Assignment Instructions

How is clinical decision making influenced?

Competency

Evaluate factors integral to clinical reasoning.

Scenario

You are working as a charge nurse on a medical-surgical unit in an acute healthcare facility. One of the staff nurses who recently from bereavement leave has been assigned to care for an elderly client, newly diagnosed with stage IV pancreatic cancer. While you are visiting with the client, the nurse is completing her assessment. The client requests assistance to set up hospice care, complete an advanced directive, and reach out to his estranged daughter. The nurse stated, “I can get you the paperwork for the advance directive, but I can’t call your child for you, I am not a social worker.” The nurse leaves the room and asks to speak with you stating, “I can’t care for this client, I need my client assignment changed now or else I will go home.”

As the charge nurse, you step in and change the nurse’s client assignment and offer to assist the client with his requests. Later, you have the opportunity to debrief with the nurse regarding her reaction and decisions regarding the client’s requests and make some recommendations on how the nurse could have responded differently. You write up a summary of the events and include the follow-up conversation with the nurse.

Instructions

Compose a written memo of the situation and debrief for the employee’s personnel file. Include the following in the summary:

  • Analysis of the internal and external cues impacting the responses of the staff nurse and the charge nurse.
  • Describe how these factors influenced the clinical decision making of both nurses.
  • Emotional intelligence action plan for the nurse based on interactions observed with the client and the charge nurse.
    • Include self-compassion and compassion toward others.
    • Include an alternative response from the staff nurse and charge nurse.

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