Levett Jones Models of Nursing

This essay discusses the Levett Jones model of nursing and its importance in clinical reasoning and decision making. It explores the different phases of the model and how it can positively impact patient outcomes. The limitations and criticisms of the model are also discussed.

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LEVETT JONES MODELS OF NURSING
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1LEVETT JONES MODELS OF NURSING
This essay is going to discuss about the Levett Jones model of nursing,2010. The
model is divided into 8 different phases that include consideration of the patient facts,
collection of information, processing the gathered information, identifying the problems,
establishing goals, taking action, evaluation and finally reflection and in reality the nurses
had to keep this cycle of reasoning while dealing with the health issues of the patients
(Heartassociation.eu 2019). The nurses with effective clinical reasoning skills tend to have a
more positive outcome on patients. On the other hand, those nurses with poor reasoning skills
tend to negate the positive patient outcome as they do not have the adequate knowledge on
the collection and implementation of cues from patients. The Levett Jones cycle represents an
ongoing and nature of clinical interventions. It also emphasizes on the importance of
evaluation and reflection. Thus, it becomes utmost important to learn, understand and
implement the components of the cycle in decision making.
The importance of clinical reasoning cycle based on Levett Jones model (2010) is that
it is used to describe the various phases which includes collecting information, processing the
cues, identification of the problem, implementing the plans and interventions, evaluation of
the outcomes and finally reflecting the new things learnt during the case (Jones 2010).
Critical thinking is necessary for solving problems and complex decision making. It is best
learnt by the learner through repeated experiences and practice (Park et al 2013). The skills
that can be gained by the cycle are confidence, flexibility and open mindedness. These can be
supported on the basis of certain evidences. The nurses can gain confidence by the repeated
experience of information collection. For example, a 60 year old patient in the ICU had an
abdominal aortic aneurysm (AAA). He could be suffering from low blood pressure due to
loss of blood at the time of surgery. So the first and foremost duty of the nurse will be to give
him more fluids so that he is prevented from going to shock. The patient is also hypovolemic
and his BP was worsened by epidural that can cause him vasodilation. At that time if the

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nurse has fine clinical skills then the nurse will ring the doctor to increase the dose of
patient’s ongoing medicine or to change his medication. The cycle also trains the nurses to be
open minded which can be explained on the basis of the following example- the
preconceptions that indigenous people are alcoholic. These opinions of nurses while the
management of their patients and their personal beliefs influence the quality of care. Thus
during the training of nurses more focus should be given on the opportunities to reflect and
questions their assumptions as it will affect the patient outcome adversely. Studies have
shown that registered nurses have more understanding and thus take critical decisions much
faster than the new nurses (LoMonaco 2014);(Cladwell 2013). Skills that are self-regulatory
and self- learning are very important aspects in learning problem solving skills. Self-
regulation again involves cognitive strategies that form a part of critical thinking (Rezaee and
Mosalanezad 2015). This can be proved by the fact that when a patient with an acute illness
comes to the hospital there is need for both physical and emotional support. Studies have
shown that the nurses who can reflect their understanding in daily duties provide better
nursing care (Cladwell 2013). This can be supported by an evidence in cases where the nurses
has to make a lot of effort to take care of their patients. Sometimes the doctors are not
available then the go to person for the patient in such a case are the nurses. Then at that
moment the nurses have to really think on their feet and take decision wisely and apply it to
the patient’s scenario. The critical reasoning requires vast amount of training to the new
nurses. It is extremely useful for them to observe the outcomes of these programs as it will
help them to evaluate the transformations in the patients through the cognitive and processed
changes in the care practices (Park et al 2013);(Yildirim and Ozkharaman 2011);(Rezaee and
Mosalanezad 2015).
There are certain problems which arise when the students do not have a chance to get
exposed to certain situations due to lack of hospital availability and acute patient exposure

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(Williams et al 2016). This cannot be fully applied in all the aspects of nursing because older
nurses can take the cues from the patients much faster than the newer ones. Nursing programs
also face lack of faculty which means that the educators do not have the facility to exercise
their expertise to teach all the students (Sedgwick and Harris 2012). The main limitations of
critical thinking tools in nursing is that they fail to capture the specific nature of nursing.
These are usually applied on students and are not examined on the nurse’s practical reality.
There is specific criticism about the studies done on critical reasoning. As it is very much
focused on analytical and personal thinking (Shaban 2015). This would hamper the growth of
nursing profession as it would lead to the deduction of creativity and dialogical interaction
between the people and community. It would also not structure the nursing practice. Many
aspects of clinical reasoning require improvements (Sedgwick and Harris 2012). Conversely,
there are certain values that negate the quality of clinical thinking and decision making as
they focus on management sciences. The mere implication of these programs does not imply
that there would be changes in the practice of the professionals. Healthcare professionals are
free to restructure their work routine based on their personal believes and contextual
influences. This might impact the patients and also to all the health system users (Park et al
2013). The concepts of reflection is thought to be a two dimensional process whereas the
models of reflections are either linear or cyclic. The most common mistake is that reflection
needs to be meaningful rather than being unidirectional (Bonney et al. 2015).
Thus, it is concluded that critical reasoning is at the core of healthcare practices.
However, it is not always clear as how and when to use these different parameters as
described by Levett Jones. Acute healthcare settings are often characterized by patients who
are critically ill and clinical reasoning might help them to a greater extent. The clinical
reasoning cycle demands that the nurses collect the right cues at the right time to take the
correct action plan for the right patient. Nurses should have the skills of thinking and making

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decision on the go. The nurses with effective clinical reasoning have a very positive impact
on the patient.
References
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