Development of the clinical reasoning of nurses of an emergency hospital service

Abstract

Objective: to understand the development of the clinical reasoning of nurses working in an emergency hospital service. Methods: qualitative research, with methodological reference of the Grounded Theory. Data collection took place through interviews, with a theoretical sample of 21 participants and analysis using substantive and theoretical coding. Results: the central category was identified as Knowing what to do, and four conceptual categories: 1) Uncovering the nurse's duties in the emergency service; 2) Improving clinical reasoning through professional experience; 3) Providing care with quality and safety for the patient; and 4) Conquering professional recognition from the health team. Conclusion: the development of nurses' clinical reasoning is a cumulative, experiential, and gradual process of knowing what to do in an emergency. It is based on the collaborative work with the health team and on the acquisition of technical-scientific knowledge to perform qualified assistance to patients.

Exploration and prioritization of strategies to improve clinical reasoning skills among coronary care nurses: A qualitative study

“…Promotion of professional competence was one of the subcategories of this category. In agreement with this finding, two former studies reported that professional competence and commitment to professional responsibilities are associated with CR skill improvement 28,31 . Certainly, professional development in nursing necessitates nurses' attention to the development of their abilities to use their knowledge, experiences, and skills and their commitment to the aims of the profession.…”

“…CR skill improvement among nurses should be based on the improvement of personal attitudes, abilities, and skills as well as interactions with peers and healthcare providers. In the process of CR skill improvement, interprofessional collaborations, discussions, and information exchange can positively affect evidence use and decision making to select the most appropriate interventions 31,39 . Improvement of professional interactions also provides nurses with a good opportunity to show their competencies to other healthcare providers and thereby, can improve healthcare providers' trust in nurses, attract stronger support for nurses, and move them toward using the nursing process based on their metacognitive skills.…”

“…Evidently, efficient education would improve the ability to use CR skills in actual practice, form a firm basis for supporting the development of these skills, and hence, should be considered as an important component in the development of CR skills in nursing education 12,15 . In addition to the fact that CR skills development is an ongoing process based on an appropriate educational planning, effective management in nursing can also form a solid foundation to support the development of these skills by planning and implementing a coherent program to promote thinking skills 31 . Another main aspect of CR skills improvement is development of professional nursing that not only enhances nurses' self‐confidence but also could enhance ability to perform logical CR and can results in accurate analyses, inferences, and decisions 26…”

“…CR skill improvement is widely affected by nurses' thinking skills, [12][13][14][15] educational strategies, 16 and actual practice in clinical settings. [17][18][19] However, most previous studies focused on CR skill improvement through educational strategies and CR models, 18,[20][21][22][23][24][25][26][27][28][29][30][31][32] or addressed only some aspects of CR skill improvement. 16,17,20,24 Moreover, some studies reported problems in CR skill improvement among nurses 3,15,25 and highlighted the need for further studies to determine strategies for CR skill improvement.…”

Biovigilância no processo de doação de órgãos e tecidos durante a pandemia: desafios para o enfermeiro

“…Para que o enfermeiro possa desenvolver essa estratégia em saúde e garantir um cuidado seguro e eficaz, é crucial que esteja sustentado em conhecimentos, habilidades e atitudes para a avaliação clínica do PD, bem como no conhecimento do processo de trabalho em que está atuando. O raciocínio clínico oportuniza a tomada de decisão rápida e segura, contribuindo para a autonomia, a liderança e a gestão do profissional enfermeiro 18,19 . Essa foi uma das estratégias ímpares adquiridas pelo enfermeiro para enfrentar essa nova realidade diante da pandemia.…”