Clinical judgment is a crucial aspect of nursing practice that involves the integration of various elements, such as evidence-based practice, critical thinking, the nursing process, knowledge, skills, attitudes, and the application of theory to promote safe and quality care for clients in different healthcare settings (Lasater, 2017; Tanner, 2006). In the context of a large urban emergency department (ED) scenario, where the nursing staff consists of an RN with 12 years of trauma ED experience, a new RN with 6 months of ED experience, and an RN from the medical surgical floor with 8 years of experience, the assignment is to determine which patient is appropriate for each nurse and provide the rationale for the decision (Fowler, 2020).
The first patient is a 76-year-old client who was involved in a motor vehicle accident and has hematuria. This patient requires a nurse with extensive trauma ED experience and knowledge. Therefore, the most appropriate nurse to assign would be the RN with 12 years of trauma ED experience. This nurse has accumulated significant clinical skills, expertise, and familiarity with managing trauma-related injuries, which would be essential in providing comprehensive and efficient care for this patient. The RN’s experience will enable them to assess the severity of the injury, identify potential complications, and initiate appropriate interventions promptly (Cartarro et al., 2021).
The second patient is a 38-year-old client with kidney stones complaining of severe pain. While this patient does not have a trauma-related condition, they are experiencing severe pain, which requires prompt and effective management. Given the new RN’s six months of ED experience, they may not have the same level of expertise and proficiency in managing patients with complex pain issues, such as kidney stones. Thus, it would be more appropriate to assign this patient to the RN from the medical surgical floor, who has eight years of experience. This nurse’s experience in dealing with patients with a diverse range of medical conditions will contribute to their ability to efficiently assess and manage the patient’s pain, provide appropriate interventions, and ensure their comfort (Empana et al., 2022).
The third patient is a 24-year-old diabetic client with an acute urinary tract infection (UTI) who requires discharge teaching. Although this patient does not have a trauma-related condition or severe pain, they require specialized knowledge and skills related to diabetes management and UTI care. Therefore, the most suitable nurse to assign would be the new RN with six months of ED experience. Although this nurse is still relatively new to the ED, they have likely received recent education and training regarding diabetes management and UTI care. This knowledge, along with their recent exposure to the ED setting, will enable them to provide up-to-date and evidence-based discharge teaching to the patient (Zolfaghari et al., 2013).
The fourth patient is an 80-year-old client who has not had a bowel movement for four days. This patient may need interventions related to constipation and potential complications associated with it. Given their expertise and familiarity with managing various medical surgical conditions, the most appropriate nurse to assign would be the RN from the medical surgical floor with eight years of experience. This nurse’s experience in caring for patients with gastrointestinal issues and managing potential complications associated with bowel obstructions or impactions will contribute to their ability to provide optimal care for this patient (Module et al., 2020).
In conclusion, clinical judgment is a complex process that involves integrating various aspects of nursing practice to provide safe and quality care to clients. In the given scenario, the assignment of patients to different nurses was based on their respective experience, expertise, and knowledge related to the specific needs of each patient. The assigned nurses were chosen based on their abilities to effectively manage trauma-related injuries, complex pain issues, diabetes management, and gastrointestinal conditions. By matching the patients’ needs with the nurses’ skills, it ensures that each patient receives appropriate and competent care in the urban ED setting.
