NCSBN
CJMM
CJMM
This is the first step of the NCSBN CJMM, where nurses identify relevant cues.
What is Noticing?
In the scenario, this vital sign was 112 and suggested early deterioration.
What is the heart rate?
This is the FIRST nursing action before calling the provider.
What is performing a focused assessment?
Cue clustering helps students avoid focusing on cues in this way.
What is isolating cues?
This step helps you learn from your decisions for future practice.
What is reflecting?
This step requires the nurse to make sense of the cues by clustering them.
What is Interpreting?
This respiratory rate indicated increased work of breathing.
What is 24 breaths per minute?
Checking intake/output and IV patency are part of this type of nursing response.
What is gathering additional data?
Tachycardia + increased respirations + “feeling off” are an example of this.
What is a cue cluster?
Reflecting helps strengthen this essential nursing skill.
What is clinical judgment?
This step involves choosing and performing the priority nursing action.
What is Responding?
This patient statement — “I just feel off” — is an example of this type of cue.
What is a subjective cue?
This action helps determine whether the patient’s condition is improving after your intervention.
What is reassessment?
Cue clusters help nurses determine this — the “story” the cues are telling.
What is the patient’s likely clinical status?
After responding, nurses ask themselves this question: “Did my action do this?”
What is improve the patient’s condition?
This final step asks the nurse to evaluate the effectiveness of their action.
What is Reflecting?
This combination of tachycardia, borderline hypotension, and increased respirations suggests this early clinical concern.
What is early post‑operative deterioration (or early sepsis/hypovolemia)?
This is the rationale for assessing before intervening.
What is establishing an accurate clinical picture?
This is the term for connecting cues to potential complications.
What is interpretation?
Reflection supports this type of thinking, which helps you grow.
What is metacognition?