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Ask the expert: Direct-care nurses: Exercising independent judgment

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, December 11, 2007

This week, a reader asks for examples of nursing staff exercising independent judgment to resolve patient-care issues. Read the response from our advisor Katherine Riley, MSN, RN, CNA, BC, assistant vice president of nursing and coordinator for the ANCC Magnet Recognition Program® at Southwestern Vermont Medical Center in Bennington, VT.

Q: What are some examples of direct-care nurses exercising independent judgment to resolve patient-care issues?

A: Nurses are expected to exercise independent judgment, within the scope of practice and professional standards of care, to address patient-care needs. The following are a few examples of how direct-care nurses can exercise independent judgment:

• A direct-care nurse who steps in to alter a plan of care if they determine that the plan is not meeting the patient's need at that time. Examples might include a nurse who determines that the patient's discharge plan does not place the patient in a safe environment and then works at making sure the patient is placed in a safe environment at discharge.
• A direct-care nurse who recognizes that a patient's condition is deteriorating and implements appropriate measures while awaiting the arrival of the emergency response team.

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