How to Trust Your Nursing Judgement: Critical Insights From 5 Experienced Nurses

by | Dec 4, 2023 | New Nurse | 2 comments

I’ve received a lot of questions from new nurses saying that one of their biggest struggles is learning how to trust your nursing judgement. You think you know what you’re doing, but you’re not sure… and are constantly questioning yourself, doubting yourself… how do you get over the hump? How do you go from an unsure newbie to a confident nurse?

I posed this question on my Facebook Page to experienced nurses, and they had some amazing responses. As a new nurse, I also struggled to trust my nursing judgment and wanted to compile their responses with my own experiences. Onward!

how to trust your clinical judgment in nursing

How Important is it to Trust Your Nursing Judgement?

Trust is a critical aspect of nursing and patient care. Trust extends to the nursing peers you work with, the physicians who manage your patients, and any support staff like CNAs, unit secretaries, housekeeping, or other technical staff. It’s important to have some level of trust with your interdisciplinary team, but trust in nursing also extends to yourself and the ability to trust your nursing judgment.

When Did You Learn to Trust?

Let’s discuss what the experienced nurses had to say about when they began to trust their own nursing judgement.

When I HAD to Trust My Nursing Judgement

“When I was forced to rely on it,” is what Micki P., RN said and I couldn’t agree more.

There were times when I wasn’t 100% totally sure… but everyone else was slammed, nowhere nearby, or whatever the circumstances, and I was forced to stand on my own two feet. While nervous, I thought critically about the situation and asked myself, “if another nurse came up to me and asked me this question, what would I tell them?

When I Was Right Again and Again

Anastasia M, RN answered when she started to trust her nursing judgment was, When my observations were confirmed with increasing frequency.”

Again, I completely identified with this. I started to notice I went from being way off base or almost correct… to being right most of the time. And it. felt. amazing.

I know, it feels pretty awesome.

“Hey, he feels a little warm and his heart rate seems to be above baseline. Let’s check a temp and I’ll peek at his CBC from this am, and circle back with the doc.”

“Hey her lungs aren’t as clear as before, she’s not urinating as much… maybe she needs some Lasix.”

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“Hummmm… maybe we wait on getting that non-STAT chest x-ray until after the resident puts this central venous catheter in and I put the feeding tube down to save the patient an x-ray and radiology another trip up to the room…”

The pieces just sort of start to fall together and all of the pathophysiology you learned in nursing school comes together with all of that time management/patient care you’ve been learning throughout orientation.

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When Others Came to Me For My Nursing Judgement

Jackie T, RN said, “When co-workers started asking my thoughts and opinions (more experienced nurses). I felt like if they thought I was good enough, that what I thought mattered, I must be then.”

Ding ding ding! YES! A few months after I started as a newbie, a new crop of nurses started as well as a few new CNA’s. I was thankful to have more new people on the unit who were hopefully as lost as I was. Yay, friends! But, I noticed that when they started asking me questions… I knew some of the answers.

I quickly went from the most lost person on the unit to someone who knew the unit relatively well, could navigate many issues, and knew who to call when I was stuck.

And soon, it wasn’t just the other new employees asking me questions, fellow nurses started asking me what I would do or what I thought about a certain situation. The first time it happened, I had one of those, “Did he just ask ME what I thought!? What parallel universe is this!? I’m the new one who doesn’t know what she’s doing!” moments. I collected myself and provided the answer I thought was best, and he agreed.

When I Could Confidently Teach Others

Stephanie B, RN said trusting your own nursing judgment kicks in, When you can confidently teach others.”

Going back to this group that started after me, I had one new nurse ask me some questions about a Cardizem drip. I answered her questions and then dove a little deeper into the why. I was a little on autopilot and didn’t really think about it until after. As I walked away from the conversation I thought, “waaaaaiiitt a minute… did I just teach another nurse something!?”

Yes. Yes, I did.

With Time Came An Increase in Trust in My Clinical Nursing Judgement

And finally, of course… I would be remiss if I didn’t mention how important it is, so give it time.

Stephanie D, RN said,

“Time. As it went on and my gut continues to be right about patients, I trust it more and more. I value being able to ask more experienced nurses their opinion. But I’ve loved the strengthening feeling of “I got this!” With each shift and with each health issue I’ve caught that could’ve been missed (or had already been by others). I’m not perfect, but I do my best to also learn from my mistakes, which I also feel makes me a stronger nurse.”

When you first start out in nursing, it’s totally normal to second-guess yourself. You’re fresh from school, and jumping into real-life nursing can feel like you’ve been thrown in the deep end. But here’s the cool part: as you rack up more shifts and spend more hours on the floor, you’ll start to see your nursing judgment getting sharper. It’s like, one day you’re questioning every little decision, and the next thing you know, you’re handling complex situations with a lot more ease.

Think of it like learning to ride a bike. At first, you’re wobbly and maybe need a helping hand. But with time, you’re cruising along, steering through challenges like a pro. That confidence comes from seeing things play out, learning from both the good calls and the not-so-good ones.

You’ll begin to trust your nursing judgment more because it’s backed by real experiences, not just textbook scenarios. And remember, it’s completely fine to ask for help or a second opinion when you need it. Trusting your nursing judgment doesn’t mean you know it all, but it does mean you’re well on yout way to becoming the awesome nurse you were meant to be.

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Final Thoughts on Trusting Your Nursing Judgement

Many of us thought we’d start our first job as a new grad feeling on top of the world and assumed we would simply know what to do in situations because we got through nursing school and passed the NCLEX. However, the path to competency is much bumpier than that.

The take-home message from this blog post is to notice the small changes that occur over a long period of time. It’s like watching a child grow up. We don’t physically point to them and go, “Look! I see you’re growing up right now!” The process is much slower than that. Only after a period of time coupled with reflection do we truly appreciate how much you’ve improved.

Keep your head up and start to notice the little clues that you’re on the right path, like when people come to you for help, when you’re first instinct is right more often, and and when you feel really good about teaching skills to others.

FAQs About Nursing Judgement

What is good nursing judgement or clinical judgment in nursing?

Good clinical judgment in nursing is the adept combination of experience, knowledge, and critical thinking. It involves accurately interpreting patient data, anticipating healthcare needs, and making decisions that enhance patient outcomes. This skill is characterized by a deep understanding of healthcare practices, effective communication, ethical reasoning, and the ability to adapt to changing situations. Good clinical judgment ensures that patient care is safe, efficient, and tailored to individual needs.

What is clinical nursing judgement?

Nursing clinical judgment is the essential process by which nurses synthesize information from various sources, including patient assessments, scientific knowledge, and personal experiences, to make informed decisions and deliver optimal patient care. This dynamic skill involves critical thinking, prioritizing, and the application of nursing knowledge, all guided by ethical considerations and a commitment to patient-centered care. It’s how nurses interpret data, anticipate potential complications, and take action to ensure the best possible outcomes for their patients.

Why is clinical nursing judgement important?

Clinical judgment is pivotal in nursing as it directly influences patient outcomes. It is how nurses apply their knowledge, skills, and critical thinking to assess, decide upon a nursing diagnosis, collaborate, and intervene effectively. By making well-informed clinical decisions, nurses ensure safe and high-quality care, responding adeptly to the dynamic needs of each patient. This crucial skill bridges the gap between theory and practice, enabling nurses to navigate complex clinical situations, anticipate potential complications, and deliver patient-centered care with compassion and efficiency.

What are the key elements of nursing judgement?

Nursing judgment is a foundational skill in nursing, representing the crucial link between education and practical patient care. It involves interpreting patient data correctly and making decisions that optimize patient outcomes. Key elements of clinical judgment include:

Critical Thinking: This is the bedrock of clinical judgment. Nurses must synthesize information from various sources, including patient history, physical assessments, and diagnostic tests. This analysis helps in understanding the patient’s condition and planning appropriate care.

Clinical Knowledge: A deep understanding of nursing knowledge is essential. Familiarity with disease processes, pharmacology, and best practices forms the basis for clinical judgments.

Observation: Nurses constantly observe their patients, noting changes in their condition. This involves keenly monitoring vital signs, physical symptoms, and behavioral cues, often the first indicators of a change in the patient’s status.

Experience: Experience shapes a nurse’s ability to make sound clinical judgments. Over time, nurses develop an intuition or a ‘sixth sense’ about their patients, which guides them in their decision-making.

Reflective Practice: Reflective practice means learning from experiences and applying those lessons to future situations. It’s about continuously questioning and evaluating one’s practice to improve care quality.

Collaboration and Communication: Effective clinical judgment often involves collaborating with other healthcare professionals. Sharing insights and discussing patient care plans with doctors, therapists, and other nurses ensures a comprehensive approach to patient care.

Ethical and Patient-Centered Considerations: Nurses must always consider the ethical implications of their decisions and prioritize patient-centered care. This involves respecting patient autonomy and cultural values while making clinical decisions.

Adaptability and Flexibility: The healthcare environment is dynamic and unpredictable. Nurses must be adaptable, adjusting their clinical judgments to new information and changing patient conditions.

Prioritization and Decision-Making: Nurses often care for multiple patients simultaneously. Prioritizing patient needs and making timely decisions is a critical aspect of clinical judgment.

Confidence and Assertiveness: Confidence, underpinned by knowledge and experience, is key in clinical judgment. It enables nurses to advocate effectively for their patients and be assertive when necessary.

Developing strong clinical judgment is a continual process, grounded in lifelong learning and a commitment to excellence in patient care. Nurses should embrace opportunities for professional development, mentoring, and reflective practice to enhance their clinical judgment skills.


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    Picture of Kati Kleber, founder of FRESHRN

    Hi, I’m Kati.

    Kati Kleber, MSN RN is a nurse educator, author, national speaker, host of the FreshRN® Podcast, and owner of FreshRN® – an online platform created to educate, encourage, and motivate newly licensed nurses in innovative ways.

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    2 Comments

    1. Bekah

      I’m a new nurse (7 weeks into my 12 week orientation) and I have asked myself and my preceptor this question. She says to give it time. It’s encouraging to know that nursing judgement will come. My thing is, I ask so many questions right now, and I’m hoping by the 12-week mark I’ll be able to ask less, because it can be time consuming to have to ask so many questions. I want to be safe, so I will still ask questions if I have them. I’m just wondering, is there a timeline for the average orientee where we are able to ask less questions…or does that come with growing in our nursing judgment?

      Reply
      • FreshRN Team

        It just comes as your nursing judgement grows. And do not ever put a deadline on asking questions. If you have them, ask!

        Reply

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