Advanced Practice Nursing Decision-Making

Advanced Practice Nursing Decision-Making

1. Describe some psychological and contextual complexities and constraints that may face the NP while making decisions in the above scenario

The ANP may face a sense of urgency in finding a diagnosis or treatment for the 69-year-old woman sense she was anxious in leaving to go home with family. Also, it may be some complexities and constraints with the root cause of her left non-dominant wrist which in the scenario was described as being grossly swollen and deformed, with bruising and swelling extending up the forearm and tenderness over the distal radius and ulna. The woman also stated she had problems with her left shoulder that appeared stiff. More investigation should be done.

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Advanced Practice Nursing Decision-Making

2.Describe intuitive and rational analytic decision-making models (thinking) that would serve to guide the ANP’s decision in this scenario (making sure to provide the decision the NP should make). Are both required, why or why not?

The intuitive analysis to guide with the decision making in this scenario will include the ANP prescribing diagnostic testing the definitively confirm the severity of the injuries the ED patient has suffered. In a recent article, “intuitive decision making is a valuable tool for managers, allowing them to make quick and accurate decisions even in complex or uncertain situations” (A.Bensla, 2023). This is very imperative for the ANP to use because of the uncertainty of when the injuries actually occurred. Contrary to intuitive analysis, rational analysis includes using visual and auditory detail from assessments and evidence-based practice to reach a decision on treatment for the 69-yr old patient. In this scenario both decision making models can be used to guide the ANP in deciding the best treatment for the patient since limited amount of clarity is given from the patient.

3.Compare and contrast the two decision-making models applied and discuss the benefits and consequences of using these decision-making methods in the above scenario.

Intuitive decisions have a numerous of advantages, they can be made quickly and without much effort. Especially in the case of minimal information like what has given in this scenario and under great uncertainty, few clear facts can be used anyway. On the contrary, rational decisions are usually made in a more structured, argumentatively comprehensible and controlled manner. Data and facts are collected in order to make a decision on this basis. Often, decisions are justified with arguments that were mainly made intuitively. But in this case, both models should be used in synchrony. In a recent article, it describes that “at the same time, it should be noted that intuitive components also flow into the rational decision-making process” (D.Seydel, 2023). For example, when evaluating information accordingly, it is often a mixture of intuition and analytically rational considerations.

4.What is the best decision-making approach/strategy for advanced practice nurses generally? Be sure to provide a well-supported response.

The best approach is the rational analytic decision-making model. This includes actuality with findings from assessments both objective and subjective. Examining the patient’s arm will allow the ANP to make a decision if further diagnostic need to be done. The patient stated that swelling to upper arm and stiff left shoulder were both old injuries from a previous fall. Conclusively, the ANP did an x-ray to the left wrist and came back negative. Although, it is the patient’s right to not be tested if they do not want to, refusing treatment can lead to further complications and the patient should be educated on the complications that may occur if the left arm injuries are not treated for. Such complications as DVT (Deep venous thrombosis), fracture which can lead to fat embolism should be educated.

5.What is metacognition and how does it help to guide decision-making for the APN?

“Metacognition comprises both the ability to be aware of one’s cognitive processes and to regulate them” (DS. Fleur, et al., 2021). The APN uses this metacognition along with rational and intuitive models to decide the best treatment possible for the patient. Metacognition can be used as the overall decision maker for the scenario. The APN will be able to determine if rational model over exceeds intuitive for this case scenario.

References

Bensla, A. (2023, November 9). The ultimate guide to intuitive decision making for managers. Risely. https://www.risely.me/intuitive-decision-making-pros-and-cons-and-4-models/.

Seydel, D. (2023, August 27). Rational vs. intuitive decision-making. Medium. https://medium.com/@decioo.com/rational-vs-intuitive-decision-making-e75c04885247.

Fleur DS, Bredeweg B, van den Bos W. Metacognition: ideas and insights from neuro- and educational sciences. NPJ Sci Learn. 2021 Jun 8;6(1):13. doi: 10.1038/s41539-021-00089-5. PMID: 34103531; PMCID: PMC8187395.

Edited by Ashley Evans on Nov 27, 2024, 3:48:30 PM