Week 2: Wisdom Versus Judgment

How does the concept of wisdom in nursing informatics compare to the concept of professional nursing judgment? What is DIKW and how do you “use” it in your practice?

I am a school nurse so I would think how I use this in my practice is signs and symptoms of illness of students that come in to the school clinic.

Something like this?
Child in school clinic for difficulty breathing after running in PE with a history of asthma
• Data – Pulse Ox (Oxygen saturation) vital signs for an individual’s heart rate, respiration, temperature, blood pressure, and lung sounds
• Information – Pulse Ox and a serial set of vital signs taken over time along with lung sounds
• Knowledge – recognition of a pattern and identification of interventions reflects information synthesis (knowledge) based on nursing knowledge and experience. If child is improving to a stable level or becoming unstable ( beginning of respiratory distress, continue to watch O2 levels and pulse and respirations
• Wisdom – accuracy of the synthesis of information and appropriate selection of interventions which would be to administer a breathing treatment per doctors order on file, or school protocol, if child is becoming too unstable and needs 911 to be called

ANSWER

Week 2: Wisdom versus Judgment

Professional judgment in nursing practices is derived from knowledge acquired through education, training, and observation. It refers to the skills that are needed in making rational decisions which are enhanced through an effective collection of data, deciphering the required information and finally developing an appropriate intervention strategy (Lindsey & Jenkins, 2013). Nursing informatics is essential in making a professional judgment. To achieve this, it is recommended that a nurse should gather sufficient data that will guide them towards making informed decisions. In the course of nursing practice, additional knowledge and skills are needed to equip the nurse with the needed wisdom while making judgments.

Nurses handle a wider range of issues that are central to the condition of every patient in terms of complications and improvements (Moen & Knudsen, 2013). Therefore, nursing judgment is the heart of healthcare delivery. The nursing judgment made guides decisions and actions among the caregivers and physicians. As such, it is imperative for a nurse to have excellent reasoning and observation skills to make reliable and sound clinical judgment. 

Wisdom in the nursing profession is built on judgment skills combined with informed instincts, available informatics, nursing judgment and education experience (Matney, Avant & staggers, 2016). According to Bremner’s theory, nurses are categorized into five levels depending on capabilities including; expert, proficient, competent, advanced beginner, and novice. As such, she believed that experience in the clinical setting of nurses is vital because it helps them to constantly expand their knowledge levels that enhance them to offer competent and holistic care to the patients (Shinnick & Woo, 2014). 

The critical issues while addressing the nursing informatics include data, knowledge, information, and wisdom. This forms the DIKW framework which underlines the conceptual clarification in support of clinical judgments.  Data refers to the discrete factors which describe the patient environment and include medical diagnosis (Topaz, 2013). In my career as a school nurse, for example, I use data to diagnose students with difficulty in breathing due to a history of asthma. Such data include Pulse Ox, heart rate, lung sound, blood pressure, temperature, and respiration. Information is essential as it is argued to be meaningful data.  Indeed, information is constructed through combining different data points to come up with a meaningful picture (IMIA-NI, 2015). In this case, Pulse Ox will be combined with a serial set of vital signs that are recorded over time along with readings. Knowledge refers to information that has been synthesized in a way that interactions and relations are formalized and defined (Topaz, 2013). With this regard, it has been established that if a patient tends to be stable, there are cases…