Chapter 13: Blended Competencies, Clinical
Reasoning, and Processes of Person-Centered
Care
Key Terms:
● Blended competencies: the set of intellectual, interpersonal, technical, and ethical/legal capacities
needed to practice professional nursing
● Caring: moral imperative that guides nursing praxis (education, practice, and research); action and
competencies that aim toward the good and welfare of others
● Clinical judgment: refers to the result (outcome) of critical thinking or clinical reasoning; the
conclusion, decision, or opinion a nurse makes
● Clinical reasoning: a specific term usually referring to ways of thinking about patient care issues
(determining, preventing, and managing patient problems); for reasoning about other clinical issues
(e.g., teamwork, collaboration, and streamlining workflow); nurses usually use critical thinking
● Concept mapping: instructional strategy that requires learners to identify, graphically display, and link
key concepts
● Creative thinking: a process involving imagination, intuition, and spontaneity-factors that underpin the
art of nursing.
● Critical thinking: thought that is disciplined, comprehensive, based on intellectual standards, and, as a
result, well-reasoned; a systematic way to form and shape one’s thinking that functions purposefully
and exactingly
● Critical thinking indicators: evidence-based descriptions of behaviors that demonstrate the knowledge,
characteristics, and skills that promote critical thinking in clinical practice
● Decision making purposeful, goal-directed effort applied in a systematic way to make a choice among
alternatives
● Intuitive problem-solving direct understanding of a situation based on background of experience,
knowledge, and skill that makes expert decision making possible
● Nursing process: five-step systematic method for giving patient care; involves assessing, diagnosing,
planning, implementing, and evaluating
● Person-centered care: model of patient care based on holistic roots in which the nurse or other
caregiver uses every clinical encounter to assess how the person is doing and to communicate respect,
compassion, and care
● Quality and safety education for nurses (QSEN): stands for quality and safety education for nurses, a
project for preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to
continuously improve the quality and safety of the health care systems within which they work
● Reflective practice: occurs when the caregiver has a profound awareness of self, and one’s own biases,
prejudgments, prejudices, and assumptions, and understands how these may affect the therapeutic
relationship
● Scientific problem solving systematic problem-solving process that involves (1) problem identification,
(2) data collection, (3) hypothesis formulation, (4) plan of action, (5) hypothesis testing, (6)
interpretation of results, and (7) evaluation resulting in conclusion or revision of the study
● Standards for critical thinking: clear, precise, specific, accurate, relevant, plausible, consistent, logical,
deep, broad, complete, significant, adequate (for the purpose), and fair
● Therapeutic relationship: relationship between the caregiver and patient that is focused on promoting
or restoring health and well-being of the patient
, ● Thoughtful practice: the care of a patient by a clinician who utilizes clinical reasoning and reflective
practice to guide thoughtful actions and person-centered processes of care
● Trial-and-error problem solving method of problem solving that involves testing any number of
solutions until one is found that works for that problem
Key Concepts:
● A thoughtful nurse is considerate and compassionate, keeping the person at the center of all
deliberations in order to promote the humanity, dignity, and well-being of the person being cared for.
● Professional nursing requires cultivated personal attributes, mastery of the science of nursing, and
reflective clinical experience in which nurses develop the blended and QSEN competencies that
promote thoughtful and effective patient-centered practice.
● Nurses who practice patient-centered care are committed to developing caring professional
relationships based on respect and mutual trust. This holistic approach, which is consistent with
theories based on human caring, seeks to promote humanism, health, and quality of living. Caring is
viewed as universal and is practiced through interpersonal relationships.
● Personal attributes that prepare you for thoughtful patient-centered care include open-mindedness, a
profound sense of the values of the person, self-awareness and knowledge of your own beliefs and
values, a sense of personal responsibility for your actions, motivation to perform to the best of your
ability because you care about the well-being of those entrusted to your care, leadership skills, and
bravery to question “the system.”
● Nurses aim to design and manage each patient’s care scientifically, holistically, and creatively. To do
this successfully, you need many cognitive, technical, interpersonal, and ethical and legal competencies.
You must be willing to sue these competencies creatively and critically when working with patients to
promote or restore health, prevent disease or illness, and facilitate coping with altered functioning.
● Critical thinking is a systematic way to shape your thinking. It functions purposefully and exactingly.
Critical thinking is thought that is disciplined, comprehensive, based on intellectual standards, and, as a
result, well-reasoned. Nurse critical thinkers work methodically through five types of considerations:
the purpose of thinking, adequacy of knowledge, potential problems, helpful resources, and critique of
judgment/decision.
● When a procedure demands manual dexterity or a complex series of steps, practice the necessary skill
until you feel confident in its execution before attempting to perform it with a patient. Never be
ashamed to ask for help when feeling unsure of how to perform a procedure or manage equipment.
● Interpersonal skills are essential to the practice of thoughtful patient-centered practice. Interpersonal
caring involves promoting the dignity and respect of patients as people and establishing a caring
relationship. As a result, both you and the patient experience mutual enrichment.
● Nurses who prize their role in securing patient well-being are sensitive to the ethical and legal
implications of nursing practice. Although it can take years to master effective patient advocacy skills
and become proficient in mediating ethical conflict, even beginning nurses are responsible for certain
basic ethical skills and for legally prudent practice.
● The overall foal of the Quality and Safety Education for Nurses (QSEN) project is to meet the challenge
of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to
continuously improve the quality and safety pf the health care system within which they work.
● May use the terms critical thinking, clinical reasoning, and clinical judgement interchangeably.
Clinical reasoning-a specific term-usually refers to ways of thinking about patient care issues
(determining, preventing, and managing patient problems). For reasoning about other clinical issues
(e.g., teamwork, collaboration, and streamlining workflow) nurses usually use critical thinking. Clinical
judgment refers to the result (outcome) of critical thinking or clinical reasoning-the conclusion,
decision, or opinion you reach.
Reasoning, and Processes of Person-Centered
Care
Key Terms:
● Blended competencies: the set of intellectual, interpersonal, technical, and ethical/legal capacities
needed to practice professional nursing
● Caring: moral imperative that guides nursing praxis (education, practice, and research); action and
competencies that aim toward the good and welfare of others
● Clinical judgment: refers to the result (outcome) of critical thinking or clinical reasoning; the
conclusion, decision, or opinion a nurse makes
● Clinical reasoning: a specific term usually referring to ways of thinking about patient care issues
(determining, preventing, and managing patient problems); for reasoning about other clinical issues
(e.g., teamwork, collaboration, and streamlining workflow); nurses usually use critical thinking
● Concept mapping: instructional strategy that requires learners to identify, graphically display, and link
key concepts
● Creative thinking: a process involving imagination, intuition, and spontaneity-factors that underpin the
art of nursing.
● Critical thinking: thought that is disciplined, comprehensive, based on intellectual standards, and, as a
result, well-reasoned; a systematic way to form and shape one’s thinking that functions purposefully
and exactingly
● Critical thinking indicators: evidence-based descriptions of behaviors that demonstrate the knowledge,
characteristics, and skills that promote critical thinking in clinical practice
● Decision making purposeful, goal-directed effort applied in a systematic way to make a choice among
alternatives
● Intuitive problem-solving direct understanding of a situation based on background of experience,
knowledge, and skill that makes expert decision making possible
● Nursing process: five-step systematic method for giving patient care; involves assessing, diagnosing,
planning, implementing, and evaluating
● Person-centered care: model of patient care based on holistic roots in which the nurse or other
caregiver uses every clinical encounter to assess how the person is doing and to communicate respect,
compassion, and care
● Quality and safety education for nurses (QSEN): stands for quality and safety education for nurses, a
project for preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to
continuously improve the quality and safety of the health care systems within which they work
● Reflective practice: occurs when the caregiver has a profound awareness of self, and one’s own biases,
prejudgments, prejudices, and assumptions, and understands how these may affect the therapeutic
relationship
● Scientific problem solving systematic problem-solving process that involves (1) problem identification,
(2) data collection, (3) hypothesis formulation, (4) plan of action, (5) hypothesis testing, (6)
interpretation of results, and (7) evaluation resulting in conclusion or revision of the study
● Standards for critical thinking: clear, precise, specific, accurate, relevant, plausible, consistent, logical,
deep, broad, complete, significant, adequate (for the purpose), and fair
● Therapeutic relationship: relationship between the caregiver and patient that is focused on promoting
or restoring health and well-being of the patient
, ● Thoughtful practice: the care of a patient by a clinician who utilizes clinical reasoning and reflective
practice to guide thoughtful actions and person-centered processes of care
● Trial-and-error problem solving method of problem solving that involves testing any number of
solutions until one is found that works for that problem
Key Concepts:
● A thoughtful nurse is considerate and compassionate, keeping the person at the center of all
deliberations in order to promote the humanity, dignity, and well-being of the person being cared for.
● Professional nursing requires cultivated personal attributes, mastery of the science of nursing, and
reflective clinical experience in which nurses develop the blended and QSEN competencies that
promote thoughtful and effective patient-centered practice.
● Nurses who practice patient-centered care are committed to developing caring professional
relationships based on respect and mutual trust. This holistic approach, which is consistent with
theories based on human caring, seeks to promote humanism, health, and quality of living. Caring is
viewed as universal and is practiced through interpersonal relationships.
● Personal attributes that prepare you for thoughtful patient-centered care include open-mindedness, a
profound sense of the values of the person, self-awareness and knowledge of your own beliefs and
values, a sense of personal responsibility for your actions, motivation to perform to the best of your
ability because you care about the well-being of those entrusted to your care, leadership skills, and
bravery to question “the system.”
● Nurses aim to design and manage each patient’s care scientifically, holistically, and creatively. To do
this successfully, you need many cognitive, technical, interpersonal, and ethical and legal competencies.
You must be willing to sue these competencies creatively and critically when working with patients to
promote or restore health, prevent disease or illness, and facilitate coping with altered functioning.
● Critical thinking is a systematic way to shape your thinking. It functions purposefully and exactingly.
Critical thinking is thought that is disciplined, comprehensive, based on intellectual standards, and, as a
result, well-reasoned. Nurse critical thinkers work methodically through five types of considerations:
the purpose of thinking, adequacy of knowledge, potential problems, helpful resources, and critique of
judgment/decision.
● When a procedure demands manual dexterity or a complex series of steps, practice the necessary skill
until you feel confident in its execution before attempting to perform it with a patient. Never be
ashamed to ask for help when feeling unsure of how to perform a procedure or manage equipment.
● Interpersonal skills are essential to the practice of thoughtful patient-centered practice. Interpersonal
caring involves promoting the dignity and respect of patients as people and establishing a caring
relationship. As a result, both you and the patient experience mutual enrichment.
● Nurses who prize their role in securing patient well-being are sensitive to the ethical and legal
implications of nursing practice. Although it can take years to master effective patient advocacy skills
and become proficient in mediating ethical conflict, even beginning nurses are responsible for certain
basic ethical skills and for legally prudent practice.
● The overall foal of the Quality and Safety Education for Nurses (QSEN) project is to meet the challenge
of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to
continuously improve the quality and safety pf the health care system within which they work.
● May use the terms critical thinking, clinical reasoning, and clinical judgement interchangeably.
Clinical reasoning-a specific term-usually refers to ways of thinking about patient care issues
(determining, preventing, and managing patient problems). For reasoning about other clinical issues
(e.g., teamwork, collaboration, and streamlining workflow) nurses usually use critical thinking. Clinical
judgment refers to the result (outcome) of critical thinking or clinical reasoning-the conclusion,
decision, or opinion you reach.
