Clinical Judgment in Nursing: Why Good Decision-Making Matters

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Clinical judgment in nursing has a significant impact as it informs patient outcomes, career satisfaction, and facility representation. Tanner's Clinical Judgment Model is a helpful tool for nurses to begin forming these clinical decision-making. skills. This subject is highly valued at NDMU and is taught to ABSN students.

nurses talking and holding clipboard

Regardless of the knowledge you gain during nursing school, some skills can only be learned through experience. Clinical decision-making is an essential pillar of nursing to consider as you enter the health care field.

No single patient, circumstance, family, or diagnosis will look the same, so every situation requires nuance and understanding. The best nurses have strong clinical judgment skills and are prepared to face anything they encounter daily.

At Notre Dame of Maryland University’s Accelerated 2nd Degree Bachelor of Science in Nursing (ABSN) program, clinical judgment in nursing is a priority. We seek to prepare students with varied experiences in skills and simulation labs as well as clinical rotations. But first, let’s explore more about what makes decision-making in nursing so vital.

Why Is Clinical Judgment Important in Nursing?

Nursing practice involves a balance of art and science. An in-depth understanding of bodily functions and treatments is as important as the science aspect. Equally important is the art of applying this knowledge to patients in complex situations with much nuance.

A nursing workforce with a strong sense of clinical judgment impacts all areas of nursing. Here are a few ways clinical judgment is important within the field.

woman sitting at table looking at papers

Did you know clinical judgment skills are required to take the NCLEX? Learn more about the NCLEX exam and helpful tips to be successful.

Patient Outcomes

Clinical judgment skills don’t just improve the quality of care; they also improve patient outcomes. The National Institute of Health reports that these skills directly support the quality of patient care.

When nurses have well-developed clinical judgment, they will be more observant of patient needs, come to more accurate conclusions about their condition, and better understand the right treatment path.

Career Satisfaction

To maintain a long and fulfilling nursing career, you must continue developing clinical judgment skills. Nursing is a highly inter-relational job, and many nurses report that their time spent with patients is a highlight of what they do daily.

NDMU nursing student standing in hallway

Being adaptable and knowledgeable in patient care can help give deeper meaning to what may seem routine. The best and happiest nurses are lifelong learners who are constantly working to ask questions and grow in everything they do.

Facility Reputation

Nurses influence the reputation of the facility where they work. A hospital full of highly trained nurses with strong clinical judgment is a quality hospital. Such a facility may even draw more nurses with these qualities by earning Magnet status — a highly reputable qualification for a hospital defined by its reputable nurses.

While all medical facilities depend on their nurses to uphold their reputation, each hospital or clinical will operate differently. However, many nurses and facilities have adopted the Tanner Model, a popular decision-making technique.

While nursing in a hospital is most common, you can work as a nurse in many workplace environments. Explore these 10 nursing specialties that might interest you.

nurse speaking with patient in room

Tanner’s Clinical Judgment Model

Tanner’s Clinical Judgment Model is a structure in which individuals can work toward thinking more like a nurse. Tanner’s model operates on the premise that the internal life of a nurse manifests through external medical practice. It informs how nurses practice and interact with others in the workplace.

The model is divided into four parts: noticing, interpreting, responding, and reflecting. This model provides a framework for nurses to develop their decision-making and critical thinking skills.


When interacting with a patient, a nurse will have a particular set of expectations based on knowledge and previous experiences. While this is inevitable, it is essential to place yourself outside of these expectations so that you can notice when situations diverge from anything you have experienced before.

This could mean noticing minute differences in patient conditions that could indicate something more significant. It could also mean noticing demeanors, behavioral changes, or interactions between patients and their families. These can significantly impact the individual’s overall care, as nursing is a holistic practice that does not focus solely on one component of care.

students in scrubs in class setting


When nurses notice something unusual or different from the expected scenario, they must interpret what that means for the patient and their care. The goal is to determine the cause of this diversion from expectations.

A patient may display tangible and intangible symptoms that should be factored in. If they are showing distress, this could indicate many issues, from discomfort to emotional frustration to something more serious that requires medical intervention. Interpretation is finding the root cause of the problem through a deep understanding of patient needs and keen observation.


Once the issue has been interpreted, the nurse will determine whether action should be taken and, if so, what action they will take. The severity of action taken will vary, making the previous two stages so important. The response should be intentional and accurate based on the patient’s needs.

Nurses employ their reasoning and critical thinking skills during this step. This could mean something seemingly simple, such as providing emotional support or adjusting their body to help them feel more comfortable. It could also mean adjusting the treatment to improve overall outcomes. These adjustments can only be made effectively by noticing, interpreting, and responding.


nurse portrait of nurse wearing scrubs and surgery garb

The final component in Tanner’s model is reflecting upon the response taken and observing the patient’s outcome. This reflection can occur internally and does not need to be systematic unless the patient reaches an undesired outcome. The nurse will then reevaluate the process to determine what went wrong.

This follows a cyclical pattern where a nurse is constantly going through the steps and, upon reflecting, reobserving to see if any additional action should be taken to support the patient. When practiced continually, this model becomes a second-nature way of thinking for nurses rather than something completed consciously.

Your Path to Nursing Starts at Notre Dame

At Notre Dame of Maryland University, equipping students with strong clinical judgment and decision-making skills is paramount. While ABSN students build their knowledge base with online coursework, they apply their learning to practical experiences in simulation labs and clinical rotations. There, students work with manikins and actual patients alongside experienced instructors so they can begin their careers prepared with clinical judgment skills in nursing.

Contact us today to learn more about the opportunities at NDMU’s Accelerated BSN program. Our admissions team looks forward to helping you take the first step toward a career in nursing.