Clinical decision making: a primer for preceptors.

The ability to apply the critical care nurses' knowledge, skills and attitudes to patient care requires clinical decision making at all phases of the patient-nurse interaction. As a novice critical care nurse, the patient care environment is often so complex as to overwhelm the orientee and prevent effective clinical decision making. This article includes a review of current strategies for teaching clinical decision making with special reference to critical care nursing. Relevant theoretical concepts in clinical decision making are applied to the clinical setting, particularly the orientation of novice critical care nurses. The approach is practical, with suggestions for the preceptor involved in the orientation process. As critical care nurses, we spend a major portion of our professional lives making decisions which will, to a greater or lesser extent, influence the hearts, the minds, and often the very survival of others. The process by which we make these decisions is sometimes mysterious even to the person making them. In order to improve our own decision making ability, and to enable us to teach new critical care nurses the skills needed in the critical care setting, we must explore and "demystify" this process.