A Philosophical Analysis of Clinical Decision Making in Nursing

Background: Clinical decision making is a fundamental aspect of nurses' clinical practice and has a direct impact on the health and well-being of each patient. Method: An exploratory analysis of the concept of clinical decision making in nursing will be provided from the two predominant theoretical perspectives: the systematic-positivist model and the intuitive-humanistic model. The origin, aim, value, ontology and epistemology, assumptions, communicability, and context specificity of these two models are discussed. Results: As nurses work in ever-changing health care environments, either the positivist model or the intuitive model is adequate to describe the dynamic processes nurses use in clinical decision making. Therefore, it was suggested that the cognitive processes used in decision making were neither completely analytical nor completely intuitive. Conclusion: Clinical decision making is complex. A combination of scientific evidence-based knowledge in conjunction with intuition and contextual factors could enable nurses to utilize excellent clinical decision making.