The purpose of this chapter is to address decision making in the field of children’s and young people’s nursing practice in relation to the field-specific competencies outlined by the Nursing and Midwifery Council (NMC) in the Standards for Pre-Registration Nursing Education (NMC 2010). In order to explore these competencies further, we will consider examples from practice, and links will be made between the various examples from practice and the competencies in order to demonstrate their importance. To allow an in-depth exploration of the examples from practice, we will use Johns’ (1994) model of reflection. ‘Reflection’ is described as a means by which nurses can closely examine their theoretical knowledge along with their nursing practice (Johns 2000). The process of reflection has been found to have great benefits for nurses, because it allows them the opportunity to change and develop practice in order to carry out improved care practices (O’Regan and Fawcett 2006). In this chapter, the evidence of decision making has been interlinked with critical evidence-based reflective practice, and demonstrates its integration and development in the role of the newly qualified nurse. The chapter will begin by discussing examples derived from practice, and key aspects from these examples will be taken and related to the NMC Standards (NMC 2010). The chapter will then go on to discuss key elements required to make decisions in clinical practice. The evidence base for many of the decisions taken in the case study is interwoven throughout the narrative, thus enabling you see how they link together in nursing practice. Centred on a newly qualified staff nurse on the neonatal unit, the single case study around which this chapter is structured considers the care of a sick neonate whose parents were adolescents. This example was chosen because it illustrates many aspects of caring decisions that have to be made for patients from birth through adolescence, because the parents themselves were still in the later stages of childhood. The case study itself appears as dialogue, and the Standards and competencies referred to are those generic and field-specific competencies that a student pursuing a children’s nursing field-of-practice pathway is required to achieve, found under the heading ‘Competencies for entry to the register: Children’s nursing’ in the NMC Standards (NMC 2010).
PRO111 Using Expert Judgement to Inform Decision Making WHEN the Evidence Base Is Limited: A Case Study in Haemophilia