
and take the proper action indeed. In this part three theories are going to be discussed. The three
theories are information processing theory, social judgment theory and cognitive continuum
theory. These three theories are very much important for the nursing practice. However, the
cognitive continuum theory is very much important for the nursing practice because inter

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professional teamwork can b e increased through the implementation of this theory. The inter
professional teamwork or collaboration is indeed very important in the nursing practice.
Core principles of nursing practice
There are some core principles or ethical things in the nursing practice. The nurses
always have to maintain these ethical codes as their profession deals with the saving the lives of
the human beings (Grove, Burns & Gray 2012). In this scenario, they have to focus on their
power of the decision making indeed. They have to maintain a good relationship with the
patients, their families, colleagues, carers of the patients and all other persons (Morton et al.
2017). These are the reasons as to why the nurses will have to concentrate on all these things
properly. At first it has to be mentioned which kind of people are included as the nursing staff.
The nursing staff generally means the nurses, ward managers in the hospitals, specialist nurses,
senior nurses, nursing interns and the student nurses (Grove, Burns & Gray 2012). The
community nurses are also the part of the nursing staff members. There are some core ethical
principles that all the nurses have to keep in their minds as they take the oath of saving the lives
of the patients in any situation. These principles are:-
The nurses should treat everyone with the utmost care and humanity. They should keep
their dignity at the first place when treating with the patients (Parahoo 2014). The nurses have to
understand the basic needs of the patients and provide the care according to that only. They
should treat the people equally with best efficiency they can provide.
The nurses are liable for answering for all the judgments and actions they take. They
might have to make some strict decisions as they are not aware of the critical facts can arise in
what time (Parahoo 2014) If these decisions can affect the patients, they might be held

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responsible as guilty. This is why the nurses will have to take up the responsibility for their
faults. The nurses and other nursing staff will have to work very closely with all the patients on
the floor (Tylor 2012).
They will need to build a strong team work between them indeed. They should have a
strong positive influence on the patients and they should provide the patients with the utmost
care indeed (Masters 2015). All the nurses and other nursing staffs have to be updated with the
recent use of technologies and they have to update their skills as well. This will surely be
important for the effective decision making process. The nurses will be able to take up the
important decisions as per their knowledge and skills indeed. The nurses must possess a good
understanding on the matters that arise during their work on the floor (Alligood 2013).
They have to be sensitive and be able to take quick decisions indeed. They are the ones
who should lead the other health sector employees by the proper example. They should influence
the other staffs and motivate them to complete their works on time. These things are very much
important indeed. The other staffs can feel motivated by the decision making power of the nurses
(DeNisco & Barker 2013).
The decision making framework
The decision making framework is very important for all the nurses and the midwives.
The national framework in Australia for the nurses should be followed properly. This framework
is very important in this context indeed (Thompson et al. 2013). The purpose of providing the
national framework is to develop the skills of the nurses primarily. The principles of this
framework are simply based on providing the patients with the proper work indeed. The
stakeholders who are engaged in this development of the nurses and midwives are the employers,

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government, health consumers, people who deploy the nursing workforce, different professional
groups who play the roles of recruiting the nurses (Thompson et al. 2013). If the nurses and
midwives are in practice, they can provide the proper care and take the important decisions as
well. There are some decision making tools that can be followed in order to provide the best
services in the nursing practice. The nurses will be supported to make the decisions all the way
because they play the viral roles of saving the lives of the human beings indeed (Barry &
Edgman-Levitan 2012).
Tools for decision making
There are some important tools for the decision making for the nurses indeed. These tools
will help and guide the nurses and make them confident enough to take all the necessary
decisions at the right time. This will increase the confidence of the nurses in many ways indeed.
They can swift their decisions as per the needs of the community indeed. These tools will also
help the nurses to make the strategic planning for their way of work (Légaré & Witteman 2013).
They can be able to make the negotiations and implement the changes in their planning as the
situation demands. The nurses will be able to acknowledge the provision of providing the quality
services in health sector by maintain all the guidelines indeed. They should look after the health
needs of the broader community indeed (Blais 2015).
The nurses should focus mainly on the safety of the patients at the first place indeed.
Thus they can provide the best services and enhance it as well. They will have to be able to
manage all the risks indeed. They should be able to identify all the risks and find out the best
ways to resolve these issues properly. They can apply their decisions in all the contexts of their
health practice indeed. These decision making tools will enable the nurses to discover new areas

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of excellence and show their skills in their field of work (Perry, Potter & Ostendorf 2013). These
tools will also make the nurses learn about the negotiation process between the health workers
and the employers. The nurses should be liable to act as per the restrictions or guidelines posed
by the government authorities (Nicol et al. 2012).
It is to mention for the common good of all that the nurses should be motivated to
provide their services to the patients as per their health needs. They need to ensure that the
outcomes on the aspect of the health provisions of the patients should be positive all the time.
They should carry out their decisions by working jointly with their colleagues, patients and their
families (Clapper & Kardong-Edgren 2012). They should be careful in implementing their plans
and hoping for the best outcomes indeed. They should build the support network indeed that
should cater to the betterment of the health facilities. Many complexities can arise while
implementing these strategies properly indeed. The nurses should be able to make a proper and
comprehensive assessment on the needs of the patients. Then only they can progress in their
work by identifying the seeming problems. They should make some strategies by which they will
be able to implement their plans positively (Wu et al 2012).
The decisions and judgments should be made by the members of nursing practice
properly indeed. They should always take the final decisions by consulting with all the people
involved in the process. The legislative policies should be followed by all the members in the
nursing practice as well (Elwyn et al 2012). They should consult and negotiate with all the
members as well. The decision making theories should be mentioned in this context. They should
maintain all the professional and regulatory standards indeed before taking the final decisions or
judgments. The nurses should always take the decisions depending on the education given to
them and their professional experience. They should be provided with the proper skills for their

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works indeed. The various decision making theories should be followed in this context as well
(Elwyn et al 2012).
Information processing theory
Information processing theory is one of the most important decision making theories.
This theory says that the human mind can be thought as a information processor of a computer.
This theory does not go with the factor that the human mind responds to the stimuli. This can be
just like a computer that analyzes the problems in a mechanical way and solves them in the same
pattern as well. This theory also states that the human mind is just like a computer that receives
the orders from external forces, processes go on inside the mind and finally it gives the output
just like the computers (Butts & Rich 2013). The information is gathered from the senses. This
can be taken as the input. The brain stores all this information and further processes it for the
output. Finally the behavioral response is brought out as the output. It can be said regarding this
theory that the information processing theory has completely ignored the importance of the
functional responses of the human brain (Butts and Rich 2013). The human brain is thought to be
a very complex mechanism so it reacts to different situations in different ways. This cannot be
predetermined like a machine indeed. There are certain inherent processes that can be linked to
the human brain. These processes can be assessed using the information that is provided through
the input process. Some ways of completing this process are perception, attention, labeling and
meaning.
The information processing theory has some practical implications in the nursing practice
through the information processing theory. The different issues like the long term memory and
cue assessment can be taken as one of those things. In the clinical practice, the cognitive

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manipulation in the long-term memory can be assessed as well. These things are indeed very
important in the information processing theory in nursing practice.
Pros of information processing theory
The assessments can be done properly and the corrections can be done smoothly through
this theory as well. If the errors are found repetitively, the corrections can be done as per the
comprehensive implications (Butts & Rich 2013). If this theory is applied the users can have a
deep understanding about the topics they are addressing. This would be very much beneficial for
them as well.
Cons of information processing theory
In case this theory is used, the verbalization process will be impacted negatively indeed.
The opinions that will come will be one sided only. This is why this theory should not be used
while addressing some important topics. The human brain will not be used properly since it will
only be used like a machine (Butts & Rich 2013).
Social judgment theory
Social judgment theory is considered to be another important theory and model regarding
decision making. This theory states that the position or view of a person on some issue can
depend on three variables (Burke & Mancuso 2012). The first one is the anchor. This position is
at the first preference for the person concerned. The second position should be the alternatives.
The alternatives mean the other options that are available other than the preferred ones. These
alternatives can either be accepted or rejected (Shaban 2015). Thirdly, the stand or position of a
person on some issue can be judged from the aspect of the personal ego-involvement. The ego of

8DECISION MAKING IN NURSING PRACTICE
a person is very much important in judging their position. In case of nursing practice, this theory
can help in identifying the risks and look for other options that could be used for helping the
patients and their health needs. This entire theory revolves on the judgment of the people. It is
very important for the nurses to interpret the situations properly.
If they are not able to identify the situations, they will be in a deep problem. They will
not be able to find out the proper solutions to these problems (Shaban 2015). The concerned
person has to listen to the problem properly so he or she can be able to initiate the change indeed.
When the people get the persuasive information, they have to make an analysis on those subjects.
Then they can choose what kind of change has to be brought in. The various categories will have
to be used in order to judge the best possible outcome. It has been found out that the level of the
ego-involvements always affect the size of the latitudes for the concerned persons (Burke &
Mancuso 2012).
Pros of social judgment theory
This theory explains the ways of how the perception of the messages can make a
thorough influence on the persuasion. This theory also makes a prediction on the attitude to
change (Shaban 2015). The latitude of acceptance is also decided in here as well (Burke &
Mancuso 2012). This theory says that if a person is involved in a topic, he or she might be
persuaded accordingly as well.
Cons of social judgment theory
The conception of the ego-involvement is not properly defined so it is very hard to assess
this fact. This theory completely ignores the evidence or the quality of the arguments. The

9DECISION MAKING IN NURSING PRACTICE
concerned people can be open to persuasion on the things that they do not know much (Shaban
2015).
The social judgment theory is also very important in the clinical practice for the nurses.
When the nurses have to apply the hypovolemic shock in a series of the simulated cases that are
presented through the computer they have to apply this theory properly indeed. The information
that is being provided to the nurses is not at all linear at all. This information is not equally
distributed as well.
Cognitive continuum theory
This decision making theory is very much important in the healthcare sector. This theory
or model completely aims at working together in critical condition indeed. This theory
completely depends on the human judgment and decision making (Dhami & Thomson 2012).
This theory is very effective in terms of improving the health practitioners at the individual level
and increasing the tem work in the inter-professional level as well. The clinical decision making
process can be implemented by utilizing this theory as well. The inter-professional clinical
decision making process could be made strong indeed (Custers 2013)..
Pros of Cognitive continuum theory
This theory contributes to the clinical decision making of the nurses in the healthcare
settings. As the inter-professional team work is increased this should be encouraged to be
implemented in the field of nursing practice (Dhami & Thomson 2012).

10DECISION MAKING IN NURSING PRACTICE
Cons of cognitive continuum theory
However, there are hardly any weaknesses of this theory for the nursing practice. It can
be said that the judgment based action taking is not encouraged in this theory (Custers 2013).
In the case of effective nursing practice, it can be said that the cognitive continuum
theory is the best theory that could be implemented. The expert nurses have to be aware of the
decision making system indeed. There are huge differences between the systematical-analytical
approaches and the intuitive approaches (Johansen & O'brien 2016). Both these approaches
convey contrary viewpoints. These differences are waved off by the implementation of the
cognitive continuum theory. The inter-professional decision making has to be at its peak for the
clarity of communication between the nurses. These things will have to be at its proper place.
Otherwise, the communicative aspects will remain hidden. The decision has to be made by the
nurses by structuring all the arguments and logics properly (McEwen & Wills 2017). This will
indeed be beneficial for the future nurses as well. The decision can be taken very effectively if
the structure is logical and perfect. The decision making process will be continuum. Thus the
differences will be reconciled indeed. The decisions will have to be taken in a systematic way
indeed.
Transition between cognitive continuum theory and practice
The decision making process in the clinical environment is a very tough process for the
nurses. It is the cognitive continuum theory that has contributed a lot to the decision making
process in the nursing practice. The theories are very much relevant to make the potential nurses
realize their aims in the profession, the concepts that are most relevant in this and the usefulness
of being in this profession. The decision making process of the professional nurses is completely

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motivated by the things stated in the cognitive continuum theory (Custers 2013). The important
framework in the nursing decision making is supported in the cognitive continuum theory. The
nurses can achieve the desired success if they follow this theory properly indeed. As the team
understanding is increased, it helps the nurses to grow a better understanding between them. If
this theory is followed the inter professional healthcare indeed.
This theory has been chosen because the other two theories do not reflect on the general
things in the nursing practice. As ego-involvement has been taken as one of the major aspects in
the social judgment theory, this thing should not be taken as important in the nursing practice
(Custers 2013). The cognitive continuum theory stresses on the collaboration between the
colleagues indeed. This fact is not reflected in the information processing theory. This theory
only focuses on the nurses as the machines. However this is not the scenario at all. These things
should be kept in mind instead. They have to do their work with much sensitiveness. They
cannot go through the input, processing and output procedure. The theorists and experts have
always opined that this CCT should be the best alternative way for providing the conceptions for
the nursing practice. CCT has been considered as the explicit analytical tool. The patients can be
taken care of by the nurses according to this cognitive continuum theory. The nurses can do their
work works better by collaboration with others. This will also increase the effectiveness of their
work. The patients would get better care if the nurses work according to the cognitive continuum
theory.
Conclusion
This paper can be completed by saying that effective nursing practice has been one of the
most important things in the healthcare sector. The three important theories have been discussed

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in this context as well. The decision making framework has been discussed in this paper. The
various tools for the nursing practice have been discussed over this paper. The core principles of
nursing have to be maintained. The legal guidelines will have to be maintained as well. These
things are very much essential for the perfect decision making model. The theories have been
discussed and it has been found that the cognitive continuum theory is the best theory for the
effective decision making in the nursing practice.

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