As a nurse, your patients rely on you to provide them with quality and compassionate care. Of course, no two patients are exactly alike, which means that your care must also be individually tailored to meet each patient’s unique needs and circumstances.
Using clinical reasoning, nursing professionals can apply their own knowledge, critical thinking, and expertise to provide optimal patient care in changing circumstances. As you can probably imagine, clinical reasoning isn’t a skill that nurses master overnight. Instead, it takes careful development and practice over time.
With a solid understanding of what clinical reasoning in nursing entails and why it matters, you can take some proactive steps to advance your own skills and expertise. This could help you provide quality, patient-focused care with confidence.
What Is Clinical Reasoning in Nursing?
Before diving into the importance of clinical reasoning in nursing and tips for developing these skills as a nurse, it’s important to understand what clinical reasoning is, what it entails, and how it differs from critical thinking in healthcare.
Defining Clinical Reasoning
In simplest terms, clinical reasoning refers to the cognitive processes that nursing professionals use to assess, diagnose, and solve patient care problems. One publication in Nurse Education in Practice defines it more specifically as “the process of applying knowledge and expertise to a clinical situation to develop a solution.”
In the healthcare field, nurses must constantly process new information and make adjustments to their patients’ care plans in collaboration with other professionals (including doctors and specialists). Clinical reasoning processes should combine both expertise/knowledge and context with the understanding that patients’ needs can change and evolve over time. Nurses and other healthcare professionals can provide the highest standard of care possible through this patient-centered and dynamic approach.
Clinical Reasoning in Nursing: An Example
What does clinical reasoning look like in action? Consider a situation where a patient in the hospital for assessment after a car accident starts suddenly complaining of chest pain and tightness. A nurse using clinical reasoning should act swiftly to assess the patient’s symptoms and consult with other healthcare professionals to adjust the treatment plan accordingly. This may include conducting additional testing to rule out the possibility of a heart attack or other cardiac conditions while continuing to treat any injuries.
How Clinical Reasoning Differs From Critical Thinking
Both clinical reasoning and critical thinking in healthcare are important skills, but it’s important to note that these terms are not interchangeable. It can be helpful to think of critical thinking as part of the clinical reasoning process, as nurses must use this skill to interpret data and evaluate patients. However, clinical reasoning is a much more specialized skill that’s unique to the healthcare practice.
How to Develop Clinical Reasoning in Nursing
While there’s no way to perfect your clinical reasoning skills as a nurse overnight, there are some practical steps you can take to advance and build upon these skills throughout the course of your career. While these skills can be developed with hands-on clinical experience, many nurses can benefit from active learning in a formal degree program. Using virtual patients and simulations, nursing professionals can practice evaluating, assessing, and making clinical judgments to improve their clinical reasoning and critical thinking skills in a safe and controlled environment.
Why Clinical Reasoning Is Critical in Healthcare
Clinical nursing may be just one of many skills nurses need to possess to properly care for patients, but it’s also among the most important. Specifically, clinical reasoning and problem-solving in nursing are important because they help nurses adapt and respond to changing situations while continuing to provide patient-focused care that keeps patients safe. This, in turn, can have a direct impact on patient outcomes.
Meanwhile, strong clinical reasoning skills can help nurses gain confidence in their abilities and prepare them for potential advancement into leadership roles with additional responsibilities.
Steps in the Clinical Reasoning Process
To better understand how clinical reasoning skills are developed, it can be helpful to explore the key steps in clinical reasoning. By seeing clinical reasoning as a process rather than a standalone skill, nurses (and aspiring nurses) can focus on improving their own execution and comprehension of each individual step.
Step 1: Gathering Patient Information
First, nurses engaging in clinical reasoning need to gather as much relevant information about their patients as possible. This can be done by conducting patient assessments and using that information to pinpoint patterns, trends, and other data that could be used to inform their clinical judgment.
Conducting a Thorough Patient Assessment
The process of assessing a patient may vary, but most assessments begin with a quick check-in with the patient and a review of their symptoms. From there, nurses may perform their own examinations by checking a patient’s vitals, assessing their cognitive function, and recording their findings.
Recognizing Key Data and Patterns
After a patient assessment is performed, nurses should take that information and review their notes along with any previous medical records that are available. From there, nurses use their critical thinking and analytical skills to look for patterns, trends, or other relevant information that might inform their patient care plans.
Step 2: Identifying Problems or Potential Risks
Another important step in the clinical reasoning process for nurses is to identify any potential problems or risks based on the patient’s assessment and other cues. If a patient comes into a doctor’s office complaining of ankle pain, for example, a nurse may speak with the patient about potential causes during the initial exam (such as playing a sport or accidentally twisting the affected ankle). This, combined with reviewing X-rays with a specialist, could lead to a probable sprained ankle diagnosis. By better understanding the patient’s problem and its potential risks, nurses can collaborate with healthcare teams and move on to the next step.
Step 3: Developing and Prioritizing Solutions
Depending on the patient’s diagnosis, the treatment may be obvious and straightforward, but this isn’t always the case. In the case of a sprained ankle, for instance, the typical treatment would be plenty of rest, ice, compression, and elevation. For other medical issues, however, nursing professionals may need to think more critically to develop and prioritize treatments based on the patient’s unique risk factors, lifestyle, and other details.
Step 4: Implementing the Plan of Action
Once all healthcare professionals involved in a patient’s care are on board with the same treatment plan, it’s time to implement it. This falls not just on nurses, but on doctors and other specialists who may be caring for the patient. Regardless, it’s important here for nurses to be in constant communication with healthcare teams to ensure that all parts of the patient’s care plan are implemented as needed.
Step 5: Evaluating Outcomes and Reflecting
Even after a plan of action is completed, healthcare professionals must continue to use clinical reasoning to assess and evaluate the results of the treatment. In a perfect world, treatment will always meet expectations and deliver the best outcomes to the patient. In reality, however, this isn’t always the case. When this occurs, nurses and healthcare teams should collaborate to assess the results of the treatment and make changes as needed to optimize patient outcomes.
Practical Tips to Improve Clinical Reasoning
Clinical reasoning is a skill that must be developed with time and practice, but there are some practical tips that nurses can keep in mind to improve their own clinical reasoning and critical thinking throughout their careers.
Utilizing Evidence-Based Practice
Because best practices for healthcare are constantly changing and evolving, nurses looking to enhance their clinical reasoning skills should rely primarily on the latest research and evidence-based practice that’s available in the field. In doing so, nurses can make better-informed clinical decisions based on evidence rather than their own beliefs or experiences. This can lead to more informed decision-making.
Leveraging Case Studies and Simulations
In the classroom, case studies and simulations can provide valuable and realistic experiences to nurses looking to build upon their clinical reasoning and critical thinking skills. Case studies, for example, can present nurses with a unique patient case. From there, nurses can practice following the steps of clinical reasoning to reach an appropriate treatment plan based on specific symptoms, medical history, and other details.
In some cases, nurses may even have access to realistic simulations in their classrooms or in workplace training. These simulations can be an excellent way for nurses to practice the clinical reasoning steps in real time, thus developing and strengthening their skills.
Reflecting Practice and Feedback
In addition to gaining real-world practice in clinical reasoning, nurses should also be prepared to engage in regular self-reflection. By identifying what went well versus which areas of the process could use improvement, nurses can proactively improve their reasoning over time. Likewise, many nurses find it helpful to seek feedback and guidance from other nurses, whether it be on-the-job or in the classroom. By understanding that you’re never truly done developing your clinical reasoning skills and being committed to a lifetime of learning, you can be in a constant state of improvement as a nursing professional.
Ready to Advance Your Nursing Education?
Nurses rely on clinical reasoning and problem-solving in nursing on a daily basis, from noting changes in a patient’s condition to planning specialized interventions. The most important thing to keep in mind is that patients’ circumstances can change rapidly, so maintaining a clinical reasoning mindset can help healthcare teams adapt and apply their own expertise as needed.
If you’re interested in building upon your clinical reasoning skills, it might be time to pursue your BSN degree. Specifically, Nevada State University’s RN to BSN online program is designed to help students enhance their analytical, clinical, and management skills in a wide range of healthcare settings. If you already have your ADN and an unencumbered RN license, you could complete this program in as little as 12 months with a convenient and flexible online format! Get in touch to learn more or start your online application now.