Applying critical thinking skills in nursing

It is important to note that nurses are never focused in irrelevant or trivial information.

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Some skills are more important than others when it comes to critical thinking. 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:.

Ways to Strengthen Your Critical Thinking in the Nursing Profession

Explaining — Clearly and concisely explaining your conclusions. The nurse needs to be able to give a sound rationale for her answers. Self regulating — You have to monitor your own thinking processes. This means that you must reflect on the process that lead to the conclusion. Sometimes an action is to not act or to delay an action until a later time. You choose to delay as a result of your experience and knowledge. Because you take accountability for the decision, you consider the results of the decision and determine whether it was appropriate.

Turning New Nurses Into Critical Thinkers

Kataoka-Yahiro and Saylor describe critical thinking competencies as the cognitive processes a nurse uses to make judgments about the clinical care of patients. These include general critical thinking, specific critical thinking in clinical situations, and specific critical thinking in nursing. General critical thinking processes are not unique to nursing.

They include the scientific method, problem solving, and decision making. Specific critical thinking competencies in clinical health care situations include diagnostic reasoning, clinical inference, and clinical decision making. The specific critical thinking competency in nursing involves use of the nursing process. Each of the competencies is discussed in the following paragraphs. The scientific method is a way to solve problems using reasoning. It is a systematic, ordered approach to gathering data and solving problems used by nurses, physicians, and a variety of other health care professionals.

This approach looks for the truth or verifies that a set of facts agrees with reality. Nurse researchers use the scientific method when testing research questions in nursing practice situations see Chapter 5.

Why are critical thinking skills in nursing important?

The scientific method has five steps:. A nurse caring for patients who receive large doses of chemotherapy for ovarian cancer sees a pattern of patients developing severe inflammation in the mouth mucositis identifies problem. The nurse reads research articles collects data about mucositis and learns that there is evidence to show that having patients keep ice in their mouths cryotherapy during the chemotherapy infusion reduces severity of mucositis after treatment.

The nurses on the oncology unit collect information that allows them to compare the incidence and severity of mucositis for a group of patients who use cryotherapy versus those who use standard-practice mouth rinse tests the question. They analyze the results of their project and find that the use of cryotherapy reduced the frequency and severity of mucositis in their patients evaluating the results.

Critical Thinking Skills in Nursing Management

They decide to continue the protocol for all patients with ovarian cancer. When a problem arises, you obtain information and use it, plus what you already know, to find a solution. Patients routinely present problems in practice. For example, a home care nurse learns that a patient has difficulty taking her medications regularly. The patient is unable to describe what medications she has taken for the last 3 days. The medication bottles are labeled and filled. The nurse has to solve the problem of why the patient is not adhering to or following her medication schedule.

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The nurse knows that the patient was discharged from the hospital and had five medications ordered. The patient tells the nurse that she also takes two over-the-counter medications regularly. When the nurse asks her to show the medications that she takes in the morning, the nurse notices that she has difficulty reading the medication labels. The patient is able to describe the medications that she is to take but is uncertain about the times of administration. In addition, the nurse shows the patient examples of pill organizers that will help her sort her medications by time of day for a period of 7 days. Effective problem solving also involves evaluating the solution over time to make sure that it is effective.

What is Critical Thinking in Nursing?

It becomes necessary to try different options if a problem recurs. From the previous example, during a follow-up visit the nurse finds that the patient has organized her medications correctly and is able to read the labels without difficulty. When you face a problem or situation and need to choose a course of action from several options, you are making a decision.

Decision making is a product of critical thinking that focuses on problem resolution. Following a set of criteria helps to make a thorough and thoughtful decision. The criteria may be personal; based on an organizational policy; or, frequently in the case of nursing, a professional standard. For example, decision making occurs when a person decides on the choice of a health care provider. To make a decision, an individual has to recognize and define the problem or situation need for a certain type of health care provider to provide medical care and assess all options consider recommended health care providers or choose one whose office is close to home.

The person has to weigh each option against a set of personal criteria experience, friendliness, and reputation , test possible options talk directly with the different health care providers , consider the consequences of the decision examine pros and cons of selecting one health care provider over another , and make a final decision.

Although the set of criteria follows a sequence of steps, decision making involves moving back and forth when considering all criteria. It leads to informed conclusions that are supported by evidence and reason. Examples of decision making in the clinical area include determining which patient care priority requires the first response, choosing a type of dressing for a patient with a surgical wound, or selecting the best teaching approach for a family caregiver who will assist a patient who is returning home after a stroke.

Once you receive information about a patient in a clinical situation, diagnostic reasoning begins. It requires you to assign meaning to the behaviors and physical signs and symptoms presented by a patient. Diagnostic reasoning begins when you interact with a patient or make physical or behavioral observations. An expert nurse sees the context of a patient situation e. This type of diagnostic reasoning helps health care providers pinpoint the nature of a problem more quickly and select proper therapies.

Part of diagnostic reasoning is clinical inference, the process of drawing conclusions from related pieces of evidence and previous experience with the evidence. An inference involves forming patterns of information from data before making a diagnosis. Seeing that a patient has lost appetite and experienced weight loss over the last month, the nurse infers that there is a nutritional problem. An example of diagnostic reasoning is forming a nursing diagnosis such as imbalanced nutrition: less than body requirements see Chapter In diagnostic reasoning use patient data that you gather or collect to logically recognize the problem.

For example, after turning a patient you see an area of redness on the right hip. You palpate the area and note that it is warm to the touch and the patient complains of tenderness. You press over the area with your finger; after you release pressure, the area does not blanch or turn white. After thinking about what you know about normal skin integrity and the effects of pressure, you form the diagnostic conclusion that the patient has a pressure ulcer.

As a student, confirm your judgments with experienced nurses. At times you possibly will be wrong, but consulting with nurse experts gives you feedback to build on future clinical situations. Often you cannot make a precise diagnosis during your first meeting with a patient. Sometimes you sense that a problem exists but do not have enough data to make a specific diagnosis. Some choose to not share sensitive and important information during your initial assessment.

Critical Thinking in Nursing Test Taking2

When uncertain of a diagnosis, continue data collection. Diagnostic reasoning is a continuous behavior in nursing practice. Any diagnostic conclusions that you make will help the health care provider identify the nature of a problem more quickly and select appropriate medical therapies. As in the case of general decision making, clinical decision making is a problem-solving activity that focuses on defining a problem and selecting an appropriate action. When you approach a clinical problem such as a patient who is less mobile and develops an area of redness over the hip, you make a decision that identifies the problem impaired skin integrity in the form of a pressure ulcer and choose the best nursing interventions skin care and a turning schedule.