Critical Thinking in Nursing

critical thinking, nursingCritical thinking in nursing makes up the most important and most basic part of being a good nurse. For this reason, clinical skills will get a nurse only so far without the critical thinking skills necessary to know when and where to use them.

What is Critical Thinking?

First of all, critical thinking is the objective analysis of facts to form a judgement.

Thinking that is regarded as critical typically has a specific set of traits including, but not limited to:

  •  Always asking questions to constructive ends; for this reason, questions asked should have a point, a direction
  • Purposeful, active, and dynamic
  • Examines, assesses, uncovers, and questions
  • Open minded
  • Drawing on experience
  • Adaptable

What is Critical Thinking Not?

  • Black and white
  • Lazy
  • Inflexible
  • Blind acceptance
  • Strict systematic process; the process cannot be reduced to rules and protocols

Three Questions in Critical Thinking

  1. How?
  2. What?
  3. Why?

Critical Thinking Applications in Nursing

  • Outcome directed; nurses are always anticipating potential problems
  • Patient, family, and community needs drive it
  • Based on nursing process principles and scientific method
  • Requires knowledge and experience

critical thinking, nursing, patient careEven though I said that we cannot be inflexible and dependent on rules, I need to reduce critical thinking to a basic outline for illustrative purposes. To that end, when approaching a situation in nursing, a nurse should harness reason and knowledge similar to this manner:

  • WHAT is normal?
  1. This draws from a knowledge base of human A&P and disease pathology
  • WHAT is the problem?
  1. What needs correcting?
  2. Are there any abnormalities?
  3. Compare data with expected normals
  • HOW can you solve the problem?
  1. Based on knowledge base and nursing practice what can you do to solve the problem?
  • HOW will an action/intervention solve the problem?
  • Support your choice of action with a rationale

Ultimately, there is no such thing as, “Because I said so,” in nursing or critical thinking.

Critical Thinking Paradox

Critical thinking cannot exist without a knowledge base. And a knowledge base is useless without critical thinking. As a result, they depend on each other. Similarly, humans are a spirit and a body. The body is a vessel for the spirit. A spirit cannot act without a body; therefore, a body cannot act without a spirit.

In other words,  Lao Tzu wrote, “What is and what is not create each other…So, the sage acts by doing nothing…”

nursing process, nurse, critical thinkingLive and breathe the nursing process in decision making

  1. Assess
  • What is the baseline?
  • How do you know anything has changed?
  • What will you tell a doctor or other nurse?
  1. Diagnose
  2. Plan
  3. Implement
  4. Evaluation

 

  • You must support and justify your actions
  1. If you can’t explain why you’re doing something – DO NOT do it!

 

In conclusion, good nurses are always assessing and evaluating.

 

 

Thoughts? Comments? Complaints? Let me know