Dayton, Ohio Oakland Ave. Box London, Ohio, In my reading, a title caught my eye. I cannot tell you how many times in my career I have heard similar comments about the lack of and need for the development of critical thinking skills in nursing. This statement sent me on a review of what new thoughts might be present on the subject of critical thinking. She defined five levels of nursing development novice, advanced beginner, competent, proficient, expert.
Buried within the concept are the characteristics of flexibility, willingness to analyze situations, a systematic approach to all decision making, focused problem solving, the capacity to expect and embrace different perceptions, and self-reflection. The overall solution remains the same — strong leadership and mentorship. As nursing leaders, how do we improve the development of a culture of inquiry and an improved learning environment? Organizations with strong mentorship programs in orientation support and develop novice staff. Critical thinking is not a simple step-by-step, linear process that you learn overnight.
It is a process acquired only through experience, commitment, and an active curiosity toward learning. Nurses are responsible for making accurate and appropriate clinical decisions. Clinical decision making separates professional nurses from technical personnel. Technical personnel simply follow direction in completing aspects of care that the professional nurse has identified as necessary. A professional nurse relies on knowledge and experience when deciding if a patient is having complications that call for notification of a health care provider or decides if a teaching plan for a patient is ineffective and needs revision.
Benner describes clinical decision making as judgment that includes critical and reflective thinking and action and application of scientific and practical logic.
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- How Critical Thinking Impacts Nursing!
Most patients have health care problems for which there are no clear textbook solutions. Instead you must learn to question, wonder, and explore different perspectives and interpretations to find a solution that benefits the patient. Observe patients closely, gather information about them, examine ideas and inferences about patient problems, recognize the problems, consider scientific principles relating to the problems, and develop an approach to nursing care.
You will find nursing to be rewarding and fulfilling through the clinical decisions you make. Jacobs is a year-old patient who had a radical prostatectomy for prostate cancer yesterday. His nurse, Tonya, finds the patient lying supine in bed with arms extended along his sides but tensed. She asks Mr. She decides that she needs to take action to relieve Mr. In the case example the nurse observes the clinical situation, asks questions, considers what she knows about postoperative pain and risk for immobility, and takes action.
The nurse applies critical thinking, a continuous process characterized by open-mindedness, continual inquiry, and perseverance, combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant Heffner and Rudy, Critical thinking involves recognizing that an issue e.
The Role of Critical Thinking in Nursing
A critical thinker considers what is important in each clinical situation, imagines and explores alternatives, considers ethical principles, and makes informed decisions about the care of patients. Tonya knew that pain was likely going to be a problem because the patient had extensive surgery. Her options include giving Mr. Jacobs an analgesic and waiting until it takes effect so she is able to reposition and make him more comfortable.
7 Reasons Critical Thinking in Nursing is Important
Once he has less acute pain, Tonya offers to teach Mr. Jacobs some relaxation exercises. You begin to learn critical thinking early in your practice. For example, as you learn about administering baths and other hygiene measures, take time to read your textbook and the nursing literature about the concept of comfort. What are the criteria for comfort? How do patients from other cultures perceive comfort?
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- 1. INTRODUCTION;
What are the many factors that promote comfort? The use of evidence-based knowledge, or knowledge based on research or clinical expertise, makes you an informed critical thinker. Critical thinking requires cognitive skills and the habit of asking questions, remaining well informed, being honest in facing personal biases, and always being willing to reconsider and think clearly about issues Facione, When core critical thinking skills are applied to nursing, they show the complex nature of clinical decision making Table Being able to apply all of these skills takes practice.
You also need to have a sound knowledge base and thoughtfully consider what you learn when caring for patients. Modified from Facione P: Critical thinking: a statement of expert consensus for purposes of educational assessment and instruction. Nurses who apply critical thinking in their work are able to see the big picture from all possible perspectives. They focus clearly on options for solving problems and making decisions rather than quickly and carelessly forming quick solutions Kataoka-Yahiro and Saylor, Nurses who work in crisis situations such as the emergency department often act quickly when patient problems develop.
However, even these nurses exercise discipline in decision making to avoid premature and inappropriate decisions. Learning to think critically helps you care for patients as their advocate, or supporter, and make better-informed choices about their care. Facione and Facione identified concepts for thinking critically Table Critical thinking is more than just problem solving. It is a continuous attempt to improve how to apply yourself when faced with problems in patient care. Modified from Facione N, Facione P: Externalizing the critical thinking in knowledge development and clinical judgment, Nurs Outlook 44 3 , Learning is a lifelong process.
Your intellectual and emotional growth involves learning new knowledge and refining your ability to think, problem solve, and make judgments. To learn, you have to be flexible and always open to new information. The science of nursing is growing rapidly, and there will always be new information for you to apply in practice. As you have more clinical experiences and apply the knowledge you learn, you will become better at forming assumptions, presenting ideas, and making valid conclusions. How might it change and why? Which physiological and emotional responses do I anticipate?
In which way will specific therapies affect the patient? What should be my first action?
2 Examples of How I Used Critical Thinking to Care for my Patient (real life nursing stories)
Do not let your thinking become routine or standardized. With experience you are able to recognize patterns of behavior, see commonalities in signs and symptoms, and anticipate reactions to therapies. Your ability to think critically grows as you gain new knowledge in nursing practice. Kataoka-Yahiro and Saylor developed a critical thinking model Fig.
An expert nurse thinks critically almost automatically. As a beginning student you make a more conscious effort to apply critical thinking because initially you are more task oriented and trying to learn how to organize nursing care activities. At first you apply the critical thinking model at the basic level. As you advance in practice, you adopt complex critical thinking and commitment.
Struggling in nursing school?
At the basic level of critical thinking a learner trusts that experts have the right answers for every problem. Thinking is concrete and based on a set of rules or principles. For example, as a nursing student you use a hospital procedure manual to confirm how to insert a Foley catheter. You do not have enough experience to anticipate how to individualize the procedure.
Critical Thinking 1 – Scenarios « The Student Nurse
At this level answers to complex problems are either right or wrong e. Basic critical thinking is an early step in developing reasoning Kataoka-Yahiro and Saylor, A basic critical thinker learns to accept the diverse opinions and values of experts e. Complex critical thinkers begin to separate themselves from experts. They analyze and examine choices more independently.
A nurse learns that alternative and perhaps conflicting solutions exist. Consider the case of Mr. Some of these skills are applied in patient care, via the framework known as the Nursing Process. The skills that are most important are:. Interpreting — Understanding and explaining the meaning of information, or a particular event. Analyzing — Investigating a course of action, that is based upon data that is objective and subjective. Evaluating — This is how you assess the value of the information that you got.
Is the information relevant, reliable and credible? This skill is also needed to determine if outcomes have been fully reached.
Based upon those three skills, the nurse can then use clinical reasoning to determine what the problem is. These decisions have to be based upon sound reasoning:.