13
Chapter
2
Model for thoughtful practice
The conceptual model provides a representation of how the
important concepts inherent in professional, person-centred
practice interrelate. In the context of medical-surgical nursing,
a thoughtful practitioner is a nurse who is considerate and com-
passionate, keeping the person at the centre of deliberation in
order to promote the humanity and dignity of the person
being cared for. At the same time, the nurse acts as a moral
agent, preserving respect for the person and providing the care
while examining the situation in order to learn. Inherent in
thoughtful practice is an acknowledgement of the influence
of power within institutional systems. Thoughtful care seeks
to empower individuals to choose their own health pathway.
To achieve this, essential care is delivered through processes
that are holistic and tailored to meet the individual needs of
the person. Care-related decisions are based on ethical and
Thoughtful practice
L E A R N I N G O B J E C T I V E S
On completion of this chapter, you should be
able to:
1
Examine the components of thoughtful practice and define
the links between thoughtful practice, motivation, moral
agency and person-centred care.
2
Outline the key components of clinical reasoning and
explain how different types of thinking inform clinical
reasoning.
3
Explain how clinical judgement and decision making relate
to clinical reasoning.
4
Discuss ethical principles and how these relate to nursing
care.
5
Explain the importance of reflection and self-awareness for
professional self-assessment and development.
6
Identify key components of cultural assessment and apply
culturally safe nursing principles, concepts, and theories
when providing nursing care to individuals, families, groups,
and communities.
7
Identify the use of the nursing process for optimising
patient outcomes during a period of nursing care.
8
Identify the use of the nursing process conceptually
by describing the purposes and significance of health
education and health promotion and the role of the nurse
in patient education using the nursing process.
K E Y T E R M S
assessment
clinical judgement
clinical reasoning
collaborative problems
community
creative thinking
critical thinking
cues
cue acquisition
culturally competent
nursing care
cultural nursing
assessment
culture
decision making
deontological or formalist
theory
ethics
evaluation
health education
health promotion
implementation
intuitive thinking
learning
minority
moral agency
moral dilemma
moral distress
moral problem
moral uncertainty
morality
nursing diagnoses
nursing process
planning
personhood
person-centredness
person-centred care
problem solving
reflection
responsibility
self-awareness
subculture
teaching
teleological theory or
consequentialism
therapeutic regimen
transcultural nursing
utilitarianism
wellness
systematic reasoning processes that are evaluated and reviewed
through reflective practice so that there is continual
learning
in and from practice for the benefit of future care encounters.
Definition and theoretical basis
The Macquarie Dictionary
(2009) defines being thoughtful as
being given to or marked by thought, being careful or mindful,
and being considerate. Therefore, being thoughtful is an
amalgamation of the reasoning for practice, the consideration
of all aspects of the situation including its practicalities, the
learning from practice, and the affective process of considering
the needs of others. Medical-surgical nursing is an example of
how these processes are integrated into a form of practice that
requires well-developed cognitive processes of clinical rea-
soning that is founded on a solid knowledge base of anatomy,
physiology, epidemiology, pharmacology and sociology. The
application of this knowledge and learning through
reflection
