Clinical decision making in nursing

In this paper, the author reflects on the new practitioner envisaged by developers of the Project 2000 curriculum in Scotland, and focuses on the need to develop critical thinking ability, in particular in relation to clinical decision making. Two approaches to decision making are outlined: the rationalist perspective and the phenomenological perspective, and a model illustrating each is discussed. The models examined are, respectively, decision analysis and hypothetico-deductive reasoning, and their relevance to nursing outlined. The author concludes by discussing the nursing process model from both perspectives; and by recommending that nurses learn from the work done by other disciplines on professional judgement. The suggested role of the nurse teacher in preparing the new practitioner is outlined.