Monday, April 11, 2011

Module 5

How did the readings influence your perception of your own clinical decision-making?

 After watching  the lecture by Daniel Kahneman and reading the article by  Amos Tversky and Daniel Kahneman  from 1974 entitled” Judgement under uncertainty: heuristics and biases, discusses descriptive decision making. It made me realize how many times I make a decision based on my initial judgment.  I have never thought much about why or how I make these decisions.  Every time I work I make countless decisions about my patients.  After some introspection, I have concluded that a majority of the decisions I make are based on my own intuition in combination with my experiences.
I have always thought that nursing requires a great deal of intuition, and I was not surprised when this belief was validated in the lecture by Daniel Kahneman.  I find that the use of intuition is especially important in the neonatal population. They are not able to tell us as what is wrong and what doesn’t feel good.  We must rely upon our assessment skills and intuition. 
I remember when I was a new nurse in the NICU and the older more seasoned nurses would look at the baby, before any labs had been drawn, and know that the baby was septic.  I remember looking at that same baby and wondering how they knew, what were they seeing that I wasn’t seeing?  Over time I have been able to gain the skill/intuition to do this.  I now believe that the ability to make these assessments is based on the combination of experience and intuition. A good nurse must be able to recognize the very subtle changes that occur in the beginning stages of sepsis. This comes from repeated exposure to the situation.  They must also rely on their intuition and act when they think something is just not quite right.
It makes me very nervous to imagine myself as a neonatal nurse practitioner.  I know that I will again be relying on the more seasoned practitioners to help me develop the skills needed to develop expertise in this new role. 

1 comment:

  1. Very insightful comments, nice work on self-reflection. Yes, it is critical that we are aware of how we think and make decisions.