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Using the Monologue of Doris Smith to Understand Situational Decision-Making


Teaching Strategies

Managing Complexity:
Using the Monologue of Doris Smith to Understand Situational Decision Making

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Overview of Teaching Strategy

Older adults are among the nurse's most complex clients. They represent a broad spectrum of strengths, needs, and expectations. Yet, nurses find themselves wondering if the care decisions they make produce the best outcomes for this population. This teaching strategy will use a monologue of a nurse who provided care for older adult, Doris, to address the need for effective situational decision making. This teaching strategy can be utilized in a variety of teaching/learning situations: didactic lectures; clinical settings such as post-clinical conference/debriefings; simulation scenario debriefings; or small seminar discussions. In addition, the teaching strategy can be used with practicing nurses as a professional development activity, as well as when orienting new graduate nurses.

Learning Objectives

The student/nurse will:

  • Assess the older adult's individualized pattern and functional status using standardized assessment tools.
  • Develop an understanding of the need to consider the expectations of the older adult on the same level as the priorities of the health care team.
  • Describe the complexities involved in making care decisions for older adults.
  • Discuss the importance of situational decision making based on an assessment of the client when caring for older adults.
  • Discuss the importance and strategies for weighing risks versus benefits when caring for older adults.
  • Develop an understanding of integrating the RN's concerns with ethics, policy, and judgment while respecting the older adult's strengths, wishes and expectations.

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