As I have read the lesson and assigned reading for this week, I have concluded that wisdom

and professional nursing judgement are very similar. Wisdom is the use of knowledge to deal

with complex problems or human needs. It involves the use of knowledge, experience, insight,

and understanding and the application of this knowledge to solve human problems. It is

gained through experiences, which we build on to form our clinical judgements (Matney, Avant,

& Staggers, 2016). According to Benner, "nursing wisdom is based on clinical judgement and

encompasses intuition, emotions, and senses" (Matney, et al., 2016).

In Benner's theory, novice to expert, a novice is seen as a new graduate in the beginning

stages of their learning. An advanced beginner is the next level that can provide adequate

care, but has difficulty associating knowledge from a previous experience to a current

practice. In the competent level, the nurse now has a few years experience and is able to

m
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prioritize and identify different aspects of care and can now begin to easily include previous

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experiences in their decision making. As skills and experiences build, the nurse advances to

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the proficient level. It is here that the nurse can prioritize care and is able to recognize

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deviations from the norm. After several years of experience, the nurse reaches the expert
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level. Here the nurse is able to make decisions based on her intuition from years of experience

and knowledge that has been gained over time (Dale, Drews, Dimmitt, Hildebrandt, Hittle, &
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Tielsch-Goddard, 2013).
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As one gains more knowledge and experience, one's nursing judgement also increases and

becomes more reliable. Wisdom, or the application of that knowledge to manage and solve
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human problems increases. Nursing judgement is based on clinical reasoning that includes
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weighing evidence, recognizing patterns, reflecting on past experiences to come to conclusions

or decisions regarding a patients' needs or to solve a clinical problem (Ashley & Stamp,
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2014).
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DIKW stands for data, information, knowledge and wisdom. Data is symbols that describe

objects, events and their environment, that alone has little or no meaning. Information is data

that is given meaning. Knowledge is when patterns or relationships are formed between
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different types of information. Wisdom is the use of that knowledge to explain human

problems (Matney, et al., 2016).

The DIKW framework is used in everyday nursing care. An example of this is the evaluation of

vital signs. For instance, a blood pressure reading of 88/40 alone does not mean a whole lot.

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 When this information is combined with other information, such as the patient is also dizzy and

has taken a double dose of his beta blocker, there is now a relationship between the low blood

pressure reading,

dizziness and use of beta blockers which may be a cause of the problem. Once this

relationship is established wisdom now takes over. Based on the nurses' previous

experiences, the nurse knows that this information needs to be relayed to the provider to

obtain orders for intravenous fluids to correct the low blood pressure and to continue to

monitor the patient for other complications that may arise. As we provide daily care to our

patients we are constantly using the DIKW framework to evaluate and make decisions

regarding what we do based on what we observe and pertinent findings from testing that help

us to plan safe and appropriate patient care.

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references

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Ashley, J., & Stamp, K. (2014). Learning to think like a nurse: The development of clinical
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judgement in nursing students. Journal of

Nursing Education, 53(9), 519-525.

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aC s
vi y re

Dale, J., Drews, B., Dimmitt, P., Hildebrandt, E., Hittle, K., & Tielsch-Goddard, A. (2013). Novice

to expert: The evaluation of an

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advanced practice evaluation tool. Journal of Pediatric Health Care, 27(3), 195-201.
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doi: 10.1016/j.pedhc.2011.12.004
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Matney, S., Avant, K., & Staggers, N. (2016). Toward and understanding of wisdom in
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nursing. Online Journal of Issues in Nursing, 21

(1), 7.

doi: 10.3912/OJIN.Vol21No01PPT02
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