[Sharon]

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

[Jaswinder]

In the hospital, once I had to make an instant decision when multiple patients needed assistance at the same time. One patient asked for help to go to the washroom, another requested for pain killer and third need their vital signs to be taken. I had to decide which patient to help first.
Through the decision making process I was able to decide which situation is most important. I prioritized the patient safety and considered the potential consequences of delaying care. I decided to help first the patient who need assistance to go to bathroom because waiting could result in fall.
After that I administered the medication to other patient and then checked the vitals. I learned from this experience how prioritizing the task is important in nursing. When more than one patients require assistance at once. The decision making process helps nurses to stay organized and selecting the best way to take action.

[Cheryl]

It can so difficult to have to prioritize tasks so quickly in the moment but it sounds like you made the right decisions with the least amount of impact to your patients! That is always the ultimate goal: making good decisions to meet high demands but in a safe manner that doesn’t compromise patient care! Well done I would say!

[Thea]

Hi Jaswinder,
Your example shows how important decision-making and prioritization are in nursing. It’s common for nurses to have several patients needing help at the same time, so deciding what to do first is key. You made the right choice by helping the patient to the washroom first, since waiting could have led to a fall or injury. Putting patient safety first is always most important.

It’s also good that you took time to reflect on what happened. Experiences like this help nurses build better judgment and time-management skills. Having a clear way to make decisions helps nurses stay organized, manage risks, and give safe care, even when things get complicated.

[Cheryl]

Every day is full of decision making and hoping we make the correct ones! Today, I have a leaking ceiling in one of our offices. It is not severe, although it is posing an issue as it is dripping directly where a staff sits. There is other vacant office space, there made the decision to relocate their office space for their health and safety. The staff felt they could manage ok and were not really pleased with this move, however, a larger issue could be in the near future not to mention a risk with water dripping near electrical cords etc. Other alternatives were explored, however, relocating seems to be the safest route.

[Shea]

I think you made a smart and responsible decision. Even though the staff weren’t thrilled about moving, prioritizing safety and preventing potential hazards is really important. Considering other options and choosing the safest one shows thoughtful decision making.

[Brittany]

Smart and practical choice. Although I am sure they were not happy with the relocation, which is understandable, I’m sure they were grateful for your leadership after the fact.

[Shea]

One example of a decision I made at work was deciding whether to give a resident their medication early because they were very anxious and upset. Before deciding, I paused and reviewed the resident’s care plan, checked with the charge nurse, and considered possible effects of giving the medication early. By going through this process, I was able to make a safe decision that calmed the resident without causing any harm. I think following a structured decision-making process helped me weigh the risks and benefits, consider alternatives, and ensure the decision was safe and appropriate for the resident.

[Jaswinder]

Thanks for sharing your experience of safe and professional decision making in nursing practice. Checking the care plan, discussing with the in charge nurse and considering the potential risks and benefits shows a careful approach. By considering patient’s needs and safety helped to make right decision. Providing support to the patients when they were feeling nervous during procedure shows good judgment and compassion which are important in providing care in difficult situations.

[Thea]

Decision-making is important in nursing because nurses often have to act quickly while considering what is best for the patient. For instance, I once looked after a long-term resident who suddenly stopped eating and became more withdrawn. At first, they might just be having an off day, which can happen. But I had to decide whether to watch and wait or to investigate further.

I decided to assess the resident’s condition more closely. I checked their vital signs, read recent notes, and talked with them about how they were feeling. I also asked other team members for their thoughts. We discovered the resident was in pain, which explained the changes in their appetite and mood. After we shared what we found and started the appropriate care, the resident improved.

Thinking back, using a formal decision-making process could have helped, as it encourages nurses to gather information, consider different options, and anticipate the consequences of each choice. Decision-making models by Jasovsky and Kamiensky (2007) and Kelly and Crawford (2012) emphasize assessing the situation, exploring alternatives, and considering possible outcomes before taking action. Even though I did many of these things naturally, being more aware of the process can help nurses make better choices in the future.

[Marion Catherine]

Hi Thea, I appreciate your situation very much and am now understanding that the decision-making process is intuitive. In recognizing that (as a result of reading your reflection) I need to be more conscious of the application of the decision-making framework so that my thoughts, intentions, and interventions are clear for anyone at any given time. Your reflection supported my learning more about how this process unfolds as it is used – thank you!

[Marion Catherine]

As I reflect on the posted scenario described in the first question, it seems that the decision-making process was applied, only I was not conscious of using it. And as I am onsite 3 days a week, an evaluation of the outcome of my suggestion to go to the Union and then leaving the nurses’ station to return to the unit will not be clearly known for a few more days. The follow up on this drags the process out but it is a significant lesson learned.
Had I consciously applied the decision-making process, I likely would have explained to the PSWs and the other RPN my thought process and what I was engaging in to let them know that I was not avoiding their concerns but rather supporting them by covering the unit while they were discussing the next steps in resolving their work load expectations.

[Tammy]

quick decision making seems to always be needed as a nursing manager. the other day there was an unexpected death on our floor. it was right at breakfast time when the charge nurse need to be administering medications to all residents. I made the very quick decision to jump in and follow our unexpected death policy to support my team and quickly report to senior leadership that my support was needed, missing an meeting that morning.

[Angusami]

Swift decision-making is very important in clinical practice. During one of my shift, we had a fire alarm buzzing. It was notified to us that the fire was located on the floor above us and just right above one of our resident rooms. Initially, there was smoke detected in our resident room. I called on our PSW staff members, and I made a quick decision to move our resident out of the room. PSW staff provided timely assistance and moved the resident. After a few minutes, our resident room had a sprinkler break — because of the fire upstairs—and flooded the room. It was a challenging time that warranted quick decision to safeguard our resident and I am thankful to our staff who did an amazing job.

[Vanessa]

I advocated strongly for a health and safety recommendation that I believed would benefit workers, but when the JHSC declined it, I respected the process and took the time to listen to their concerns. Even though as co chair I wanted to push the recommendation forward, I recognized the importance of collaborative decision making and chose not to pursue it further.

[Brittany]

As a fellow JHSC leader and member, I understand it is hard not to pursue further. You did the right thing by bringing it forward, and if it becomes an issue in the future, it is documented that you advocated for change. Never be afraid to speak up. 🙂

[Sharon]

I agree Angusami;
Swift decision-making is very important in clinical practice. During one of my shift working at an overnight Respite facility I was informed that a client was exhibiting aggressive behaviours towards another client. I quickly decided to remove the client at risk to another location and tried to de-escalate the situation. The safety of the non-aggressive client and the safety of the staff is always the highest priority, requiring immediate action.

[Brittany]

A recent example of decision-making at work occurred last week when our clinic experienced a scheduling error that resulted in several double-booked appointments. At the same time, our EMR system began to go down, which typically shows subtle warning signs beforehand. Recognizing these early signs, I quickly anticipated that we might lose access to patient information. Acting proactively, I printed the schedule to ensure we had access to patient names and contact details. Once this backup was secured, I shifted my focus to maintaining clinic flow by rooming patients, taking vital signs, and assisting the PCP to reduce their workload during the disruption.

My decision-making process was: identifying early warning signs, anticipating potential system failure, and prioritizing patient flow, helped minimize delays and maintain organization during a chaotic situation. This approach ensured that patient care continued as smoothly as possible despite the technical and scheduling challenges.

[Author]

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