NR-512 Discussion Week 2, Wisdom Versus Judgement (Two Versions)

Week 2: Wisdom Versus Judgment How does the concept of wisdom in nursing informatics compare to the concept of professional nursing judgment? What is DIKW and how do you "use" it in your practice? Initial post: 3/12 Our text book defines wisdom as “knowledge applied in a practical way or translated into actions” (McGonigle & Mastrian, 2018). I believe the concept of wisdom in nursing informatics and the concept of professional nursing judgement work together. Nursing informatics uses computer science to organize data in a manner that enhances and assists the bedside nurse in the care of the patient. Wisdom in nursing informatics is utilizing data from the computer, such as lab value trends and vital signs, and making changes to the patient care or calling the physician immediately due to a change in the patient’s condition. The nurse is using her professional nursing judgment by actively taking her own personal knowledge base from nursing school and clinical practice, as well as the computer data and information and coming up with a plan of care. For example, at change of shift the patient was resting quietly in bed and the lights turned low. The nurse knew the patient was being treated for a GI bleed and monitoring H+H every 4 hours. The next result came in the computer and the nurse noted the Hgb was 6.7. The nurse quickly went into the patient’s room and turned on the lights to better examine the patient’s pallor. The patient was pale and weak. The nurse knew to look for active signs of bleeding and report the findings to the physician. The nurse prepared for the physician to order a blood transfusion. DIKW stands for data, information, knowledge and wisdom. It is a paradigm used related to nursing informatics. Data is the facts. Information is clusters of data with more meaning. Knowledge is the understanding of the information and data. Wisdom is using the knowledge after interpreting the data and information to guide the situation and make decisions. This paradigm is not only used in nursing (McGonigle & Mastrian, 2018). DIKW are always in motion and their relationship with the other. The model created by Ramona Nelson as a visual representation of the DIKW concept shows the increase in complexity and increase in interactions and relationships within model (McGonigle & Mastrian, 2018). As a bedside nurse, I am constantly using this model (unknowingly) to decipher and treat my patient and their condition. I take report at the beginning of the shift and have a basic understanding of the data and information. My nursing knowledge is then applied to the data and information given in report as well as my own assessment of the patient and review of the computer chart. Then, I take the knowledge, information and data and can plan and prioritize what the patient needs most from me as the nurse in the wisdom phase. As I move through the day, the complexity of the patient’s data and information increases as well as the relationship and interactions. Reference: McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett. Instructor post: 3/13 Class, Thank you for starting off our week 2 discussion on the DIKW framework. It is somewhat difficult to explain clinical or informatics wisdom since we all have different paths of knowledge and experience in our nursing specialties. Is having wisdom relevant to your current or future specialty? In your opinion, how long do you think it takes to achieve wisdom in your clinical specialty? Where would you place yourself now on the wisdom meter? Is there a role model in your nursing career who has displayed extraordinary wisdom? Dr. Anderson I believe wisdom is very relevant in my current nursing career as well as my future specialty as an FNP. I have gained wisdom over the 10 years working as a bedside nurse. As in the DIKW framework, nursing school data becomes information which becomes knowledge which becomes wisdom as we continue to work and grow with experiences and interactions with patients. I feel it is similar to Benner’s Novice to Expert stages in nursing. I would gage my wisdom meter as 8 out of 10 in the ICU world of nursing. I have switched to hospice nursing this week and would rate myself 6 out of 10 because it is a new specialty for me. I will take previous wisdom in nursing into this new role; however, it will take a few more years of experience, education and knowledge with patient interactions to grow in wisdom as a hospice nurse and FNP. A nurse and role model who stands out the most to me and displays 10 out of 10 on the wisdom meter is a girl name Libby. She was my preceptor for ICU and had 15 years of previous nursing experience. I admire her skill level and knowledge in nursing and was humbled (and very intimidated) to train with such a great nurse. She was always open and willing to teach anyone who had a question during the shift, even if she was busy with her own patient’s. I hope to some day achieve such wisdom as my dear Libby. Peer post: Ryan, Thank you for sharing your insight regarding nursing wisdom. I like your reference to a “wise nurse” yields better results. As we all know, nurses all work together to care for patients. Some nurses on your unit have been a nurse for 20+ years and some have worked only 6 months. I believe we all have something to learn from each other. As much as I love working with “wise nurses” who have been nursing for a long time with many years of experience, knowledge, and wisdom to share, I also love working with new nurses. I believe mixing the strengths and weaknesses of both wise nurses and new nurses help patient care as well as each other. I remember nurses used to “eat their young” but now we are changing that mentality. New nurses help keep my nursing skills fresh and up-to-date. Precepting a new nurse to the unit gives you the chance to really embrace the relationship of nursing. We want to share our wisdom with new nurses as well as they can share their knowledge that can be much fresher in their mind than those of us who went to nursing school many years ago.