Clinical Reasoning Appropriate for Situation
Nurses each day are encountered with the challenges of establishing the cause of illness for their patients. To determine an accurate causative agent or the actual disease, they have to engage themselves a lot in clinical reasoning. Clinical reasoning is crucial because it helps a nurse in discovering identifying illness or disease faster so that interventions can be done as early as possible. For clinical reasoning to be practical, a nurse must employ the techniques of inquiry used in nursing. These techniques aid examination in discovering the condition of the patient, and this is important as it helps in the delivery of services. The nurses’ methods of investigation include empirical, ethical, aesthetic, and sociopolitical inquiry methods (Leeman & Sandelowski, 2012). These inquiry methods are useful in the process of delivering the anticipated results.
The empirical method of inquiry characteristics is based on evidence and facts which are observable. In my first shift as a nurse, I have encountered scenario of a patient Ruth who is critically ill. Ruth was brought to the hospital by her neighbor; the neighbor said that Ruth was experiencing nausea and vomiting for a week. The neighbor of Ruth said she thought the problems Ruth experienced were due to the stress level. The neighbor also states that tonight Ruth vomited fresh blood, and she appears to be dizzy. When I get into the Emergency Room, I ask Ruth whether she is aware of why she is in the emergency room, but she counters by asking where her husband is because he is usually home early. The husband to Ruth, on the other side, is admitted to the Alzheimer’s Unit in a long-term facility. As a nurse based on the signs that I see from Ruth, I can infer that she has altered mental status. Ruth appears to be confused and to be experiencing some form of loss of memory. She also has an open wound on her foot and history of diabetes, blood sugars would need to be checked. Ruth also has elevated temp at 101.8 and increased BP with low oxygen saturation. Due to such evidence, my empirical hypothesis can best be concluded that it ruth is suffering from an infection and possible sepsis.
The ethical method suggests that nurses have to make decisions that reflect their qualities as nurses. Some of the qualities that nurses should have include; delivering high-quality services, doing things sympathetically, and showing care and concern. As a nurse in the ER unit, I have to give Ruth the best services that I can afford. Based on the signs that Ruth demonstrates, I have to ask myself hard questions. Does my judgment improve Ruth’s conditions? Is Ruth suffering from infection? How best can I help Ruth? The decision that I made to enquire about Ruth’s presence at ER demonstrates care and concern. The response I got reveals that Ruth has altered mental status. The best hypothesis is that it is a fact that my qualities helped in ascertaining the fact that Ruth has active infection.
The aesthetic method allows a nurse to make the processing of knowledge about a particular infection an Art. A nurse should make the process of discovering diseases an art. The art of each nurse is relating one specific sign with a specific disease. This Technique always entails observation. When I enquired about Ruth’s presence at the ER, her answer made me conclude that she is critically ill and intervention needs to be made as soon as possible. Through this aesthetic technique, it is possible to come up with a hypothesis that suggests that Ruth has her infection exorbitated by her current medical problems, that of diabetes and possible lung disease, or just decreased lung oxygenation capacity due to her smoking history.
The sociopolitical method suggests that when a nurse is enquiring about a particular disease, he/she should consider when the condition has root to the family or the political jurisdiction. When looking at financial status of the patient, we can determine that she only has Medicaid for insurance, and most likely she is limited in getting proper access to health care resources as well as seeing her primary care doctor.
Clinical Reasoning for Empirical Method
The empirical method gave the best evidence of coming up with a hypothesis. The hypothesis concluded that Ruth has an infection. According to the medical journals, the signs of this infection are confusion with changes in mental status, and elevated temperatures (Simmons, 2010). Ruth’s behavior of asking where her husband was when I asked her about the reason that led to her being at the ER, is a visible sign of a person who is confused and not oriented to her situation presently.
An evaluation plan for ionfection has several steps (Oermann & Gaberson, 2016). Firstly, the creation of a conceptual model, the essence of this plan is to establish whether the infection that Ruth is suffering from is sepsis or pneumonia. Secondly, Evaluation Questions, the evaluation questions for infection include; Does Ruth have access for microbes to enter her body? Does she have elevated temperature? Is Ruth’s infection related to her diabetes? Is Ruth’s diabetes managed well? Thirdly, the Creation of evaluation design, the reason behind this evaluation plan is to establish Ruth’s state. The method that I will use to ask her questions involves interviewing. Fourthly, collection of data, I will collect my information by using techniques such as observation and interviewing. Finally, Data Analysis and Interpretation, I will go through the information that I have and try to find out whether Ruth developed sepsis and if she did what stage is it at (Mayo Clinic, 2018). Is it Sepsis, severe sepsis or, in the worst-case, septic shock?
Leeman, J., & Sandelowski, M. (2012). Practice‐based evidence and qualitative inquiry. Journal of Nursing Scholarship, 44(2), 171-179.
Sepsis. (2018, November 16). Retrieved September 06, 2020, from https://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/syc- 20351214?utm_source=Google
Oermann, M. H., & Gaberson, K. B. (2016). Evaluation and testing in nursing education. Springer Publishing Company.
Simmons, B. (2010). Clinical reasoning: a concept analysis. Journal of advanced nursing, 66(5), 1151-1158.