Module #4 Question 1

How did the readings influence your perception of your own clinical decision making?

How do we reconcile the value of nursing experience with known heuristics and biases based in human decision making?

The articles were very attention-grabbing and provoking. As I read the articles I thought about the few times that I have looked up evidence for information to support a decision. Besides researching EBP for protocols or policies that needed to be originated or revised in the ICU I can only remember two times that I looked up information to find out what the best evidence showed. When I was a new nurse I just relied on the supposed expertise of the more experienced nurses where I work. The only other times that I have done any substantial research was for a school assignment. This situation is not because I have a lack of resources either. After much thinking I have come to realize that most nurses’ decision making relies on experience, and if they do not know something they ask someone more experienced. After much research in the year 2003 Thompson stated that nurses rely heavily on past experiences to meet the information needs associated with decision making under uncertainty (and there is probably more uncertainty then any nurse wants to admit too). A great part of uncertainty comes because our decisions are not up to date and backed by evidence base practice.

As I became more experienced and independent heuristics became more of a subject, but until now I didn’t have a name for this unsafe practice. After passing nursing boards I kept working on the same unit for two years and then I began to see the bias that was incorporated into how things were done. Because of this situation I started working in Las Vegas Nevada at the University Medical center to increase my understanding of the healthcare field. It is evident that by using heuristics in nursing it has lead to errors that could have been avoided if nurses would utilize the resources that are available to them.

The readings in this module show how evidence base practice is vital to giving the best care possible to patients. As stated by Thompson “Evidence base nursing is designed to be a systematic means of combating the biases that arise from uninformed decision making”. Nurses need to make a habit of incorporating evidence base practice into their own decision making and be help foster younger nurses.