Nursing Decision Making Process

Critical Thinking in Nursing

• Critical thinking is the ability to perform nursing skills proficiently and make reasoned judgments effectively.
• It involves thinking out of the box, being creative, and making informed decisions.
• Components of critical thinking include:
  • Competencies: ability to perform nursing skills proficiently and analyze information.
  • Knowledge: prepares a nurse to better anticipate and identify patient problems.
  • Experience: allows nurses to learn from observing, sensing, talking, and reflecting actively about patient care.
  • Attitudes: confidence, fairness, thinking independently, risk-taking, creativity, curiosity, integrity, and humility.
  • Standards: intellectual standards (clear, precise, specific, accurate, relevant, consistent, logical, complete, and significant) and professional standards (ethical criteria for nursing judgment, criteria for evaluation, and professional responsibility).

Reflection and Human Caring Theory

• Reflection involves purposely thinking back on a situation to discover its meaning.
• Caring requires nurses who focus on the relationship with the human being by seeing, understanding, and taking responsibility.
• Watson's Human Caring Theory consists of 10 caritas processes, which include:
  • Practicing loving-kindness to self and others.
  • Being authentically present to enable faith, hope, and the inner-subjective life world of oneself and others.
  • Fostering one's own spiritual practices.
  • Developing trusting interpersonal caring relationships.
  • Forgiving and showing empathy to self and others.
  • Using problem-solving for decision making.
  • Engaging in genuine teaching-learning experiences.
  • Creating a caring-healing environment for all involved.
  • Valuing humanity.
  • Embracing the unknowns and miracles in life.

Theory, Ethics, and Professionalism in Nursing

• A professional nurse has both dependent and independent functions.
• Ethics and values provide an ordered set of moral standards to be used in assessing what is morally right and wrong in nursing practice.
• Ethics is concerned with the determination of right and wrong in relation to people's decisions and actions.
• Moral refers to judgments about behavior based on specific beliefs.
• Value refers to personal beliefs about the worth a person holds for an idea.
• The introduction to ethics includes:
  • Health ethics: moral decision-making situations in the practice of medicine and health.
  • Bioethics: concerns from diverse fields including health, medicine, law, philosophy, biotech, and life sciences.
  • Islamic ethics: right principles and values based on Islamic sources.
  • Nursing ethics: professional standards of conduct practices by nurses related to moral behavior in providing health care services.

Purpose of Ethics in Nursing

• The purpose of ethics in nursing is to facilitate informed decision-making, enhance quality of care and patient safety, prioritize patient welfare and advocacy, and ensure nurses comply with legal and regulatory compliance.
• Ethics also helps develop a sense of personal fulfillment, satisfaction, and professional integrity.

Ethical Theories

• Utilitarian theory: focuses on the results of action and treats intentions as irrelevant, right actions ought to produce the greatest happiness or pleasure for the greatest number of people.

Legal System in Malaysia Related to Nursing

• The right to health in general is protected by the Federal Constitution of Malaysia.
• The Federal Constitution provides for the fundamental rights of citizens and non-citizens.
• According to Islam, the right to health is guaranteed by the Federal Constitution of Malaysia.
• The right to health is interpreted indirectly within the right to life.