The Role of Critical Thinking and Intuition in Nursing Decision Making

This essay delves into the critical aspects of nursing decision-making, emphasizing the significance of critical thinking and the application of various decision-making models. It begins by highlighting the importance of effective decision-making processes in nursing, which directly impacts patie...Read More

Nursing Decision Making
Introduction
Nursing process and clinical decision making are crucial parts in the organization because
these impact the entire activity of the organization (Munteannd, pp. 2). The profession of
nursing faces the numerous decisions on the daily basis. It is necessary to have the
effectiveness in the decision making process to make sure the positive outcomes in the
clinical setting. The misunderstood decision making process of nurses can lead the
organization into anticipated outcomes. Moreover, immaturity in clinical thinking might
impact the decisions due to ineffective experience and knowledge (Banning 2008, pp 178).
Nursing decision making process is the skill of critical thinking. Critical thinking is the
process that shows the ability to accumulate and process data in a way to arrive the effective
conclusions. This assignment will reflect the role of critical thinking and the process of
nursing in making clinical decisions. The involvement of the decision making model is
necessary in guiding the decision making process. That is why it is vital to know about the
nurses’ decision making model and theories in aiding the learning and development of
decision making skills. Three theories will be described in this assignment to describe the
importance of decision making models and theories. One theory of them will be opted and
analyzed in the context of how nurses make decisions in their practice. Furthermore, the pros
and cons of the theory will be critically examined. Along with that the complexities,
contradictions and inconsistencies associated with the theory will be discussed in this
assignment with supporting counter argument. At last, the essay will provide the practical

applications of intuition theory which will be considered as the most appropriate nursing
decision making theory.
Social judgement theory
Social judgment theory is considered as the framework that studies human judgment. It is a
Meta theory that defines the research on cognitive perspective which shows how someone
reacts on the situations (Asemah and Nwammuo, 2017, pp. 76). It assists to simplify the
principles of psychophysical judgmental and the social judgement. It is majorly focused on
the internal process of the personal judgment of the person in order to make the relations
between employees. It has advantages as well as disadvantages in the context of nursing
decision making which will be discussed. The advantage of social judgement theory is based
on the idea. It has been analyzed that the consequences of the persuasive message on the
specific issues is dependent on the way that the receiver analyses the situation of the message.
The nurses can take the decision by applying social judgment theory because it suggests that
formative research should be made as the campaign message (Bambini, Washburn &Perkins
2009. pp.80). The major pros of this theory is that it is practical utility, testable, predicts and
intuitive appeal. Social judgement theory also represents how people contrast their personal
positions on concerns to the position of others. It has been found that the social attitudes are
not increasing especially in the term of specific issues where the attitude is extreme (Chau,
Wong, Chow and Fung, 2014, pp.1).It means that person is not agreed with the less extreme
stands relative to his position even though the similar direction (Polit& Beck 2008). The
major agenda of this theory is creation, judgment process and critics. It assists nurses to take
decision after evaluating that why two people may perceive the single message differently.
The weakness of social judgment theory is that it is not likely to happen with clear message
and along with that this theory can impact persuasion. Another drawback of this theory is that
it ignores the other factors that can influence the persuasion.

Information processing theory
Information processing theory is the approach of understanding the thinking of the human.
George A. Miller was the founder of this theory who has provided the major two ideas for
this theory that are fundamental to cognitive psychology and the information processing
framework (Moos, n.d., pp.4). Nurses of the healthcare are considered as the key decision
makers. The decision of the nurses is expected from the authority of the healthcare team and
the people that they will take best available evidence in their judgements and decisions. As
per this theory human is able to store the objective data which will be coded as the symbols
and this majorly focuses on three memory store such as sensory memory, cognitive process,
long term memory and work process memory (Moos, n.d., pp.4). Symbols refer the group
which comprise as the pattern in the brains thus memory is stored in chunks. It has been
analysed that these patterned groups of symbol are linked with external stimuli. The most
benefit point of this theory is that people identify the patterns in the time of re-occurring of
similar stimuli that pretends to fit the experience of person. Communication and the clarity is
the strength of this theory that stimulates nurses to take appropriate decision in the context of
welfare of the people (Wong & Cummings 2009, pp.524). This model is systematic that
facilitates nurses to elucidate how they reached at the decisions and what factors are
considered in the process. The cognitive processing can be seen in clear way by using this
theory. The drawback of this theory is that it consumes a lot of time of nurses to take
decisions. It only influences external events such as verbal agreements, pictures and
diagrams. It has been found that the nurses have to depend too much on the computer as an
analogy for how human thinks. The complexity of neural networks is not represented due to
sequential depiction of information processing.

Intuition theory
Intuition theory is considered as the human ability for knowing without adequate causes. It is
a process of identification of the truths without rational thinking (Senanayake, 2017, pp.5).
There are numerous definitions of intuitions. In this model, the decision maker deliberately
integrates recall knowledge that comes from education. This theory provides the information
based on the beliefs, justification is not required under this theory (Lisko&O'dell, 2010, pp.
106). The spirit of intuition has the ability to identify the cues which is helpful to increase
the experience in the management of patients in the field of nursing. Intuition theory
facilitates nurses to take decision quickly without considering any analytical model which
may confuse them. The huge benefit part of this theory is that it helps to take the quality
decision making. Intuition is able to trust on past experience to reach at the judgement
without considering the procedures of analytical (Light hall &Vazquez-Guillamet 2017, p.
156). By experiencing the same incident in the past, nurses can evaluate the current condition
and take decision as per the requirement of time. There is another merit of this theory that it
lies in the linked applications of emotions, it’s considered as the holistic approach for the
situations and the ability to recognize the amending scenarios which assist it to expand the
process of decision making by accumulating both experience and memory. Intuitive theory
can be used within the organization when goals are unclear and organization faces the major
issues. The weakness of this theory is that nurse should be experienced to apply this theory in
decision making process. It has been stated byJefford, Fahy and Sundin (2011), that nurses
are entirely reliable on intuition have information builds which are only appropriate in
specific contexts entailing that unexpected outcomes might be attained if intuitions is put for
unnecessary context. Moreover, the theory of intuition is condemned for ignoring analytical
principles.

Applying the intuition theory in nursing practice
As per discussion above, it is cleared that intuition theory is the supreme decision making
theory for the nursing practice. This theory is being chosen because it is based on
probabilistic programs and it is effective theory which can influence the decision making
process (Senanayake, 2017, pp.5). It supports prediction that is why it can be considered as
the ideal for the profession of nursing. This theory allows nurses to predict about future on
the basis of present. There are various kinds of nursing procedures which may be applied in
nursing care and the involvement of this theory is necessary for the patient to get better. It has
been analysed that nurse are not required to use analytical reasoning in creating clinical
decisions which is helpful to save the time. It is worth noting that the decision making
process has the theory’s preferences. There are major two thought processes in the case of
nursing care for patients in various situations. The first kind of thinking of nurse in the
context of decision making is analytical and rational which focus on observable data. On the
other hand, the second kind of thinking is an unconscious process that happens holistically
and rapidly and rooted in emotions. After that the later procedures is deemed as intuition. It
has been argued by Thompson et al. (2008), that intuition is the legitimate and important
element of decision making. Intuition theory permits the nurse to utilize counterfactual
inferences in decision making. For instance, there is a child patient who is malnourished. In
such case, the nurse would ask question from mother about the knowledge about nutrition.
The nurse would tell about the role of government in a school feeding program for poor
children. The nurse would ask about the daily activity of the child. These questions would be
helpful for her to evaluate the case to figure out the condition of the patient. It can be done
that the patient would not be in the hospital and would be active at other place such as school
and home. By taking help of such intuition, the nurse would be able to make the decisions in

the context of malnourishment by providing knowledge about information on malnutrition
and how to avoid it. By taking help of nutrition, the nurse would be able to define about the
entire issues the patients are faced with. Furthermore, the nurse would be able to describe
those factors which are not included in the issues of malnutrition like gender because
malnutrition does not impact any specific gender. There are many reasons of malnutrition
such as bad eating habits along with the lack of food which might hugely be referred as
environmental factors (Thompson et al. 2008, pp.3). Apart from that there are number of
ways in which nurses utilizes the intuition theory in making decisions in their nursing
practices. There might be numerous factors but the fact is that they may be similar since how
each patient of the healthcare is influenced by the emotional and cognitive factors. The role
of intuition theory in such scenarios is big because it assists nurses to evaluate the condition
of the patient take action as on same so that they come up with right strategies.
Complexities, contradictions and inconsistencies between the theories and counter
agreement
Social judgemental theory
The major complexity of the social judgement theory is that it ignores the message content. It
has been found that there are various evidences that show several messages are variables such
as evidence or quality of argument which may affect persuasion (Asemah and Nwammuo,
2017, pp.77). Social judgment theory does not take into account any variable messages as
other theories do. For instance, a variable message that reduces the in the latitude of rejection
may not be rejected due to its strong argument for its position. It is not sure that the patient
makes a judgement about the situation of the influential message. It is not necessary that the
message is judged before attitude amends takes place. The process can be reversed and the
persuasive messages might be accepted by listeners. It can be possible that the listener may

react like that, ‘the message or information has the nature of persuasive’. It should have been
near to my attitude.’ The differentiation in the understanding can be the major reason of
wrong interpretation which may influence the nursing decision making’. This complexities
and inconsistencies in the nature of this theory are high in comparison of other theories.
Intuition theory
The contradictions of intuition theory are not as higher as other theories. There are various
decisions made are linear in nature that includes the process of knowledge and action. It is
considered as the linear process of thinking. It has been cleared in this theory that the
importance of experience is huge to understand the emotions and the situation of the patient.
Intuition could not be defined in rational manner but it put huge impact on the outcomes of
the patient (Senanayake2017, pp.8).
It has been found that major complexities of this theory is that it cannot understand the
specific requirements of the patients and by taking help of intuition theory, nurses start to
assume that the problem is limited and for making this kind of thinking, they do not go
beyond the issue. However, intuition is generally represented as the capability to act
appropriately without balancing alternatives (Harteis and Billett, 2013, pp.1). For instance,
there was junior nurse who look after one patient who had issue of high blood pressure and
the communication between them was open. A junior nurse found that the patient had severe
heart ache which could not be controlled by him and she started to provide the treatment and
sent him for testing. This information was being sent to senior nurse who had 20 years
experience in nursing. She observed that junior nurse could not understand that the patient
was experiencing a heart attack. After getting reports of patient, it was clear that he was
having a heart attack. It has been concluded by junior nurse that senior nurse was not to
identify the concern of the patient due to intuition theory and sent him for right test. It is

cleared to analyse that the senior nurse recognized the concern but it has been countered that
the intuition theory is applicable for them who has huge experience. Heart related test was
conducted of the patient but the patient was the victim of diabetes and due to intuition she did
not provide any precautions regarding diabetes which may lead him in severe disease. It
shows that the intuition theory bound the thinking of the nurses which may influence her
decision making (Ροβίθης 2015, pp. 1).
Information processing theory
Information processing theory enables to increase the understanding of the process of how
nurses will react on the specific situation and further develop nursing theories. This theory is
necessary to develop the research into nurse patient communication. They are expected from
the authority of the healthcare team and the people that they will take best available evidence
in their judgements and decisions (Dickison e al. 2016, pp. 5). The expansion of nursing
theory might recognize effective response of nurse to particular patient interactions with
insinuation for nursing care and the outcomes of patient. The communication with nurses of
patients influences the outcomes such as adherence, anxiety and satisfaction with care. The
counter agreement for this theory is that is it possible that patient understand the solution and
the discussion about the concern which he or she raised up? This theory generally applies in
the system of the company by using the model of the computer to describe how the brain
works. For instance, nurse describe about the precautions and the diet chart in effective way
by using the computer. It is not vital for every patient to understand about the way in which
nurse communicates. It is the big complexity in this process. The inconsistency has been
found in this theory in comparison of others. The difference is significant because all memory
processes within the information processing model happen at the same level of awareness
(Ammenwerth et al. 2011, pp. 27). For instance, the interaction with a child, it has been found
that the acknowledgement of him is different from his father. The expression while

communicating him was different but the way in which he opts to behave in the entire
process is based in a conscious choice and it is done due to his awareness. As consequences,
the action of consciously identifying social context would be contradictory to the major
principles of information processing theory if it happened in the time of processing of
stimulus in the sensory memory store.
Conclusion
In the limelight of above discussion, it has been concluded that the role of nursing in health
care organization is vital that is why their decision making process impact the entire activity
of the organization. The involvement of the decision making model is necessary in guiding
the decision making process. That is why it is vital to know that the nurses’ decision making
model and theories in facilitating the learning and development process within the
organization. The three theories have been highlighted in this assignment such as social
judgment theory, information process theory and intuition theory. All theories have merits
and demerits which have been discussed in this assignment. It has been found that the major
focus of social judgement theory is on the internal process of the personal judgment of the
person in terms to the relations within a communicated message. Information processing
theory has explained in this assignment which shows that the communication is the strong
evidence for this theory and human are able to store the objective data which will be coded as
the symbols. Intuition theory has applied in the nursing decision making with various
examples. The huge benefit part of this theory is that it aids to take the quality decision
making. Intuition is able to trust on past experience to reach at the judgement without
considering the procedures of analytical. The complexities, contradictions and inconsistencies
between the theories have been described in this assignment by taking support of counter
argument for each theory. it has been found that after having the complexities in intuition
theory, it is integral as it permits inference in the time of making decisions which can be

defined and have certainty hence objecting in providing the quality of judgements. Intuitions
enable nurse to recognize the concerns or issues of patients and hence give the correct and
suitable intervention programs to them.

References
Ammenwerth, E., Rauchegger, F., Ehlers, F., Hirsch, B. and Schaubmayr, C., 2011. Effect of
a nursing information system on the quality of information processing in nursing: An
evaluation study using the HIS-monitor instrument. International journal of medical
informatics, 80(1), pp.25-38.
Asemah, E.S. and Nwammuo, A.N., 2017. Implications of social judgement theory for
persuasive advertising campaigns. Journal of Research in National Development, 15(1), pp.
75-82.
Bambini, D., Washburn, J.O.Y. and Perkins, R., 2009. Outcomes of clinical simulation for
novice nursing students: Communication, confidence, clinical judgment. Nursing Education
Perspectives, 30(2), pp.79-82.
Banning, M., 2008. Clinical reasoning and its application to nursing: concepts and research
studies. Nurse education in practice, 8(3), pp.177-183.
Chau, H.F., Wong, C.Y., Chow, F.K. and Fung, C.H.F., 2014. Social judgment theory based
model on opinion formation, polarization and evolution. Physica A: Statistical Mechanics
and its Applications, 415, pp.133-140.
Dickison, P., Luo, X., Kim, D., Woo, A., Muntean, W. and Bergstrom, B., 2016. Assessing
higher-order cognitive constructs by using an information-processing framework. Journal of
Applied Testing Technology, 17(1), pp.1-19.
Harteis, C. and Billett, S., 2013. Intuitive expertise: Theories and empirical
evidence. Educational Research Review, 9, pp.145-157.

Jefford, E., Fahy, K. and Sundin, D., 2011. Decision‐Making Theories and their usefulness to
the midwifery profession both in terms of midwifery practice and the education of
midwives. International Journal of Nursing Practice, 17(3), pp.246-253.
Lighthall, G. K. & Vazquez-Guillamet, C., 2015, 'Understanding Decision Making in Critical
Care', Clinical medicine & research, vol. 13, no. 3-4, pp. 156-168.
Lisko, S.A. and O'dell, V., 2010. Integration of theory and practice: Experiential learning
theory and nursing education. Nursing Education Perspectives, 31(2), pp.106-108.
LoBiondo-Wood, G. and Haber, J., 2017. Nursing Research-E-Book: Methods and Critical
Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Moos, D., n.d. Information Processing Theory in Context. Accessed on 20th March, 2018,
from: https://homepages.gac.edu/~dmoos/documents/IPT_000.pdf.
Muntean, W. J., (n.d.). Nursing Clinical Decision-Making: A Literature Review. Clinical
decision-making, pp. 2-3.
Polit, D.F. and Beck, C.T., 2008. Nursing research: Generating and assessing evidence for
nursing practice. Lippincott Williams & Wilkins.
Senanayake, T., 2017. Intuition in Nursing Practice: Knowledge, Experience, and Clinical
Decision Making.
Thompson, C., Dalgleish, L., Bucknall, T., Estabrooks, C., Hutchinson, A.M., Fraser, K., de
Vos, R., Binnekade, J., Barrett, G. and Saunders, J., 2008. The effects of time pressure and
experience on nurses' risk assessment decisions: a signal detection analysis. Nursing
research, 57(5), pp.302-311.

Thompson, C., Spilsbury, K., Dowding, D., Pattenden, J. and Brownlow, R., 2008. Do heart
failure specialist nurses think differently when faced with ‘hard’or ‘easy’decisions: a
judgement analysis. Journal of Clinical Nursing, 17(16), pp.2174-2184.
Wong, C. and Cummings, G., 2009. Authentic leadership: a new theory for nursing or back to
basics?. Journal of Health Organization and Management, 23(5), pp.522-538.
Ροβίθης, Μ., 2015. Intuition in nursing practice.ICUSnurs web j │ issue 22│april - June 2005
(nursing.gr)pp. 1-5.