Clinical reasoning is an essential skill in clinical practices and medicine at large. The skill is particularly emphasized in both nursing education and clinical practice because of its substantial influence on the ability to provide safe, high-quality care (De Carvalho et al., 2017). Clinical reasoning involves collecting and evaluating data to inform personal judgment about diagnosing and managing patient problems. During this cognitive process, a healthcare practitioner gathers, generates, and tests hypotheses, and determines the optimal diagnosis and treatment contingent on the data and insights obtained when interacting with the patient (Bradshaw & Hultquist, 2016). Several factors perceived to contribute to the patient’s impairment and limited performance are analyzed to obtain an accurate diagnosis and effective plan of care.
Handling a suspected case of pneumonia presents an excellent example of a situation in which a student used clinical reasoning. In this scenario, the patient finds a student in the emergency department in a local hospital and complains of difficulty in breathing, cough, and congestion for a couple of days. The patient explains that she loses her breath even when doing simple tasks and expects yellow stuff when she starts coughing. She further states that she is often forced to sit down to catch her breath, but denies any history of substance use and COPD. Before diagnosing the health problem in this case, the student conducts several tests, including cardiac rate and rhythm, chest rise and fall, respirations, orientation, facial expressions, bowel, and skin. Based on these data, the student formulates and tests several hypotheses to inform possible care actions for improving the physiological and psychosocial outcomes the patient presented (Bradshaw & Hultquist, 2016). For example, difficulty in breathing, persistent cough, yellow sputum, and other vital signs that might indicate ineffective airway clearance linked to profuse respiratory secretions secondary to pneumonia. Based on the physiological and psychosocial outcomes obtained, the student devises a plan of care comprising oxygen, breathing treatment, steroids, chest x-ray, antibiotics, fluids, and sputum collection. This scenario illustrates the application of clinical reasoning in collecting and assessing a patient’s information which helps to identify the most appropriate interventions for improving her condition.
References
Bradshaw, M. J., & Hultquist, B. L. (2016). Innovative teaching strategies in nursing and related health professions (7th ed.). Jones & Bartlett Learning.
De Carvalho, E. C., Oliveira-Kumakura, A. R. D. S., & Morais, S. C. R. V. (2017). Clinical reasoning in nursing: Teaching strategies and assessment tools. Revista Brasileira de Enfermagem, 70(3), 662−668. Web.