Clinical decsion Essay Example

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The Clinical Decision

Nursing as one arm of medicine plays a very important role in a patient’s life. The nurse is trained to care and nurse the patient back to health. The decisions the nurses make are therefore important for this objective to be achieved. In this essay report, clinical reasoning will be looked at through a live example of a case study of a young man who died while in the care of nurses.

The hospital clinic contains a few doctors who are on call and not residents of the clinic. The clinic is basically run by the head nurse, nurses and nursing assistants. Situated in a small town outside the capital city it is a major contributor to the healthcare delivery in the small town. It is a general practice as well as an accident and emergency centre.

The young man of interest had been brought in as an accident victim; he had deep cuts and hence was bleeding profusely, his legs were broken which was visible due to the protruding bones in the legs. The patient was immediately put on oxygen and after stabilizing him, x-rays on the legs and blood work were ordered by the head nurse to determine the extent of the damage.

Due to the information on the accident that shows that the victim was ejected from the car and landed on his back, the nurse orders for back x-rays to determine if there was spinal injury. This goes hand in hand with the clinical reasoning cycle of collecting information based on patient’s history (Levett-Jones 2010).

The x-ray showed no damage to the spine, but indicated broken bones in the left leg. The patient was taken in for surgery, where glasses lodged in the body were removed and a metal rod put into the broken leg. The patient was put in recovery ward and seemed to be responding well to medication. As a result of past experience, I had a concern that i shared with another nurse but as we are talking, we heard the emergency beep from his room and rush there only to find him convulsing and having difficulty breathing and as we tried to stabilize him, he went numb and died.

A postmortem was ordered and the results confirmed my concern, the patient had broken ribs which had pierced the liver and this had caused a clot to form that had resulted in a cardiac arrest.

For a long time I reflected on what had happened, the clinical decision and the outcome. I recalled the exact situation where an accident victim had been brought in with similar representation as the current patient. The other patient had been found to have punctured organs as a result of broken ribs. I felt that we should have carried out thorough investigation, collected all necessary information before taking action. After contemplating on what should have been done I decided to air my concerns next time to avoid losing patients in a similar way due to negligence of critical clinical reasoning (Daly 1998).


Daly WM (1998). Critical thinking as an outcome of nursing education. What is it and why is it important to nursing practice? Journal of Advanced Nursing, 28 (2), 323- 331.

Levett-Jones, T., (2010). The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients. Nurse Education Today30(6), 515-520.