42
UNIT 1 How Nurses Think
■ Caring involves thinking and acting in ways that preserve human dignity and humanity. It does not treat people as objects. A caring nurse’s actions are never routine or impersonal. For example, a caring nurse drapes a client for privacy when inserting a urinary catheter. Caring has at least five components (see Table 2-4). Caring is the central concept in several nursing theo- ries. You will learn more about the caring theories in Chapter 4. Think Like a Nurse 2-6: Clinical Judgment in Action Using the five components of caring, how can you show caring to your client? WHAT IS FULL-SPECTRUM NURSING? Key Point: Full-spectrum nursing is a unique blend of thinking, doing, and caring. It is performed by nurses who fully develop and apply nursing knowledge, criti- cal thinking, clinical reasoning, and the nursing process to client situations to make sound clinical judgments. The purpose of full-spectrum nursing is to practice safe, effective care and achieve good client outcomes.
■ Nursing process is essentially a problem-solving process. As such, it is one of the complex critical-thinking processes. Complex thinking skills, such as the nursing process, make use of many different critical-thinking skills (see Fig. 2-2). How Is the Nursing Process Related to Clinical Judgment? The steps of the nursing process correlate and overlap with those of clinical judgment, as shown in Table 2-3. The nursing process provides a systematic process for problem-solving and critical thinking. It facilitates clini- cal decision making. As a complex critical-thinking tool, the nursing process guides clinical reasoning to provide a solid foundation for the development of sound clinical judgment, which is the outcome required for safe clini- cal practice. WHAT IS CARING? Caring involves personal concern for people, events, projects, and things. It allows you to connect with oth- ers and give help as well as receive it. One aspect of self-knowledge is to be aware of what and whom you care about. Knowing what the client cares about reveals what the client considers stressful because only things that matter can create stress. Caring also enables you to notice which interventions are effective. ■ Caring is always specific and relational for each nurse– person encounter. A caring perspective highlights each person as unique and valued. ■ Caring is not an abstraction. That is, you don’t just care for “suffering humankind,” but you respond com- passionately to this client’s needs right now, in the moment, even if you are busy and tired. Table 2-3 ➤ Comparison of Nursing Process With Clinical Judgment Model NURSING PROCESS STEPS NURSING CLINICAL JUDGMENT MODEL LAYER 3 Assessment Recognize and analyze cues Analysis/Diagnosis Analyze cues and begin to prioritize hypotheses
What Concepts Are Used in Full-Spectrum Nursing?
Recall that when we put concepts (ideas) together to explain something, it is called a model. You will learn more about concepts in Chapter 4; for now, think of them as ideas. The four main concepts that describe full-spectrum nursing are thinking, doing, caring, and client situation (or context; Table 2-5). When nurses think, they use the nursing knowledge that they have stored in their memory and the experi- ences that they have had. In addition, they think about the client situation, which they understand through the use of the nursing process. Situation, or context, refers to the context for care: the client’s environment outside the care setting, relationships, resources available for cli- ent care, and so on. Figure 2-3 is a simple visual model of full-spectrum nursing. You can see that the concept’s full model involves everything you have learned about in this chapter—clinical judgment, clinical reason- ing, critical thinking, nursing knowledge, and nursing process—but organized under the simple concepts of thinking, doing, caring, and client situation. Let’s see how the model concepts work together for a full-spectrum nurse. They are all interrelated and overlapping, but we divide them into simple categories to help you understand and remember them. You can see that a full-spectrum nurse needs excellent clinical judgment, clinical reasoning, and critical-thinking skills because there is so much to think about and much to do in the complex healthcare environment .
Planning (outcomes and interventions)
Prioritize hypotheses and generate solutions Take action on solutions generated Evaluate implementation and outcomes
Implementation
Evaluation
Source: Adapted from Dickison et al. (2018); Next Generation NCLEX News (2019);Wilkinson et al. (2020).
25
Powered by FlippingBook