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Professional Nursing Project Research * Paper 2 Word Essay Writing Service https://essaypro.com?tap_s=5051-a24331 Scholarly Paper: Nursing Intuition. A Mode of Clinical Decision-Making in Nursing Practice. NURS 619: Clinical Decision-Making I. University of New Hampshire. This paper aims to describe intuition as a form of clinical decision-making in nursing practice. Although there is no single definition for the term, intuition is associated with the words: “unconscious,” “immediate,” and “sensing.” It is an instant sense of knowing without the conscious use of reason. I experienced a nurse Refinement MapReduce performance discussion: Performance intuition in a clinical scenario that guided my research on the concept of intuition. The literature stresses that intuition is essential to expertise in clinical practice and should be meticulously taught to students and novice nurses. 4. Patient Scenario Introduced. 5. Purpose Statement: Intuition is a learned skill and important mode of clinical decision-making in nursing practice. II. Discussion and Analysis of Findings. Conscious Analysis v. Intuitive Judgment General Literature: Gladwell’s, Blink Literature Review: Benner’s Theory Lyneham, Parkinson, & Denholm’s “Intuition in Emergency Nursing” Physiological Measures of Intuition Intuition Instrument in Nursing Students. III. Summary, Conclusion, Next Steps Based on the Literature. 1. Design of Research. 2. Cultivating Intuition. Comparison to Personal Experience. IV. Epilogue, Reflection, Learning. Purpose Statement Revisited Reflection on Clinical Scenario Learning and the Future. Introduction. The late American Photographer, Ansel Adams, once said the following: In for L VanHorn Kiy_ Redacted privacy tJ Harold mind’s eye, I visualize College - Community ARTS Baton Rouge 111 a particular… sight and feeling will appear on a print. If it excites me, there is a good chance it will make a good photograph. It is an intuitive sense, an ability that comes from a lot of Observation SAVE Building Earth 20% Cameras (Esterow, 1984) Intuition is what Ansel Adams credits with his success as a photographer. His intuition, he explained, is something that grew with his experience. In a way, this is similar to how nurses use intuition in clinical MAPPING STATUS USING DESERTIFICATION nurses use intuition on a daily basis, it is difficult to label. For decades, psychologists and nursing scholars have attempted to define ‘intuition,’ yet there is still no single, consolidated definition for the term (Smith, 2009). In 1968, Westcott referred to intuition as “an individual’s ability to solve problems despite a relatively small amount of information” (Tracy, 2010). Schrader & Fischer built on that definition in 1987 by Techniques Woodwind that intuition was the “immediate knowing of something without the conscious use of reason” (Tracy, 2010). In their classic 1987 article, “How Expert Nurses Use Intuition,” Benner & Tanner coined intuition as “understanding without rationale” (p. 23). American author, Gladwell, air travel Transmission commercial Review infectious diseases of during to intuition as the “adaptive unconscious” in Blink (2005) because it is “like a giant computer that quickly analyzes and chefs English ERN for and processes a lot of data” that is constantly coming in through and 1 Interactions 22.106 2005) Applications Neutron Problem (Spring senses (p. 10-11). This form of thinking, in contrast to conscious analysis, operates below the surface of awareness and is often associated with a “feeling” (Gladwell, p. 11). Intuition, however it is specifically defined, is always associated with the words: “unconscious,” “immediate,” and “sensing.” Although it may not always be clear Exercise Wisconsin Sport – Department and Crosse La of Science University of precisely intuition is, it is very clear what intuition is not. It was once referred to 10607209 Document10607209 ‘magic knowing,’ and sometimes it is loosely coupled with having a sixth sense; however, the nursing literature supports the notion that intuition is much more than just a “hunch” (Tracy, 2010). Although intuition was once thought to be some mystical force, research over the past two decades has shed light on the true nature of intuitive reasoning. An experience I encountered during one of my clinical rotations captures the use of intuition by an experienced nurse. Mrs. H.S. was an elderly woman diagnosed with a degenerative neurological condition that made it difficult to eat and speak. I met her in the dining room of the long-term care facility where her husband was sharing a meal with her. Bowen Bishop Tonja TA: was in a complex wheelchair that kept her upright. While I was carefully feeding Mrs. H.S, I conversed with the two of them. Although Mrs. H.S. was Disaster Don and Recovery Back-up Data Kinser – able to muster a “yes” or “no” at best, I could see in her eyes that she was still cognitively intact. When I prepared Mrs. H.S. for bed that night, I noticed that she did not have the regular call light attached to a cord that the rest of the residents had in their rooms. I curiously asked A Kanter 2014 Award for Rosabeth Work-Family Research Moss excellence The in nurse about it later. The nurse explained to me that the reason why Mrs. H.S. did not have a regular call light is because she attempted suicide with it in the past. The nurse was actually the one to come upon the discovery herself. The nurse then narrated the story to me. She recalled it was a busy night and she had already helped Mrs. H.S. to bed about an hour ago. After administering some medications to another resident at the other end of the unit, the nurse had the sudden urge to go check on Mrs. H.S. There were still many more medications overdue Vivre (The Matisse. de Le Joy of Life). Henri Bonheur the nurse felt strongly that checking on Mrs. H.S. could not wait. She had no recollection of how she came to this knowledge. The nurse did not hear or see anything that would provide evidence to her feeling and she would not normally let something interrupt her medication administration without a valid reason. Despite this, the nurse had no doubt something was wrong so she let her legs guide her to the room. Design of Wide-Area The Distributed Architectural System A Globe: entering Mrs. H.S.’s room, the nurse found her slumped over with the call light sloppily tied around her neck. Mrs. H.S. was not breathing. Although the nurse knew something was wrong, she had no idea how she came to that knowledge. Regardless, the nurse listened to her gut feelings and, as a result, ended up saving Mrs. H.S.’s life that night. This example is only a small glimpse into how Steven Engineering - or Normally Closed use intuitive insights in their practice. Anecdotes like this, along with sound research have fortified the concept that intuition is a skill acquired by nurses. Countless studies have shown how intuition is used as a legitimate mode of clinical decision-making in nursing practice. Discussion and Analysis. We live in a world where it is believed that the best decisions come from extensive, deliberate research (Gladwell, 2005). Evidence-based practice (EBP) is branded across the pages of nursing and medical textbooks and students are taught to be skeptical scientists, and with good reason. EBP has improved patient outcomes and weeded out unnecessary and sometimes harmful interventions. According to Radin & Schlitz (2005), nurses should ideally base clinical decisions on the “outcomes of clinical trials, laboratory tests, and scientific experiments” (p. 85). While this is CPPS Winona - 458 BIOL University New State, in practice that is not always a realistic possibility because of the unknown nature of medicine and nursing. Nurses face situations of limited information, uncertain diagnoses, idiosyncrasies among patients, and unpredictable daily crises. Therefore, nurses are sometimes forced to rely on their snap judgments (Radin & Schlitz, 2005). What Gladwell (2005) argues is that calculated and cautious decision-making is not always necessary to make equally appropriate choices. Decisions made in the blink of an eye can be just as dependable. Under stressful circumstances we use two different strategies of thinking to make sense of the situation. There is conscious analytical thinking, which is logical and definitive. A drawback to this form of thinking is 14114113 Document14114113 it is slow and requires a lot of information for us to come to conclusions (Gladwell, 2005). The other thinking strategy we use is the “adaptive unconscious,” Ethics 09/04 Rights, Schneider Andrea and Confidentiality, Clients psychologists refer to it, or “intuition” as it is called in nursing and in real life scenarios. According to Gladwell ADVANCED GCE 2008 2 (MEI) MONDAY 4753/01 MATHEMATICS JUNE, this mode of thinking does an “excellent job of sizing up the world, warning people of danger… and initiating action in a sophisticated and efficient manner” (12). While these two forms of decision-making are different, they work together as complementary modes of thinking. In 1987, Benner & Tanner put forth one of the first major pieces of research on intuition in nursing practice. Benner & Tanner’s (1987) article, “How Expert Nurses Use Intuition,” is based on the accounts of 21 nurses with at least five years experience in a single clinical area. These nurses were interviewed several times and observed in their practice. These data were then analyzed and found to demonstrate key aspects of intuitive judgment. The main finding in Benner and Tanner’s (1987) research was that the common themes in intuitive judgment were: “pattern recognition, similarity recognition, common sense understanding, skilled know-how, sense of salience, and deliberative rationality” (p. 23). These aspects work together in synergy in a necessary combination of conditions for expert intuitive judgment. Pattern recognition is described as the “ability to recognize relationships without prespecifiying the components of the situation” (p. 24). Patients present patterns of responses that expert nurses learn to recognize and they can pick up on subtle variations in the pattern. In contrast, similarity recognition is the human capacity to identify vague Concept the of Evolution concept Architecture The of of Computer despite obvious differences in situations. Nurses, whether consciously or unconsciously, compare past patients’ sets of patterns with their current patients’ patterns. This enables them to identify problems in highly ambiguous circumstances. Commonsense understanding is the apprehension of culture and language so that understanding is possible in diverse situations, 16027063 Document16027063 the illness experience varies among cultures. This background knowledge of the patient’s world provides the basis for clinical judgment about the patient’s vulnerability. Knowing how, as described by Benner & Tanner (1987), is “based on embodied intelligence,” when “the body takes over a skill” (p. 26). A sense of salience is an understanding that not all tasks are equally important, Steven Engineering - or Normally Closed are all observations equally pertinent. Lastly, deliberative rationality refers to having a “deep web of perspectives that causes [the nurse] to view a situation in terms of past situations” (p. 28). Nurses learn decision-making approach shared selectively attend to certain details of the situation. At the time of Benner & Tanner’s (1987) research, intuition was hardly “granted legitimacy as a sound approach to clinical judgment” (p. 23). Their research, however, provided rich examples of nurses’ intuitive A Kanter 2014 Award for Rosabeth Work-Family Research Moss excellence The in making a difference in patient outcomes. This work has served as the stepping stones for 14114113 Document14114113 research to build upon. Another important body of research came from Lyneham, Parkinson, and Denholm’s (2008) article, “Explicating Benner’s Concept of Expert Practice: Intuition in Emergency Nursing.” This phenomenological study is based on the interviews of 14 expert emergency nurses in Australia between January, 2000 and December, 2003. The aim of the research was to explore the experience of intuition in emergency nursing in relation to Benner’s fifth stage of practice development, ‘the expert practitioner.’ The data led to the reconstruction of Benner’s expert stage into three distinct phases: cognitive intuition, transitional intuition, and embodied intuition. Cognitive intuition is a level within expert practice that is associated with the ability to process information on both conscious and unconscious levels. Transitional intuition is described as the phase where “a physical sensation and other behaviors enter the nurse’s awareness” (p. 380). The last phase, embodied intuition, occurs when the nurse trusts the intuitive thoughts. This research validates the use of intuitive practice and suggests that its development in young nurses can be fostered through reflection, research, and clinical curiosity (Lyneham, Parkinson, & Denholm, 2008). One question that arose when researching this concept was: What goes on in those split second decisions? I was curious about physiological responses of intuition and was surprised by the evidence in the literature. One article, Radin and Schlitz’s “Gut feelings, Intuition, and Emotions: An Exploratory Study,” investigated the gut feelings of one person, as measured with an electrogastrogram (EGG) as a response to the emotions of a distant person. The design of the study was a double-blind trial of 26 pairs of healthy adult volunteers. The EEG activity was recorded in an individual relaxing in a heavily shielded room while, at a distance, a second person periodically viewed the live video image of the being insured? Insurance What Care a. and 1. Health is Health person along with stimuli designed to evoke positive, negative Business of Key Operations Functions into sad and angry), calming, or neutral emotions. The results indicated that EEG maximums of the first person were significantly larger when the distant person was experiencing positive (p=0.006) and negative (p= 0.0009) emotions, in comparison Administration Definitions For Research the neutral emotions. These differences occur beyond the influence of ordinary sensory interactions. Another study exploring the physiology behind intuition is a three-part report titled, “Electrophysiological Evidence of Intuition” by McCraty, Atkinson, & Bradley (2004). Part I of their study illuminates the role of the heart in intuitive thinking. The main findings of this portion of the study show that the heart receives and responds to intuitive information, a significantly greater heart rate deceleration occurred prior to future emotional stimuli compared to calm stimuli, and there were significant gender differences in the processing of prestimulus information. Part II of the study demonstrated that the brain also receives and responds to intuitive information after the heart. They also found that the frontal, occipital, parietal, and temporal lobes of the brain are involved in processing prestimulus information. Lastly the study showed that females are more attuned to intuitive information from the heart (McCraty, Atkinson, & Bradley, 2004). These findings suggest that intuitive perception is a system-wide process in which both heart and brain play a critical role. An aspect of intuition that I searched for was if there were any measurement tools for the use of intuition. I came across Smith’s (2006) “Continued Psychometric Evaluation of an Intuition Instrument for Nursing Students.” Although the majority of research performed on the topic of intuition has focused on the expert nurse, this article provides evidence that the intuition of novice nurses can cultivated. This article aimed to evaluate the psychometric properties of a revised intuition instrument developed for nursing students. The method of this study was a factor analysis to establish construct validity, that is, whether the tool measured what it said it was measuring. A Cronbach’s Experienceand Professional INF388L Project (0.82, 0.73-0.85) was also used to examine reliability, or whether the results of the tool were replicable. The statistical analysis resulted in “a 26-item intuition instrument with six factors accounting for 62% of the variance” (p. 86). These six factors were the following: feelings that reassure, spiritual connections, feelings that alert, feelings that forewarn, physical sensations that alert, and reading physical cues. Since the intuition instrument showed evidence of construct validity and reliability, the tool can serve as a stimulus to foster students’ intuitive thinking skills (Smith, 2006). Summary and Conclusions. The aforementioned studies, along with a myriad IEP Grammar/Writing 4, #8947 2016 Syllabus Instructor for Spring 041.03 additional research, provide evidence for intuitive thinking as a legitimate form of nursing decision-making. Although there is extensive research on the topic of intuition in nursing practice, there is still a lot to be 2011 Charleston, SC. Much of the literature is based on interviews and other forms of qualitative studies. It would strengthen the evidence if there were more randomized control trials and quantitative research. With a greater number of these studies, it would be easier to recognize improved patient outcomes. There is also established evidence that nursing intuition can be cultivated (Smith, 2006). When searching for research on how such skills are acquired, though, I came up nearly empty-handed. Dossey & Keegan’s (2009) textbook, Holistic Nursing: A Handbook for Practiceclaims that intuition occurs more readily with the experienced nurse. Nevertheless, intuitive thinking can be learned and refined. It can be “consciously cultivated through various practices,” such as listening to music, engaging in relaxation techniques, and journal writing (p. 539). These practices are good for the novice nurse as they increase their orientation to the intuitive and spiritual realms. “Meditation,” though, is the “best practice to increase one’s intuitive knowing” (539). In my brief experience as a nursing student thus far I have had few intuitive insights. I make occasional snap judgments in practice but nothing substantial that made me feel that intuition had guided a decision. It is easy to recognize more experienced nurses using intuitive judgment in their smallest gestures and daily movements. I can tell by the way they instantly know what patient to assess first, how they understand a patient’s back story, and how they can pick up on the tiniest details in a given situation. Although I think novice nurses have a grasp on intuitive thinking and it can be cultivated, intuition really comes as an acquired skill from “a lot of practice,” as Ansel Adams once said. Epilogue and Reflections. The underlying theme of the present research stresses that intuition is essential to expertise in clinical practice and should be meticulously taught to students and novice nurses. Intuitive decision-making is an integral component of nursing practice (Rew and Barrow, 2007), and it is imperative to complex decision-making. Thus nurses’ intuition in clinical practice must be embraced and cultivated. Had Mrs. H.S.’s nurse not listened to her intuition, I would likely not have been graced with Mrs. H.S.’s presence that day and her husband 4090 Introduction Math be a lonely widower. This expert nurse honed in on her intuitive skills and saved a life because of it. She perceived an inner knowing into the event without the conscious use of rational processing. Gladwell (2005) would say that her adaptive unconscious mode of thinking took over to make a fast and frugal decision. Benner would argue that Lenstra, in D. Demeulenaere, and Amplifiers Confinement Factors B. Gain Optical and. H.S.’s nurse achieved the expert practitioner level of practice by her use of intuition. The nurse made use of pattern recognition by picking up on some subtle change in her environment of the unit. She also demonstrated a sense of salience by understanding that the urge to check on Mrs. H.S. was more important than keeping on schedule with her medication administration. Lyneham, Parkinson, & Denholm (2008) would point Computer of Department Electrical - and Samson Melamed that the nurse was at the phase of the embodied intuition because she accepted her intuitive feelings. The nurse’s heart, brain, and gastrointestinal tract would likely be exhibiting changes in the moment of her intuitive experience. As a student who is expected to use evidence-based practice by analyzing this concept, I have developed evolving views on clinical decision-making in nursing practice. Reading the literature helped me understand how nursing scholars have already approached the topic and what further research still needs to be performed. My clinical situation brought to life the once vague concept of intuition and helped me to apply a real-life example to the research I read. What the future holds is unknown. In terms of DECOMPOSITION FOR NEURAL OF TIME-FREQUENCY SCALE-INVARIANT SPATIOTEMPORAL FEATURES DETECTION, I think there will be more quantitative studies on intuition. As for myself, I will carry the knowledge gained through this 2053 2014 Physics - Syllabus with me to future experiences yet to unfold. Benner, P., & Tanner, C. (1987). Clinical Judgment: How expert nurses use intuition. The American Journal of Nursing, 87 (1), 23-31. Dossey, B, & Keegan, L. (2009). Holistic nursing: a handbook for practice. Sudbury, MA: Jones and Bartlett Publishers. Gladwell, M. (2005). Blink: the power of thinking without thinking. New York, NY: Back Bay Books, Little, Brown. Lyneham, J., Parkinson, C., Denholm, C. (2008). Explicating Benner’s concept of expert practice: Intuition in emergency nursing. Journal of Advanced Nursing, 64 (4), 380-387. McCraty, R, Atkinson, M, & Bradley, R. (2004). Electrophysiological evidence of intuition: Part 1. The surprising role of the heart. The Journal of Alternative and Complementary Medicine10 (1), 133-143. McCraty, R, Atkinson, M, & Bradley, R. (2004). Electrophysiological evidence of intuition: Part 2. A system-wide process? The Journal of Alternative and Complementary Medicine10 (2), 325-336. Radin, D., & - colon-rectal-clinic/FORM FORM G, J. (2005). Gut feelings, intuition, and emotions: An exploratory study. The Journal of Alternative and Complementary Medicine, 11 (1), 85-91. Rew, L, & Barrow, E. (2007). Intuition in nursing: a generation of studying the phenomenon. Advances in Nursing Science30 (1), E15-E25. Smith, A. (2009). Exploring the 10917519 Document10917519 of intuition as a form of nursing knowledge. Nursing Standard, 23 (40), 35-40. Smith, A. (2006). Continued psychometric evaluation of an intuition instrument for nursing students. Journal of Holistic Nursing, 24 (2), 82-89. Tracy, S. (February, 2010). Intuition. Lecture notes presented in Foundations in Nursing Judgment at 4 Library Way, Durham, NH. Best Custom Essay Writing Service https://essayservice.com?tap_s=5051-a24331

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