Catholic Health Care: Clinical Questions

Critical thinking is a term you will often here in regards to nursing education and the ability to be a successful nurse. Critical thinking is one of the most important skills of a nurse. Nurses must be able to constantly asses and analyze situations in order to prioritize what is the most important task to accomplish next. This is an ever changing situation in health care and especially in the Intensive Care Units.

It’s the nurse's duty to advocate for her patient and to make sure that the patient understands and ask questions if necessary.

I also agree with you that nurses should collaborate with other members of the patient's health care team. Collaborating is an important part of the patient's plan of care. In this particular situation the nurse, could use the collaboration to gather information to aid in the plan to approach the patient's family about their mother's decision pertaining to end of life

Nursing practice requires both critical thinking and clinical reasoning. Critical thinking is the process of deliberate higher level thinking to define a patient’s problem, examine the evidence-based practice in caring for the patient’s, and make options in the delivery of optimal care. Critical thinking involves the demarcation of statements of fact, judgment, and opinion. The progression of critical thinking requires the nurse to think imaginatively, use reflection, and engage in logical thinking (Alfaro-LeFevre, 2013). Critical thinking is a vital skill needed for the recognition of patient’s

The most relevant theory in this situation is the preservation of integrity for the patient and in my practice. In order to preserve integrity and social justice I want to attain a respectful nurse-patient relationship. The nurse-patient relationship in high acuity as written in Module 1 BCIT High Acuity course “is one of the central aspects of high acuity nursing practice” (Bungay, 2005, p. 40). I feel confident this theory is the central aspect of all nursing practice. All patients, including the one I’m referring to in this journal, has her own unique beliefs, history, and experience. On top of these, the patient is now, due to critical illness, experiencing an actual or potential physiological crisis (Bungay, 2005, p. 42). It would useful and respectful of me to acknowledge that on top of her present concerns, all concerns she had prior admission still exist. I did not give her the opportunity to express her concerns. I never asked her if she had a cat she was concerned about, was missing Saturday’s farmer’s market, wanted a Sherry, missed her friend, or disliked men. There could be a myriad of things that may be concerning her at the time. All real and potential factors support or challenge having a positive relationship with the patient (Bungay, 2005, p. 41).

1. Family members of a patient who has a traumatic brain injury ask the nurse about the purpose

In class, we’ve discussed a lot of things during our group discussion. First, we discussed the professional nursing responsibilities of this case. We said that nurses job is to educate the patients so they don’t have to come back; they can’t be judgemental no matter what the situation is; they have to report certain evidences even if the patient doesn't want us to; we can provide the information to the client’s authorities (not just anyone); and we need to look and observe the patient for verbal and nonverbal clues. Second, we discussed the nursing ethical implications for this case. We said that nurses should always respect the patient's decisions; need to provide the same, equal, and quality care for all patients; don’t always make assumptions; take patient’s values to consideration; to ask patients who they are comfortable with visiting them during their stay; always provide all the information to the patient; and remember to keep boundary, know what information to give and what not to give. Then we discussed elements of the nurse patient relationship we think are

Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. Critical thinking has been described as the ability to gather and process data in such a way as to arrive at the best conclusion using the filters of prior knowledge, experience and external resources to overcome personal emotions, biases, and assumptions. (This description was developed during NUR/300 class, University of Phoenix, S. Colorado, March 16, 2006) Note that critical thinking is described as a

Critical thinking used throughout the nation in nursing everyday to protect and treat patients in the most effective way. An example would be if a patient walked in to the hospital with a platelet count of 1, the nurse would know that they have a risk for bleeding and would place them on “risk for bleeding” protocols. Without critical thinking, the nurse would not know what to do. Critical thinking is a learned skill that every nurse should acquire, not only during his or her education, but also throughout his or her career.

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

There are several legal and ethical issues relating to FWR. Some of the key legal concerns expressed by healthcare professionals include the potential for litigation, patient confidentiality, and the patient’s right to privacy (Mian et al, 2007; Critchell et al, 2007). Litigation and liability concerns arise from the fact that, in most cases, family members will have little understanding of the procedures used in the code room. The fear is that the staff’s actions could be perceived as detrimental or harmful to the patient in the eyes of the typical lay-person. The reality is that once healthcare providers become educated and experienced with FWR,

Healthcare professionals will be faced with ethical dilemmas throughout their career, particularly in the hospital environment. Having an education regarding professional healthcare ethics will provide some direction in how to best address these dilemmas at a time when either the patient or their family is in need of making decisions for themselves or their family member. It can be difficult for healthcare professionals to weigh professional protocol against their own personal beliefs and ethical understandings when determining critical care for their patient.

Critical thinking and clinical judgment are important skills that professional nurses use in every day clinical setting. In 2012, a mix method qualitative study by Dr. Jeanne Mann was done to evaluate the effectiveness of educational strategy to develop clinical judgment skills in nursing students. In this study, the population was identified as volunteered Level II baccalaureate nursing students from a Midwest nursing program. The variables identified in this article are the relation between critical thinking and clinical judgment. The title of the article clearly indicated the focus of the study and created an interest in reading the research due to nurses utilize their ability to critical think and

Critical thinking and clinical reasoning are similar in the fact that each term represents a set of methods that guide the nurse to reliable evidence-based practice while delivering care. Critical thinking and clinical reasoning are centered on knowledge base that is associated with the discipline of nursing. With each concept, the nurse must have an existing developed knowledge base in which to apply each concept to. Nurses apply critical thinking and clinical reasoning skills when patient care decisions are made. With both critical thinking and clinical reasoning, information about the patient is collected and examined. They work together to produce clinical judgment. They both direct nursing care to meet patients’ needs resulting in higher quality of care and better patient outcomes.

As a senior nurse Susan is expected to use better judgment because of her experience and/or expectation of job duties. Unfortunately, this was not the case. Susan did not use her critical thinking skills to the best of her capabilities. According to Aristotle a person who does their job well, or performs their function well, will use reason and rationale and use it well. As a nurse manager, Susan did not use her use her reason and rationale well concerning her staffing issue. Her careless action ultimately led to severe patient incidents, bad publicity and ramification for her institution and ultimately her termination from her