Nursing novices

Have been reading through an interesting nursing book which is for an essay of 4000 words length concerning the use of clinical decision making in nursing using an analytical framework. A situation has to be described and written of. The reading I have done is the context of the junior staff nurse who is newly qualified, they are considered a novice nurse and they do not have the experience of dealing with patients to be able to make any intuition which if considered to be derived from acquired skills.

Clinical decision making is to enable the nurse to decide the best course of action for delivering care and treatment to patients and the best way to do this. The type of method which is used can be defined by using the cognitive continuum theory as defined by Hamm (1998). The theory suggests that thinking is neither purely intuition based nor purely analytical based but is based on a continuum somewhere between the two (Hamm 1998, cited in Thompson and Dowding 2005 p12). According to the cognitive continuum, the main determinants of whether the individual practitioner uses an intuitive or analytical approach will be based on the position of the task on a continuum which is ordered from the most rigid, scientific experiment evidence through to sheer intuitive decision (Thompson and Dowding 2005 p12). In the essay, treatment is the choice of dressing for a pressure ulcer.

However, it just seems so odd to think that while as a first and second year student, we very rarely were in a position to make these assertions but learned much from the study that we did in learning contracts for the placements that along with the competencies as set by the NMC that we never seem to have in the two years ever appreciated the gravity of the choices that we face. After reading and considering my past nursing, it makes me realised that even though we may be novices, that knowledge and interpersonal skills are of the uttermost importance.

Now, I am 3 weeks away from being on a ward (first time since January 2006 mind you), and suddenly feel very apprehensive about all of it. Novice? Crikey yes! Knowledgeable? Well, anatomy and physiology check, nursing code of conduct, check, general nursing theory check, self belief in being able to not become a quivering wreck for the first shift... oh dear.