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    Decision Making and Problem Solving in Nursing

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    Critical Thinking

    Decision making is a purposeful and objective coordinated effort that uses a precise procedure to pick among alternatives. Not all decision making starts with a problem circumstance. Identification, selections of alternatives or choices forms the hallmark of decision making (Buerhaus, P., Staiger, D., & Auerbach, D. (2009).  Problem solving on other hand, includes the decision-making steps. It aims to find a solution to an immediate problem (Holmes, V. (2017). The immediate problem can be perceived as a gap between ‘What is’ and ‘What should be’.

    Critical thinking also comes into play. According Scriven and Paul, 2007, it is the intellectually disciplined procedure of effectively and skillfully conceptualizing, applying, analyzing, orchestrating, as well as assessing information gathered from, perception, encounter, reflection, thinking, or correspondence, as a guide for conviction and action. Active critical thinkers are often aware of individuals who strive in improving their reasoning through asking ‘how’, ‘why’, or ‘what’. Therefore, in this instance, the nurse could have implied this leadership strategy to solve the situation. She could have thought critically to solve the situation at its initial stage. A nurse who engages the patients using questions in a positive manner without creating disagreement is thinking critically.

    The nurse could have informed the wife of the patient earlier that it is not in their scope to refrigerate drugs for family members in the hospital. However, the nurse manager using decision making skills and problem-solving skills strategies, and critical thought managed to explain to the patient’s wife that it was not in the nurse’s scope of practice to refrigerate anything for family members. It is vital for nurse leaders and managers to evaluate staff individuals’ capacity to think critically and improve their insight and aptitudes through staff-advancement projects, training, and role modeling. Unfortunately, this situation demonstrated that the nurse needs improvement in this area.


    Creativity is fundamental for the generation of alternatives or solutions. Creative people can conceptualize new and imaginative ways to deal with a problem or issue by being more adaptable and free in their thinking (Holmes, V. (2017). Creative thinking in nursing is imperative for safe practice, and nurses must be willing to ask the difficult questions, as well as make inquiries during their practice. It must be approached with intellectual humility which expects eagerness to admit to ones’ weaker areas while staying open-minded and tolerant of others’ opinions (Holmes, V. (2017). Creativity as leadership strategy was portrayed by the charge nurse and nurse manager. They both portrayed a high level of creativity in convincing the patient’s wife that the nurse misinterpreted the request made by the patient’s wife and the situation was ameliorated.

    Critique of Plan of Action and Potential Outcomes

    In this situation, the nurse failed to utilize her leadership role for effective care. The nurse should not have agreed to patients’ wife’s demand of keeping her drugs under refrigeration since she was not the patient. The nurse knowing the drug, assumed the responsibility without engaging the patient’s wife. This is not right, as it later generates into problems within the hospital.  Nurses should be guided by general rules of nursing practice to avoid such problems. However, it is not within the scope for the nurse to refrigerate drugs of the patient’s family. The family and friends should be made aware in a polite way that they are responsible for their belongings. The nurse failed to articulate this properly. Effective nursing practice would enable nurses to think critically, have a good decision making and solve problems strategies for effective care.

    Moreover, the nurse manager had the ability to calm down the angry patient’s wife. This shows that she possesses good qualities of leadership and management. The nurse manager, having an excellent decision making and problem-solving skills managed to educate the patient’s wife that it was in their jurisdiction to take care of her drugs since she was not the patient. This comes after critical thinking to arrive at such amicable solution. This is an effective approach to problem-solving displayed by the nurse manager.

    Future Implication for Nursing

    All nurses must be pioneers in the plan, implementation, and assessment and advocacy for the continuous changes to the framework that will be required. Furthermore, being a nurse requires leadership abilities and capabilities that extend beyond the health care system. Nursing practice and the research taking place, must reach beyond the hospital walls. The nurse in this situation seemed to have forgotten the basic rules of her nursing practice act and her scope of practice. In the future nurses must recognize and create evidence-based enhancements to care and have stronger problem-solving skills. Nursing leaders must also make an interpretation of new research discoveries from nursing education and implement into training and policy. Lastly, in order to demonstrate quality management and be a patient advocate, the nurse must be associated with basic leadership about how to enhance the delivery of care. Nurses ought to have a voice in health policy basic leadership. Perhaps, in the future nurses will be able to refrigerate items of non-patients. It is up to nurses to explore these avenues and dynamics of change.

    Future and Technological implications of decision making in nursing

    The use of technology is a leadership skill that is critical for nurses in the 21st century. The use of transient computers at the bedside are capable of facilitating quick and informed decisions and actions to patient health risks and emergencies. Computers also pose ethical dilemmas for the future due to the breach of confidentiality of patient information. Nurses ought to have a generous level of mastery of knowledge information, acquisition and distribution. Technology is a powerful tool in assisting nurses to become more effective and efficient in their decision making. The complexities of care environments such as the care of high acuity patients and complex diseases, require nurses to be competent. The nurse needs to be competent enough for the delivery of high-quality care by the use of these technologies.

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