Is the most important skill you’ve developed as a nurse also your most valuable skill beyond the bedside? How your ability to assess, interpret, prioritize, and act is your greatest asset.
This post was first published on my Medium blog—follow me there for the most up-to-date entries!
Ask any nurse what’s at the heart of safe patient care, and you’ll likely hear the phrase clinical judgment. Undoubtedly, you recognize the clinical judgment you’ve demonstrated during your many years at the bedside. But has it occurred to you that clinical judgment might be the most transferable skill you have to offer as you move to a non-traditional role?
Contrary to popular assumption, clinical judgment is more than intuition or experience. It’s a structured, observable process that continues to matter long after you hang up your scrubs.
What is clinical judgment?
The National Council of State Boards of Nursing (NCSBN) defines clinical judgment as the ability to:
“Assess a situation, interpret the data, prioritize what matters most, and act on it to ensure safe care.”
They’ve identified it as the most important skill for modern nursing — and the primary reason for overhauling the NCLEX exam through the Next Generation NCLEX (NGN).
“No aspect of nursing today is more important than developing the skill of clinical judgment.”
— ATI, based on guidance from NCSBN
What clinical judgment looks like in a traditional setting
Clinical judgment isn’t a buzzword — it’s something we use every single shift. Here’s how those four steps (assess, interpret, prioritize, and act) play out in the bedside situations you’ll recognize.
New-onset diabetes (Pediatric clinic)
Parents say their 9-year-old is “just tired.” You see more.
- Assess: Dark circles, low energy, fruity breath.
- Interpret: Classic red flags for undiagnosed Type 1.
- Prioritize: This isn’t a routine well-visit.
- Act: Immediate glucose check and urgent referral.
You prevented a crisis — and it started with what others might miss.
Clinical judgment means recognizing what isn’t in the medical record.
Rapid sepsis progression
A middle-aged man post-appendectomy, and something isn’t right.
- Assess: Vitals creeping up. Restlessness, a mild temperature increase, and slight confusion.
- Interpret: Early signs of sepsis.
- Prioritize: Labs and blood cultures.
- Act: Call the Rapid Response Team — before the full crash.
Clinical judgment means calling for help even at the risk of looking silly if you’re wrong.
Postpartum depression, 12 weeks out
A new mother brings her baby in for a well-infant checkup. The baby is healthy, gaining weight, and meeting milestones, but the mother seems withdrawn. She smiles, but the smile doesn’t reach her eyes. You notice poor concentration, low energy, feelings of guilt, and delayed responses.
- Assess: Flat affect, guilt, poor sleep, no interest in usual routines.
- Interpret: Signs of delayed-onset postpartum depression. Maybe missed at 6 weeks — or new onset.
- Prioritize: Support, screen for PPD, and engage the provider team. This isn’t just about the baby.
- Act: Open the conversation, refer for follow-up, flag for continuity of care.
Clinical judgment means looking at the whole picture — including recognizing that the person who is on the schedule isn’t the one who needs intervention.
I know, I know, you’ve probably never thought of these examples as “clinical judgment”. You just thought you were doing your job. But in each of these situations, you’ve demonstrated an ability to assess, interpret, prioritize, and act. That’s the accepted definition of clinical judgment.
What clinical judgment looks like beyond the bedside
Clinical judgment isn’t tied to a setting. It’s tied to how you think. If you’ve ever questioned a policy, restructured a learning experience, or paused to ask a critical question, you’ve used clinical judgment.
And if you’re pivoting away from traditional nursing roles, this is a transferable skill you already own — one that can shape your next chapter. Here are a few examples in the consultant role that demonstrate how clinical judgment might be the most transferable skill you have to offer.
Device rollout audit
I was brought in as an educator-consultant to review orientation practices for a new clinical device. Staff were making frequent errors, but a checklist already existed. The issue? I could find no clear competency defined, and no validation method to ensure staff know how to use the device safely. Clinical judgment then called for me to
- Assess: Current training structure inadequate.
- Interpret: Disconnect exists between completion and competence.
- Prioritize: Develop measurable, validated competencies.
- Act: Recommend targeted changes and validation strategies — protecting both patients and the organization.
Mock audit: Policy vs. practice misalignment
During a mock survey, I reviewed three different nurses’ documentation of the same patient care task. All followed policy — but each charted differently.
The real risk? A surveyor could flag this as inconsistency.
- Assess: Variability in documentation, despite shared policy.
- Analyze: The policy wasn’t wrong. The interpretation was.
- Prioritize: Align charting expectations across teams.
- Act: Standardized documentation language, retrained staff, and re-audited.
The problem wasn’t compliance; it was confusion. Judgment helped uncover it.
Patient handouts: Safety by design
A client wanted me to “fact-check” their education brochure. But I noticed something more important: the danger wasn’t in the facts — it was in how the safety messages were buried inside of the facts.
- Assess: Escalation instructions were hidden. Language too technical.
- Analyze: Patients wouldn’t know what to do, or when.
- Prioritize: Clear language and visible safety actions.
- Act: Rewrote and restructured the handout using plain language principles.
If patients don’t understand it, they won’t act on it. That’s not just communication. It’s safety.
Test item review: Are you testing recall or judgment?
A publisher asked me to review their NCLEX-style questions. Technically, most correct options were “right.” But the distractors? Ridiculous. No nurse would pick them.
- Assess: Distractors were implausible.
- Analyze: Items were testing recall, not clinical judgment.
- Prioritize: Realistic errors sharpen reasoning.
- Act: Rewrote the items to reflect actual decision points.
If a test item doesn’t make the learner think, it’s not testing judgment. It’s trivia.
Nontraditional leadership role: Night shift realities
A healthcare system rolls out a new huddle policy after every patient fall. Great idea in theory — except what happens a 2 a.m. when the night shift is almost always running a skeleton crew?
I asked the hard question: “Who’s supposed to attend this huddle?” That question set up the clinical judgment:
- Assess: Staffing patterns.
- Interpret: How policies may fail in practice.
- Prioritize: Feasible, safety-oriented adaptations.
- Act: Advise leaders to tailor protocols based on shift realities — not just policy ideals.
Final Thoughts
Clinical judgment doesn’t expire when you leave the bedside. It grows stronger the further you go. It’s what allows you to lead, teach, consult, innovate, and make decisions that protect patients — even when you’re no longer the one starting the IV.
If you’re thinking about a pivot, or already in a non-clinical role, don’t underestimate it: clinical judgment might be the most transferable skill on your resume.
➡️ Follow me for updates on transferable skills and the nursing pivot journey.
🎙️ And stay tuned — I’ll be joining the AWHONN podcast soon, where I’ll dive into how clinical judgment translates beyond the bedside and the real skills that can carry you into the next chapter of your career.
This post was first published on my Medium blog—follow me there for the most up-to-date entries!