Clinical Judgment in Action: A Case Study of Complex Decision-Making in Geriatric Nursing Care

Clinical Judgment in Action: A Case Study of Complex Decision-Making in Geriatric Nursing Care Student's Name Institution Course # and Name Professor's Name Submission Date Introduction In this case, the patient is male, aged 95 years, and has been admitted to the hospital ward after complaining of breathing difficulties, cough, as well as bilateral pitting edema. The clinical decision to be examined revolves around a geriatric patient who requested assistance to use the commode during a night shift, and this led to an unforeseen loss of consciousness after some time. For this analysis, the patient would be assigned the pseudonym Mr. K to avoid revealing their "real world" identity. This is congruent with the requirement to meet legal and ethical confidentiality requirements in healthcare practice and research (Heaton, 2022). The student was first to arrive on the scene and used the emergency button upon accessing the situation, where other health professionals arrived promptly. The Nursing & Midwifery Council (2015) code on confidentiality requires that healthcare professionals share relevant information with other practitioners only when the interest of public protection and patient safety supersedes the need for confidentiality. In this context, a student nurse, a healthcare assistant (HCA), and the doctor collaborated to diagnose and implement interventions tailored to stabilize the patient. This happened without seeking patient consent because the patient was unconscious and thus lacked the capacity to make the decision. In this emergency, Mr. K lacked comprehension and voluntariness; thus, healthcare professionals must act to safeguard his wellbeing (Sherman et al., 2021). However, explaining the clinician's decision after the patient is stabilized would be necessary. Assessment Geriatric nurses are equipped with patient-centred assessment skills that are needed in the management of patients. In this case, the assessment targeted the underlying factors contributing to the patient's sudden loss of consciousness and guided subsequent interventions. This case involved a structural clinical decision-making procedure from the student nurse to the healthcare assistant and the doctor on duty (James, 2021). Utilising the ABCDE approach, the nurse prioritised the assessment of airway, breathing, circulation, disability, and exposure, ensuring prompt identification of any emergent concerns (Resuscitation Council UK, 2021). The aim was to examine Mr. K’s medical history, analyse the presenting symptoms, and manage vital signs. Fortunately, a blood glucose test diagnosed that the patient had hypoglycemia. The geriatric patient was offered fast-acting carbohydrates followed by hourly blood glucose level monitoring. The nurse also conducted a biopsychosocial assessment, which included the patient's cognitive status, functional abilities, and social support system. Geriatric nursing care is a demanding area that needs attention to minor details since ageing patients battle with many challenges outside their physical health. In this case, the student nurse noticed she could not manage the situation single-handedly and pressed the emergency button, where the HCA and the doctor on duty arrived promptly. The three healthcare professionals formed a collaborative team prepared to assess, plan, and treat the geriatric patient. The three minds concluded that the state of unconsciousness is most likely attributed to the patient's hypoglycemic condition. Interprofessional communication enriched the assessment discussions and ensured a comprehensive healthcare delivery, as Bok et al. (2020) reported. Planning Failure to plan in healthcare is equally considered a plan to fail in delivering client-centered care. The planning phase aimed at addressing the patient's loss of consciousness through an analysis of medical history. The basis of planning was evidence-based practice and interprofessional collaboration to ensure that vital signs were addressed and the patient was safe from danger as soon as possible (Rodziewicz et al., 2023). The student nurse, HCA, and the doctor synthesised assessment findings and diagnostic results to establish the most probable diagnosis and decide on interventions that must be prioritised. Collaborative discussions in healthcare decisions highlight that communication and mutual respect are key to overcoming challenges and optimising patient care (Zajac et al., 2021). The doctor requested an electrocardiogram, ...