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UNIT 1 How Nurses Think
Client Situation
FIGURE 2-3 Model of full-spectrum nursing.
Knowledge Check 2-7 ■ What are the four main concepts of the full-spectrum model of nursing? ■ Where do the four types of nursing knowledge fit into the full-spectrum model? ■ What is the ultimate purpose of full-spectrum nursing? How Does the Model Work? The full-spectrum nursing model is used throughout this text, so it is important that you understand how it works. ■ Nurses use clinical reasoning, critical thinking, and the nursing process to make sound clinical decisions. They also apply these competencies to the four kinds of nursing knowledge. ■ When they are doing for the client, caring motivates and facilitates the thinking and doing. ■ The goal of thinking, doing, and caring is to have a positive effect on a client’s health outcomes. The following client situation illustrates how the four main dimensions of full-spectrum nursing work together. As you read, notice how the concepts over- lap. Also, notice how the nurse uses clinical reasoning and critical thinking with nursing knowledge and the nursing process. Client Situation When taking a client’s oral temperature, a nurse sees a glass of ice water on the over-the-bed table. Realizing that a cold drink can reduce the accuracy of the tem- perature reading, she asks the client, “How long since you’ve taken a drink of water?” The client tells the nurse
it was just a minute ago. The nurse is busy and tired, but she returns to retake the client’s temperature later, when it will be accurate. Thinking ■ Theoretical knowledge. The nurse realized that a cold drink can lower the temperature reading. The nurse used interviewing principles to get more information from the client. ■ Recognize cues. The class of ice water on the bedside table is a relevant cue for a temperature reading. ■ Analyze cues. The nurse used theoretical knowledge to link the effect of cold water on the temperature value. ■ Clinical reasoning. The nurse synthesized knowledge and information from textbooks and experience to alter the plan of care for the client based on the information obtained. ■ Critical thinking. The nurse recognized relevant information and identified the need for more infor- mation. She used the client’s answer to decide what to do. ■ Context. Being aware of context is important to deci- sion making. The context in this scenario includes ice water within the client’s reach and that the client was physically capable of reaching it. The context also includes the nurse’s other responsibilities. ■ Prioritize hypotheses. Select the hypotheses that best explain the client’s cues and can be used to generate possible solutions. Doing ■ Practical knowledge. The nurse used a psychomotor skill when she measured the client’s temperature to acquire more vital sign data and a communication process to question the client.
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