A proficient nurse has made the leap beyond basic competence into a more holistic assessment of understanding of patient needs. Finally, the expert nurse no longer relies upon clearly articulated analytical rules of judgment regarding patient diagnosis and treatment at all, but can proceed to judgment on a more intuitive, but still rational level. The expert can deploy both creative thinking and rational thinking simultaneously and effectively in the clinical environment.

             Discuss the ways in which the nursing process contributes to effective clinical decision-making.

             The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse's personal qualities as well as upon the setting of the assessment. (Quan, 2006) For example, during the assessment, increased knowledge on the part of the nurse practitioner leads to greater clinical accuracy in judgment. The more experienced nurse knows what to look for, based upon clinical knowledge and personal experience, and can use that observed and filtered knowledge in making a more competent diagnosis. A more competent diagnosis leads to a better-planned and implemented course of treatment, and a better assessment of how and if the treatment is working. (O'Reilly, 1993).

             But treatment is not merely a checklist. Intuition is also said to be the hallmark of expert judgment, where intuitively on a subconscious level accumulated knowledge 'kicks in' in helping the nurse understand what, if anything, in the patient's state of health may be wrong. Creative thinking when assessing the patient's psychological and physical state, the ability to fuse emotion and reasoning in the mind of the seasoned nurse, can lead to a better mental selection of important data and a more effective diagnostic conclusion. (O'Reilly, 1993).

             Also, self-concept, the empowered use with confidence of one's knowledge that comes with experience and the practice of years can increase the speed and efficacy of the planning of the treatment and its implementation and evaluation.