This chapter introduces the underlying principles of decision making. You will be encouraged to consider decision making as a student in university together with decision making as a student nurse (see Chapter 1 ). In 2010, following a review of pre-registration nursing education, the professional body for nursing in the United Kingdom, the Nursing and Midwifery Council (NMC), published new Standards for Pre-Registration Nursing Education , including competencies that all students must achieve to qualify as a registered nurse. These competencies have to be met in four broad areas known as ‘domains’. 1. Professional values 2. Communication and interpersonal skills 3. Nursing practice and decision making 4. Leadership, management, and team working You will find reference to these domains throughout the book, and there will be an opportunity to learn how the competencies in each of these that relate to decision making can be linked to your clinical and university-based learning. There are a number of terms that can be found in the literature that are often used interchangeably; you may see terms such as ‘decision making’, ‘problem solving’, ‘clinical reasoning’ or ‘clinical judgement’, and others used when writers are discussing how and why nurses respond to clinical situations in a particular way (see Chapter 1 for more detail). For example, Levett-Jones et al. (2010: 515) provide a helpful definition of clinical reasoning as ‘the process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process’. They also emphasize that a nurse’s ability to develop these clinical reasoning skills depends on what they term as ‘five rights’—that is, the nurse’s ability ‘to collect the right cues and to take the right action for the right patient at the right time and for the right reason’. In the context of ensuring that any patient receives the best possible care, these ‘five rights’ are very appropriate, and indeed if one were to fail to pick up on the right cues and to take the appropriate actions in many clinical situations, the outcome may have serious repercussions for the nurse and the patient.
