How to Practice Clinical Judgment in Nursing

Clinical judgment in nursing is a vital part of providing quality health care. It impacts resource allocation, patient prioritization, and health outcomes. Nurses who understand how and when to apply clinical judgment and learn tips for enhancing their clinical judgment will be well positioned to analyze a patient’s condition, determine the best course of action, and implement care.

To learn more, check out the infographic created by The University of Tulsa’s RN to Bachelor of Science in Nursing (RN to BSN) program.

What Is Clinical Judgment?

The term “clinical judgment” refers to the informed opinions and decisions that nurses and doctors make through patient interactions.

Clinical Judgment Basics

Clinical judgment is built on critical thinking and problem-solving skills, strengthened through collaboration with peers, and informed by research and professional communication. It’s vital to quality care, even if it’s not the final answer.

Types of Clinical Judgment

The following are the types of clinical judgment. 

• Reflective

• For thoughtful, deliberate decisions

• Draws on critical thinking and past experience

• Emergency Intuitive

• For urgent, high-pressure situations

• Draws on instinct, speed, and problem-solving

• Patient & Peer-Aided

• For collaborative care planning

• Draws on teamwork and communication with patients and staff

• System-Aided

• For unclear or complex cases

• Draws on research and consultation with specialists

• Critical

• For chronic or long-term care

• Draws on deep analysis of evidence and professional literature

6 Steps of Clinical Judgment

The newest version of the nurse licensing exam, the Next Generation National Council Licensure Examination (NGN), prioritizes clinical judgment in nursing by using the NCSBN Clinical Judgment Measurement Model (NCJMM). 

Measurable Steps

The NCJMM focuses on six measurable steps.

1. Recognize Cues

   a. Identify key patient information
   b. Review charts for concerning changes
   
   

2. Analyze Cues

   a. Evaluate information to understand the condition
   b. Gather details for context and meaning
   
   

3. Prioritize Hypotheses

   a. List possible causes of the problem
   b. Rank them by severity and urgency
   
   

4. Generate Solutions

   a. Identify possible solutions
   b. Compare options
   
   

5. Take Action

   a. Implement the chosen intervention
   b. Follow an evidence-based care plan
   
   

6. Evaluate Outcomes

   a. Monitor the patient’s progress
   b. Modify the treatment plan as needed
   
   

Nursing Process

How are the different types of clinical judgment reflected in the NCSBN model of the nursing process?

• Assessment

• Collect data and use critical thinking

• Aligns with “Recognize Cues”

• Analysis / Diagnosis

• Analyze patient information using clinical knowledge

• Aligns with “Analyze Cues” & “Prioritize Hypotheses”

• Planning

• Set goals and create treatment plans

• Aligns with “Generate Solutions”

• Implementation

• Carry out the treatment plan or intervention

• Aligns with “Take Action”

• Evaluation

• Review outcomes and adjust care as needed

• Aligns with “Evaluate Outcomes”

Tips for Improving Clinical Judgment in Nursing

Nurses can improve their clinical judgment through continuing education, self-reflection, and collaboration.

Pursue Continuing Education

Nurses should consider the following:

• Taking courses, reading journals, and attending workshops

• Learning new techniques, technologies, and procedures

• Building confidence and improving decision-making

Engage in Self-Reflection

This might include the following:

• Assessing past actions and decisions

• Learning from the outcomes of previous situations

• Sharpening instincts and handling future cases more effectively

Embrace Collaboration and Teamwork

This involves the following:

• Giving and receiving feedback, discussing patient care, and participating in simulations

• Practicing skills and learning from peers

• Enhancing critical thinking and quick decision-making

Practice Clinical Judgement 

Clinical judgment in nursing is not a single skill, but a set of abilities and experiences that any nurse can develop and apply. By understanding different types of judgment and aligning decisions with the nursing process, nurses continually strengthen their judgment and provide high-quality, patient-centered care.

Sources

American Nurses Association, Critical Thinking in Nursing: Tips to Develop the Skill

EBSCO, Clinical Judgement (Medical Profession)

NCLEX, Clinical Judgment Measurement Model

StatPearls, “Nursing Process”

UWorld, Clinical Judgment in Nursing: Definition and Importance