Honours Bachelor of Science - Nursing Degree

Honours Bachelor of Science, nursing Nursing, Nurses

Nursing Relational Practice

According to Tanner (2006), the terms, "clinical judgement," "problem solving," and "critical thinking" are often used together.  However, Tanner (2006), defines clinical judgement in nursing to mean an interpretation about a patient's concerns or health challenges and/or the decision to take action, use accepted approaches or improvise new ones as considered by a patient's response.

According to Tanner (2006), clinical judgement in nursing involves four aspects:

  • Noticing
  • Interpreting
  • Acting
  • Reflecting

Caputi (2015) adds to this model by recommending that the development of clinical reasoning or judgement is the core of nursing education and allows nursing students to become self-directed thinkers who are able to make effective patient-centered health care decisions. Furthermore, effective clinical reasoning or judgement is crucial for preserving nursing care standards and good patient outcomes. Caputi's Clinical Judgement Framework includes these five steps:

  • Getting information
  • Making meaning of the information
  • Determining actions to take
  • Taking action
  • Evaluating outcomes and your thinking



L. McMaster (personal communication), March 9, 2023)

RNAO.(n.d.). Information and knowledge management. https://rnao.ca/sites/rnao-ca/files/eHealth_Section_4.pdf

Schoessler, Mary. (2013). Tanner's model of clinical judgement applied to preceptorship: part 1. Journal for Nurses in Professional Development, 29(5), 274-275. https://oce-ovid-com.georgian.idm.oclc.org/article/01709760-201309000-00012/HTML

This is requisite knowledge for establishing therapeutic relationships: background knowledge, knowledge of caring, knowledge of culture, diversity, knowledge of person, knowledge of health care and knowledge of systems

This illustration from the Registered Nurses Association of Ontario's Framework for Therapeutic Relationships breaks down the key aspects of therapeutic relationships for nurses including knowledge of culture, person, health/illness and systems.

The following guidelines are very helpful in understanding more about therapeutic nurse-patient relationships:



RNAO. (2006). Establishing therapeutic relationships supplement. https://rnao.ca/sites/rnao-ca/files/storage/related/943_BPG_TR_Supplement.pdf

Communication is an extremely important skill for the nursing profession.  According to the RNAO Best Practice Guidelines: Intra-Professional Collaborative Practice Among Nurses (2016), Recommendation 1.6 states that "Nurses promote open, honest and transparent communication" by:

  • Promoting a culture of effective communication
  • Establishing processes for verbal, written and electronic communication



RNAO. (2016). Intra-professional collaborative practice among nurses, second edition. https://rnao.ca/sites/rnao-ca/files/Intra-professional_Collaborative_Practice_7.pdf

chat loading... if this message persists, please try reloading your page.