Clinical Decision Making In Nursing

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CLINICAL SCENARIO AND IDENTIFICATION OF DECISION CHOSEN As part of my exploration to fulfill the requirement of the clinical decision- making analyses, I have identified a scenario in my working environment, which is Penang Hospital in Psychiatric Department. A female patient has been admitted into the female psychiatric ward, which was diagnosed to suffer bipolar mood disorder. In brief, the patient, who is 38-years old, has been further analyzed to undergo auditory hallucination and it could not be controlled due to allergic of anti-psychotic medication (Haloperidol and Clopixol Acuphase). Describing further on her condition due to bipolar mood disorder, she was irritable and restless most of the time. Therefore, she was unable perceive …show more content…

The use of heuristics in nursing reflects assessments of subjective possibility that are dependent on nurses' memory and past experience (Cioffi J, 1997). Cioffi suggested that heuristics enable nurses to develop short cuts to reduce the complexity of real practice. The main principles of heuristics consist of representativeness, availability, and anchoring and adjustment (Elstein & Schwars 2002). Representativeness can be viewed as estimating the possibility of diseases by judging how similar a case is to a diagnostic prototype (Elstein & Schwars 2002). Representativeness is the most typical type among three types of heuristics and it is more likely to take place in high-complexity cases than low ones (Cioffi & Markham 1997). Another type of heuristics is availability that refers to the estimation of probability of clinical events by the ease with which previously experienced relevant instances come to mind(Tversky & Kahneman 1973). Nurses always estimate the likelihood of the outcome based on similar events that they can recall (Buckingham & Adam 2000). However, nurses in real practice may place overemphasis on rare and salient conditions because unusual cases can be memorized more profoundly and easily than regular ones (Elstein & Schwars 2002). The third form of heuristics is anchoring, which involves the decision-making strategy that seeking for an anchor as a standard when nurses make decisions. In some cases, anchoring is valuable and even desirable in profession practice (Cioffi J, 1997). (Thompson 2003) implied that experts are commonly experts because they are proficient in employing these anchors that are led by accumulation of experience. However, he also argues that not all anchoring is desirable because anchoring sometimes may distort reasoning and it is a challenge to accumulate enough experience to establish anchors in every

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