The art of noticing: essential to nursing practice

Abstract

Noticing is integral to the everyday practice of nurses; it is the pre-cursor for clinical reasoning, informing judgement and the basis of care. By noticing the nurse can pre-empt possible risks or support subtle changes towards recovery. Noticing can be the activity that stimulates action before words are exchanged, pre-empting need. In this article, the art of noticing is explored in relation to nursing practice and how the failure to notice can have serious consequences for those in care.

Blending teaching strategies to improve nursing students’ clinical judgment abilities

“…The literature indicated that nursing students need the necessary support to understand and articulate what they notice and to recognize its relevance. [34,38] The clinical instructor can coach students throughout the clinical day while undertaking patient care responsibility and during the post-conference when debriefing and reflecting on daily encounters. Students' active engagement in these debriefings will enhance the "narrative-reflective" reasoning pattern, [32] formally identified by Tanner [34] as the "narrative" reasoning style.…”

“…Engagement in clinical judgment parallels what other authors have termed as "noticing". [23,38] Noticing is the ancestor for both clinical reasoning and clinical judgment. It is only possible when students link clinical experiences with formal learning and knowledge of the particular patient's patterns of responses.…”

“…It is only possible when students link clinical experiences with formal learning and knowledge of the particular patient's patterns of responses. [38] Poor attention to patients' needs and modest communication are the factors hampering these processes. [38] Linking students with more experienced nurses who are able to effectively mentor or precept will add to the previous interventions.…”

“…[38] Poor attention to patients' needs and modest communication are the factors hampering these processes. [38] Linking students with more experienced nurses who are able to effectively mentor or precept will add to the previous interventions. Preceptors can draw students' attention to not only the technical aspects of care, but also to the social and emotional subtleties that, when noticed, will prevent unnecessary patient suffering.…”

“…Preceptors can draw students' attention to not only the technical aspects of care, but also to the social and emotional subtleties that, when noticed, will prevent unnecessary patient suffering. [38] This may require assigning students their own caseload, while maintaining their supernumerary status, rather than using them as nursing assistants. [40] The effective preceptorship or clinical teaching strategies will subsequently strengthen deep thought processes to establish clinical judgment in nursing students.…”