Monday, April 11, 2011

Blog #5

How did the readings influence your perception of your own clinical decision-making?
I have been a nurse for over 17 years.  The readings in this module have made me reexamine the way that I make my decisions.  I feel pretty confident in my clinical decision making skills from many years of making them.  However, now I am finding myself paying more attention to why I am making the decisions the way that I am.  I worked as an adult nurse for 12 of the 17 years.  Some of that time I spent on a CCU and the Thoracic ICU.  I found it interesting in the lecture by Daniel Kahneman when he talked about a nurse knowing something was wrong by just looking at a patient.  I found that there were many times in the ICU that you could tell who was going to code on you that night just by looking at them from the hall.  I had never bothered to break it down to why like Mr. Kahneman did but I know it happens.  Now that I have read a little more about this I am trying to find what the reason is that I make the decisions that I make.  It is easy to do things because we are using our nursing “intuition” but there are times that it is wrong or based on tradition.  I think it is a rut that many can get trapped in.  Taking the time to decide why I am making the decisions that I am will help me to make sure I have appropriate information to base it on
I was also impressed with the CPG system that IHC has one of the CDSS out there.  I have to look at it for updates each month, but I haven’t really spent time reading it.  Most of the time I don’t have the time to look things up, but I think that taking time before things happen, and after an incident is over can be helpful in learning from each situation.  It is a great reference to find best practice information.  References are available to read and from the references you can get other articles that cover the same information.  I think too often we are not up to date with the current information out there.  I know when I first came to the unit that I work on that there were differing opinions on how things should be done.  Some of the older nurses had “always done it that way” and “never gotten in trouble for it” so they continued in the same way.  The newer nurses were more up to date, but it was hard to decipher the proper way to do it.  With CPG you can know what is expected, what documentation is required, and be assured that you are following company policy.  Continued education for the staff so they get used to performing searches can make it easier for the staff to find the information they are looking for.  With continued success finding the information they we are more willing to use the CPG system.  I know as I use it more my clinical decisions will become more in line with current evidence based practice which will make me a better clinician.   

1 comment:

  1. Very insightful comments, nice work on self-reflection. Yes, it is important to be aware of how we think and make decisionas plus have the tools that can enhance this process, because as humans we are prone to error.