Critical Thinking Nursing

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.

Castledine, G (2010) in Critical thinking is crucial in British Journal of Nursing 19 (4) pp271

Not all patients are capable of independently identifying and articulate their care needs, so the nurse also adapts the role as an advocate. Clarity and continuity in a trusting environment enables good communication. Progressive identification of needs takes place as nurse and patient communicate with one another in the interpersonal relationship (Peplau 1988, p. 84). Being considerate to the needs and vulnerability of patients is a moral attribute, as nurses are accountable for the care they deliver.

Critical thinking and clinical reasoning are two terms that are similar in natural and at times have been used inter-changeably throughout nursing literature. However, while there are similarities that can be observed when examining these two terms they are also uniquely different and should be treated as such. While many definitions of critical thinking exist The American Philosophical Association (APA) has defined critical thinking as “purposeful, self-regulatory judgment that uses cognitive tools such as interpretation, analysis, evaluation, inference, and explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations on which judgment is based” (American Philosophical Association, 1990). Much like critical thinking, multiple definitions exist for clinical reasoning. While numerous definitions may indeed exist “a clear and precise” definition has not yet been found within nursing literature (Simmons, 2010, p. 1151). According to Dr. Simmons, clinical reasoning within nursing is defined as “a complex cognitive process that uses formal and informal thinking strategies to gather and analyze patient information, evaluate the significance of this information and weigh alternative actions” (Simmons, 2010, p. 1155).

As the nurses who participated in a study (Jones & Cheek, 2003) overwhelmingly advised, there is no such thing as a typical day for a nurse. Nurses face new situations everyday and it is important that they can adjust their knowledge and skills accordingly. Critical thinking and reflection are essential skills because they can enhance nurses’ ability to solve problems and make sound decisions. Critical thinking skills enable nurses to identify multiple possibilities in clinical situations and alternatives to interventions; weigh the consequences of alternate actions; and make sound judgement and decisions (Brunt, 2005). Through reflection, nurses can examine their practice, explore feelings and reactions and connect new meanings to past experience (Brunt). Reflection can enhance self-awareness, foster professional satisfaction and growth and increase the possibility for change and improvement in nursing practice and therapeutic relationships (Thorne & Hayes, 1997).

In addition to these characteristics, nursing also involves critical thinking. "Critical thinking is the active, organized, cognitive process used to carefully examine one's thinking and the thinking of others. It involves the use of the mind in forming conclusions, making decisions, drawing inferences, and reflecting" (Perry,

Critical thinking is a nursing process that includes reflective practice, problem solving and decision making which are connected to one another. The definition of critical thinking is transferring and applying knowledge and skills in a new situation. The critical thinking is needed in a lot of aspects of the nurses’ job such as when the nurses need to provide the precise identification in the specific problems had by the patients. They need to be in detail and also critical to themselves in every time in order to be able to provide identification precisely. When you have the profession in nursing, it is important to be critical thinker. The nurses have the high responsibilities and their responsibilities are increasing from time to time.

Closely linked to this decision-making model is the ubiquitous nursing process. The nursing process includes data collection and documentation, analysis of the data to determine current condition and real or potential health related issues, development of an individualized plan of care to deal with these issues, implementation of that plan of care, and evaluation of the plan of care to determine its effectiveness and adjust the plan as needed. (Blais, Hayes, Kozier, & Erb, 2006)

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

Demonstrate the use of critical thinking skills in the integration of current nursing knowledge and evidence-based findings to direct clinical practice decisions.

How often, and under what circumstances, do you ask questions that start with “But what if…?” or “It depends…?”

As a nurse I will use my knowledge of critical thinking skills with in the nursing process: assessment, analysis, planning, implementation, and evaluation. Furthermore as a member of the nursing profession, I will assume accountability and responsibility for the quality of nursing care that I provide to clients, act as an advocate to promote quality health care for all clients, and take part in activities that promote the development and practice of professional nursing.

A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).

As nurses help others they will be faced with many decisions that are very difficult. According to American Society of Registered Nurses (2007), “Professional

The nursing process is a five stage systematic framework, and based on the problem solving approach; it forms the foundation for nursing practice to facilitate focussed, individualised care planning for patients (Yildirim and Ozkahraman 2011). This assignment will serve to identify the five stages of the nursing process: Assessment, Nursing Diagnosis, Planning, Implementation and Evaluation. The skills: Communication, Observation, Critical Thinking and Reflection involved within the nursing process in partnership with the patient will also be highlighted.