Clinical Judgement

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Pain is an unpleasant sensory and emotional experience that is universal among all people (Crisp, et, al, 2009). Pain management is a crucial part of nurse’s duty of care to patients, and can have detrimental effects on their health if uncontrolled. Postoperative care of Josie Elliot needs to be well managed due to other factors contributing to her pain such as her diabetes. Tanner’s model of clinical judgement shows how nurses can systematically notice, interpret and respond to patient pain effectively, as well as reflect on how the response worked. Postoperative pain occurs after surgery, whether it is major or minor and is completely subjective, as there is no way to measure a patient’s pain level (Brown, et. al, 2009). If unmanaged it…show more content…
The process of making a clinical judgement goes through phases, as suggested by Christine Tanner in ‘Thinking like a Nurse: A Research-based Model of Clinical Judgement in Nursing’, specifically 4 phases (Tanner, 2006). The first phase in the process is ‘Noticing’ and this involves what the nurse would expect to happen in the situation, and therefore the signs the nurse is looking for in the patient (Tanner, 2006). This is due to the knowledge not only about the procedure, but also knowledge of the patient’s context and background. The next phase in Tanner’s model is Interpreting and this involves understanding the situation using reasoning patterns and the data provided, such as observations or symptoms, and assessing it to come to a conclusion about the situation and what needs to be done (Tanner, 2006). Interpretation can happen analytically, through the use of data and clinical knowledge or intuitively, an immediate interpretation due to recognition of the data (Tanner, 2006). This is followed by a response to the situation, in the phase ‘Responding’ (Tanner, 2006). Through the conclusions made in the previous phase, the nurse can deliver an appropriate response to the patient (Tanner, 2006). The final phase is ‘Reflection’ comprising of reflecting on the nursing intervention administered as well as reviewing the outcomes as a…show more content…
Noticing is an important phase in pain management for Josie, as the nurse would expect Josie to be in pain after surgery, but shown in her patient notes, her pain rating was high. The nurse would also have to be aware of changes in respiration rate and heart rate as responses to pain (Crisp, et, al, 2009). The interpretation of this data is critical to the management of her pain, as the nurse has to understand that her pain caused the elevated observations, and therefore is not managing it well. The nurse’s response needs to be appropriate to the conclusions made in the previous phase and in this case it would their decision to administer an analgesic to Josie. The final phase, reflection, is vital, as the nurse must assess how successful the nursing intervention was to her pain management. Therefore the nurse can reflect-on-action afterwards, to build on their knowledge about Josie’s specific pain management and general postoperative pain
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