Embodied Responses to Harmony and (Poly)Rhythm: An Integrated Ratio-Based Perception-Action Framework.

Clinical judgement is a defining attribute of nursing practice, directly influencing patient outcomes, safety and professional credibility across healthcare settings (Bussard et al. ). Foundational scholarship has examined clinical judgement primarily through frameworks of competence, critical thinking and diagnostic accuracy, clarifying how nurses interpret cues, prioritise interventions and evaluate outcomes (Connor et al. ; Sezer et al. ). These contributions have strengthened understanding of cognitive processes underlying decision‐making. However, contemporary healthcare environments characterised by escalating complexity, rapid technological integration and interprofessional coordination have intensified scrutiny of how nursing judgements are not only accurate, but ethically defensible and publicly accountable (Notarnicola et al. ; Zumstein‐Shaha and Grace ). Regulatory standards and professional guidelines delineate scope of practice and expected competencies, yet they do not fully explain what renders a clinical judgement legitimate within everyday relational contexts of care (Mendívil‐Pérez et al. ). Emerging evidence suggests that nurses frequently encounter tensions between institutional demands and professional commitments, particularly when performance metrics or system pressures constrain relational engagement (Koivisto et al. ; Zhang et al. ). These tensions indicate that clinical judgement cannot be reduced to technical proficiency or procedural compliance alone; legitimacy requires more than correct decisions it requires defensible and ethically grounded enactment. Recent leadership and organisational scholarship further emphasise that professional legitimacy is increasingly evaluated through transparency of reasoning, ethical orientation and relational responsiveness rather than outcomes alone (Iddrisu ; James and Priyadarshini ). In nursing, accountability extends beyond documentation and compliance to include attentiveness to patient vulnerability, dignity and lived experience (Ghanem Atalla et al. ; Molina‐Mula and Gallo‐Estrada ). Yet these dimensions regulatory competence and moral‐relational orientation are often analysed separately, limiting theoretical understanding of how they interact within enacted clinical judgement (Ali and Khalifa ; Luo and Chan ). In this paper, relational accountability refers to the alignment of self‐regulatory processes with caring‐based ethical commitments in nursing clinical judgement. Despite growing recognition of competence, ethics and leadership in nursing practice, limited theoretical attention has been given to how these domains converge to sustain accountable judgement.