Newman’s theory of Health as Expanding Consciousness served as the theoretical framework to study the phenomenon of clinical reasoning. Newman’s Research as Praxis methodology was used to collect and analyze data. Individual interviews were conducted with seven participants. Together with the participants, the researcher gained an understanding of how the participants made decisions through the clinical reasoning process.
Patterns of individual participants and across participants were examined to gain an understanding of the whole pattern of clinical reasoning. The patterns of relating, knowing, and decision-making emerged in the participants and contributed to the evolving pattern of clinical reasoning. The meaning of clinical reasoning for these participants was establishing a relationship with a patient to interact and connect with them. Through formulation of a connection and trusting relationship, participants gained information to make clinical decisions that facilitated a transformation. The evolving pattern of clinical reasoning was a maturing process over time as the participants gained insight and expanded consciousness through multiple experiences and interactions with members of the interprofessional team and the instructor.
Implications for nursing science and research include that pattern recognition by the participants in nurse-patient interaction substantiate empirical support for the Health as Expanding Consciousness theory. The findings broadened the theory to how students think in the clinical area. In both education and practice prolonged engagement facilitates nurse-patient interaction to learn patient patterns. Collaboration with members of the interprofessional team inspires the understanding of another’s thinking process. As a result of this study the researcher broadened the application of the Health as Expanding Consciousness theory beyond clinical instruction and collaborated with a pharmacist in the development and implementation of an undergraduate nursing pharmacology course. Students gain insight into pharmacological principles from both a pharmacist and nurse perspective. Therefore students expand their consciousness and apply these principles to the clinical reasoning process when interacting with patients and administering medications.
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