[Sharon]

Think of an example of a decision you made at work; would the decision-making process have helped?

[Katherine]

I had a client with schizoaffective disorder became anxious and refused to attend a group session. I initially thought about insisting he participate, but that could have increased his anxiety.

Using a decision-making process would have helped me be more systematic: identifying the problem, gathering information, considering alternatives, weighing risks, and implementing the best option. I chose to offer a one-on-one session first, which helped the client re-engage with the group and maintained trust.

Reflecting on it, following a formal process would have ensured I considered all factors before acting.

[Stephanie]

Thanks for sharing! its great to see how the decision making process could have bettered your therapeutic relationship with this patient and ensure they were continuing with there treatment by making adjustments that would work better for them!

[Stephanie]

Think of an example of a decision you made at work; would the decision-making process have helped?

An example of Decision-making that i have made at work would be when a co-worker started to have a patient who was not doing well and required some immediate attention and care. They had received orders from the Doctor and needed to implement these. At the time I wasn’t sure what was going on however I just kept continuing hear the nurse telling everyone about her patient and getting too many people involved in the orders and trying to figure it out. This is when i noticed that the patient orders hadn’t even been started and there were just too many hands in the pot. This is when i made the decision to take the nurse aside and speak with them about the issue, encouraged them to just begin with the orders provided and i would assist her without having everyone involved and heightening the situation more. After i made the decision to assist her we were able to complete the orders together and provide the patient with the correct care as ordered by the Doctor at this time. I think if we can, nurses should try and use the decision making process as i feel it would have helped my co worker in this situation to better organize her heightened situation.

[Jessica]

That was so great you offered to help your co-worker. Team work is so important, especially in a field like Nursing where you’re either floating or sinking! Things can turn ugly quickly, and it’s so helpful to have a supportive Team to rely on when things get though. I agree with you and think the decision making process would have helped your coworker prioritize tasks and stay organized.

[Loubna]

Thank you Stephanie for sharing this great example. You showed strong teamwork and leadership by redirecting the nurse’s focus back to the patient’s care. I agree that the decision-making process use can really help nurses to stay organized and focused in challenging situations.

[Jessica]

I resonated with the decision making process activity because I have experienced very similar situations throughout my time working as an infection control professional.

An example of a similar situation that occurred was when we had a Palliative Patient who tested positive for Covid and was in isolation. Our Hospital policy outlines requirements for visiting Patients in isolation and has changed over the last few years, but at this time we were only allowing two designated care providers (one at a time) at the bedside for Covid positive Patients, and no children.
Despite the policy, we weighed the risks and benefits of the situation and allowed additional visitors and grandchildren to visit under the agreement they were agreeable to wearing the appropriate PPE and they understood the risks. There are situations in which things may not be black and white and exceptions can be made, especially at end of life.
The decision making process would have definitely helped in this situation, but I think we would have come to the same conclusion. No one should be refused the opportunity to say goodbye.

[Amit Kaur]

Hi Jessica
Thank you for sharing.Yes I agree no should be refused the opportunity to say goodbye.Decisions made empathetically by maintaining professional boundaries, build trust in nurse client relationship.

[Amit Kaur]

On the Weekend day shift it was a dispute resolution decision.
I was short with 1 PSw and only 2 Psw for 27 residents. Both PSWs were arguing with each other and affecting resident care,late for D/R,late for call bell response.
By considering resident care and safety top priority.I switched lower seniority PSW with another unit PSW with lowest seniority.I was able to prioritise my nursing duties and support both PSW.
The situation was reported to the supervisor,who appreciated taking the right step.

[Katherine]

I like how you prioritized resident safety while also managing staff conflict. It sounds like a challenging situation, but you handled it calmly and made a fair, practical decision by switching the PSW. Reporting it to your supervisor afterwards was also a great move, showing accountability and teamwork. Your approach really demonstrates effective problem-solving under pressure.

[Anastasia]

One decision I made at work was sending an additional PSW to assist a client who was becoming increasingly aggressive during personal care. The original PSW felt unsafe, and I had to decide quickly whether to send a replacement or provide support in another way. I chose to send a second staff member for safety and to maintain the client’s care plan.
Looking back, using a more structured decision-making process—such as assessing the situation using the steps of identifying the problem, gathering information, considering alternatives, and evaluating outcomes—would have helped. I made the decision based on instinct and experience, but a systematic approach could have helped me weigh factors like staffing availability, client history, and long-term safety planning. This would have ensured consistency and provided better documentation for accountability and future planning.

[Trudy]

Hi Anastasia,
That is quite a difficult decision, especially when it comes to ensuring safety. You have to think quickly, as events in situations like that can change rapidly. Good decision-making by calling in another staff member for additional support!

[Tina]

I have had to make many a decision at work over the last 27years. Sometimes it has been the right and sometimes it has not been the right decision.
One example I can think of at this time, was deciding to help the PSW’s with care of a resident, sometimes it has worked out that the decision was right based on that I was able to successfully help get the care provided and the resident up. On other occasions it has not worked, as the resident did not respond well to extra persons in the room, or me being there.
It can be a challenge at times to see if we are making the right decision, but I believe by assessing the situation, working with the team and evaluating what needs or can be done as a team, can help with the decision process in the work place.

[Stephanie]

I completely agree with the way you put that our decisions can be right and sometimes wrong. I like how you put assess the situation and work as a team. I agree it is a challenge and may not always work out. Thank you for putting into that aspect.

[Stephanie]

I think as nurses, we are always making decisions whether they are simple or complex. It is, in my opinion a huge part of being a nurse. Being great at decision making does come with time and experience.
I can think of many decisions over my short career, being made. People we give care to are ever changing, whether it is for good or bad. As long as we are considering all aspects of each individual, like cultural, religious/spiritual, family dynamics, social circles or ADL’s nurses are able to make appropriate decisions with the best interest of the resident/ client.

[Trudy]

We were very short-staffed staffed, which is not uncommon in nursing. This particular shift, we got someone from float pool. This person and one of the unit staff already had their differences from a previous situation. They both did not make the shift any easier, and instead, another co-worker and I found ourselves babysitting these two, trying to put out any fires that arose that day between the two. I decided to split the two co-workers apart. We had to buddy up to get all unit tasks and patient care completed. The decision-making process would have helped in providing more sensitive care to the situation and understanding. A structured approach would have provided both parties involved with better long-term solutions rather than band-aid solutions.

[Mauei Caela]

Hi Trudy,
Thank you for sharing your experience. I am very sorry that this happened to you, but your quick action to remedy the situation is amazing. Things could’ve been handled differently, like you said, but you worked with what you had and made it through the day. Your collaboration with your colleague shows good teamwork and rapport with each other. I find this really helpful despite having a bad day at work.

[Mauei Caela]

I remember a decision-making moment caring for a quadriplegic, non-verbal patient using an eye-gaze device in our chronic trach area. The SLP highlighted the dangling eye-gaze charger bar risked damage and costly replacement if wires loosened, suggesting placement in the bed but away from the patient. Evening PCAs repositioned it dangling, citing electrocution risk if short circuiting occurred in bed. I asked about SLP’s thoughts on electrocution risk; SLP assured wires were enclosed, risk arose if pulled and damaged.

Balancing concerns, I placed the charger bar on the patient’s side table (close to bed), avoiding dangling and bed proximity risks. This blocked wheelchair access for ceiling lift transfers; morning staff would reposition the table. I emailed my manager details: the issue, dual concerns, temporary solution, consequences, and suggestion – exploring a charger extension for safe placement.

This experience showcased weighing competing priorities – device preservation and patient safety – requiring thoughtful decision-making and proactive communication. My process involved identifying the problem, diagnosing it, discovering alternatives, implementing a solution, and planning follow-up. By considering multiple perspectives and finding a middle ground, I addressed immediate safety concerns while highlighting a potential long-term solution for safe charger management, demonstrating adaptability and patient-centered care in a complex situation effectively.

[Loubna]

When I was a new nurse in long term care, I faced a situation where a resident became very agitated and aggressive toward staff. The resident was attempting to hit anyone who came near. First, I tried to use calm communication and reassurance, but the behavior continued to escalate. At that moment, I had to make a quick decision to call code white to ensure everyone’s safety in the unit. Then, we were able to manage the situation safely without injuries. Reflecting on this experience, I realized how important the decision-making process in safe nursing practice.

[Viatcheslav]

The one situation from my practice which fits the question would be the decision to send the patient out to acute care.
During the rounds I noticed that patient, even though often quiet, is less alert than usual. Quick assessment confirmed their LOC was way below the baseline. Vital signs showed slight fever, but nothing else really stood out. Still concerned with how the patient is and knowing how easy the patient can crash, I contacted the doctor with my concerns of potential sepsis. Upon looking at the history of the patient, doctor agreed that there is a high risk and ordered to send them out.
It turned out that patient was in fact at the early stages of sepsis and have went fully in while being in ER.
Personal knowledge and decision-making process have played a big part in making the appropriate decision in this case.

[Kayla]

I can think of multiple situations where the deision making process would have helped. There was a time where we implimented a new procedure for safety in our clients homes, we created and implimented an in home safety assessment that is done on intake and reviewed before going into clients home for the first time. The decision making process would have been helpful to identify goals and alternative options. In the end it was evaluated and turned out to be a good new process and we have continued to use it

[Author]

Posts