During the assessment phase of the nursing process nurses cluster cues before forming
a nursing diagnosis.
In this video I am going to outline exactly what a cue is and how you can cluster them.
Knowing how to cluster cues is especially important for forming nursing diagnoses.
Some students try to skip this step and jump right to a diagnosis, but that only leads
to trouble for a couple of reasons.
Teachers will often test your ability to cluster cues.
More importantly, if you don’t know how to cluster cues you could miss important information
during your assessment which may lead to the wrong nursing diagnosis or an incomplete care
plan.
Students sometimes panic when teachers start talking about cue clustering because they
aren't sure what a cue is.
Don’t panic, it’s nothing fancy that you need to memorize.
Cues are simply pieces of information that the nurse gathers.
This information may be subjective symptoms or objective signs.
During the assessment phase nurses interpret these cues to make inferences or judgements
about the client’s health status.
When cues are put together to try and support the inference and identify a client’s problem
that is called cue clustering.
Cue clustering is just putting cues together.
The process isn't really that complicated, but sometimes schools make it seem complicated.
Mothers learn to pick up on cues naturally when they are trying to figure out what is
wrong with a baby.
Babies can’t talk so a mother relies on watching the baby for signs that he or she
is hungry before the baby gets really hungry and starts screaming like crazy.
If the mother picks up on these cues early she can keep the baby happy.
Mothers learn to pick up on these cues through experience.
Nurses also get better at picking up on cues with experience.
Sure, you should have some natural ability to recognize that certain things mean that
there is a problem - you know like bleeding, pain, that kind of thing - but you should
not expect that you will be an expert at assessment and cue clustering right away.
You need to practice.
A great way to practice is with case studies.
When nurses pick up on cues during assessment they ask more questions to find out what the
cues mean.
As more questions are asked and more data is gathered cues are clustered and categorized
and patterns begin to emerge.
These patterns lead to nursing diagnoses later in the nursing process.
Nurses are often simultaneously identifying problems and potential solutions to those
problems during their assessment.
Just make sure you document the cues that support your inferences during your assessment
so you don’t forget anything important.
Just keep a piece of paper to make notes on with you.
Often when you start asking questions a new potential problem can surface and you could
branch off into a line of questioning without having the inference you are working on assessing
supported.
It is okay to branch off just make a note to return to anything that needs to be assessed
more thoroughly later.
It is important to use critical thinking to anticipate assessment questions so that important
areas are not missed.
As a student what tools do you use to cluster cues?
Please let me know in the comments below.
Where I teach we use Gordon’s Functional Health Patterns to help students see what
cues may be related to other cues.
If you use Gordon’s Functional Health Patterns do you think it helps or do you think it complicates
the process?
I would love to hear your thoughts.
When I was in school they encouraged the use of concept mapping, which really helped a
lot of us, but they let the cue clustering process be more open to individual preferences.
With concept mapping we would write down cues then draw lines between each cue and all the
other ones that we thought might be related.
I don’t think there is any one right way to cluster cues.
Just make sure you take notes and think critically.
Don’t jump to conclusions.
Remember that being able to cluster cues and gather information to support inferences is
a skill that gets better with experience - that is why case studies are so useful for learning
this process.
This video is part of a series where I walk you through how to apply the nursing process.
If you haven’t seen the nursing process overview video yet I recommend that you watch
it.
If you aren't already subscribed you can subscribe to be notified when the next video in this
series comes out.
At the end of the series I am planning to walk you through a real life case study -
It is going to be awesome!