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Homework Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings. Keeping that in mind, answer the following scenario: You are the Charge Nurse in a large Urban Emergency Department (ED). Your nursing staff includes: RN with 12 years of Trauma ED experience New RN with 6 months ED experience RN from the Medical Surgical floor with 8 years of experience The following patients are in the ED, which patient will you give to each of the nurses and why? (Include at least 1 reference and citation) A 76-year-old client who was involved in a motor vehicle accident and has hematuria. A 38-year-old client with kidney stones complaining of severe pain. A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching. An 80-year-old client that has not had a bowel movement for 4 days. Provide 1 reference and 1 citation Students response According to our Medical-Surgical Nursing book clinical judgment is defined as a “nursing judgment, is an iterative process that uses nursing knowledge to observe and access presenting situations, identify a prioritized client concern, and generate the best possible evidence-based solutions in order to deliver safe client care” (Ignatavicius et al, 2021, p.10). With that being said as a charge nurse you’re always critically thinking and making some sort of judgment on how to further help your patients and your staff; while maintaining their safety as well. Recognizing my staff’s strengths and where they may need to improve is essential; as well as knowing their experience because this will then further help me assign them to the proper patient. I would give the 76-year-old client who was involved in a motor vehicle accident with hematuria to the registered nurse that has twelve years of Trauma ED experience. The reason why is because he is more critical than the rest of the patients and that type of nurse’s experience will help resolve his situation much faster. For example, the nurse already knows that MVA’s are associated with traumatic brain injuries (TBIs). Therefore, this is one of many reasons that it is imperative decisions are made quickly and efficiently so no further neurological damage occurs. I would give my 38-year-old client with kidney stones that is complaining of severe pain to my registered nurse that has eight years of experience on the Medical-Surgical floor. The reason why is because this nurse will be more familiar with the nursing interventions and how to further help and assess this patient. According to our Medical-Surgical book, it states that “urinary tract obstruction is an emergency and must be treated immediately to preserve kidney function”(Ignatavicius et al, 2021, p.1346). To elaborate, this nurse will be quicker to identify this patient’s labs to preserve their kidney function and then follow with the proper nursing interventions, such as recommending an unenhanced helical CT scan of the abdomen and pelvis (Ignatavicius et al, 2021,p.1346). To be able to confirm that it is in fact urolithiasis if need to. I would give my 24-year-old diabetic client with an acute urinary tract infection that is needing discharge teaching to my new registered nurse with six months of ED experience because even though she’s a new grad she is more than competent and capable of taking care of this patient. Throughout the emergency department, there are admissions and discharges happening all day. Therefore, she is knowledgeable on discharge teaching that includes a common diagnosis. I would give my 80-year-old client that has not had a bowel movement for 4 days to my registered nurse that has eight years of experience on the Medical-Surgical floor. The reason why is because this can be easily missed if one is not thoroughly checking a patient’s chart. It’s important that nursing interventions are implemented as soon as possible. If the patient is alert and orientated one can start by asking when their last bowel movement was, checking what kind of medications they are on, checking if they received any medications to help them have a bowel movement, etc. This will help prevent the patient from having any further complications, such as a bowel obstruction. Reference: Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2021). Medical-surgical nursing: Concepts for interprofessional collaborative care (10th ed.). Elsevier. Answer to the post Please make an initial post with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. At least 1 reference and citation is required for each response post.
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