Picture this: You’re a new graduate nurse, fresh out of orientation on a critical care unit. You’re getting a report on your patient, who has been admitted for an acute exacerbation of heart failure. The nurse mentions that the patient has been receiving a large dose of diuretic medications and has been having some irregular heartbeats on the telemetry monitor. Reflecting on your nursing knowledge, you remember that abnormal potassium levels can affect the heart’s rhythm, so you pull up the patient’s chart to check the latest entry for their potassium levels. Sure enough, the patient’s potassium levels are very low, likely from the high dose of diuretics being administered. You quickly contact the provider to make them aware of the situation and recommend potassium replacement to bring the patient’s levels back to normal. Had you not made this connection, the patient could have experienced cardiac arrest or other life-threatening symptoms related to low potassium levels. You used your nursing knowledge to make a clinical judgment that probably saved your patient’s life.
It is imperative that new nurses are able to think critically and employ clinical judgment in practice. The rest of this chapter provides an unfolding case study that highlights how nurses can systematically work through the clinical judgment measurement model and use clinical judgment to make practice decisions.