1 Shannon Sheffer Nursing 324 Reflection Paper Critical thinking is utilized in a variety of different professions.

It is a major aspect of the nursing field that contributes to patient safety, enhanced nursing practice, and increased problem solving skills. Critical thinking is important, yet it is equally as imperative each nurse understands its practice, significance and relevance, and continually strives to better the practice. I can definitely see and understand how critical thinking is gradually developed, improved upon, and honed over time. It is evident that there is no magical way enrich or advance the process of critical thinking and immediately be an expert in the field. When I was in nursing school, I had no idea what it meant to think critically. It was a foreign subject for which I had no concept or reference. As I began to slowly traverse through the nursing program and gather more information to put into practice, it became clear what critical thinking entailed; yet I still had no idea how I could become accomplished in the art. I remember questioning if I would ever be proficient in the skill. After graduation from the program, I began to work as a registered nurse on a medical-surgical floor. It was here where I began to learn more about the process and began to prioritize and think critically. I believe this was accomplished from observing other experienced nurses who were comfortable and established in their practice. I also believe that my skills matured as I was learning to apply the information I had collected from my own successes and mistakes. It was as if the pieces of the enormously vast and difficult puzzle were slowly coming together, one piece at a time. I believe that my one and a half years of working on the medical-surgical floor allowed me to gain a beginners knowledge crash course on critical thinking. I felt semi-confident in my nursing skills, and was beginning to practice adequate critical thinking skills. My world was flipped upside down when I transferred to the operating room (OR), which is where I have been for the last three years. The ORs significantly different environment left me feeling as if I was transported back to nursing school I had no idea what was going on and how to even begin to think critically in the situations with which I was faced. However, as I moved through the orientation phase and began to understand my role as the circulating nurse, I again began to piece together the critical thinking puzzle and slowly (and cautiously) began to practice critical thinking again. A great illustration of critical thinking is having the ability to think outside the box. This coupled with creativity and unique problem solving skills is the right path to being a great nurse. An illustration of this process occurred just last week as I was circulating during a Da Vinci robotic case. The electro-cautery device that the doctor was using to cut and coagulate tissue was not working optimally. My immediate instinct was to first check that the maryland bipolar forceps instrument was in proper working condition. Next, I switched out the disposable cord that connects the instrument to the electro-cautery machine. After that, the final step was to replace the electro-cautery machine. Because we were in the middle of the case, I had to cleverly rig the new machine into the Da Vinci robotic system as not to disrupt the doctor

2 while he was continuing to perform surgery, but in an effort to get this crucial piece of equipment to work properly. I believe this example displays that true critical thinking comes with experience. First, I had to identify the problem. From that point, I needed to sequentially work through the multiple step process in an effort to solve the problem. If the new electrocautery machine would not have worked, my next step would have been to obtain an entirely different type of bipolar instrument (called a PK dissecting forceps) that is hooked to a different generator located on the Da Vinci stack tower. Although the particular doctor performing the surgery does not typically use the PK instrument, it would have allowed him to finish the surgery in a safe and effective manner. Through this course, I believe that my knowledge base has expanded and my critical thinking skills have improved. The three journals that I wrote earlier in the semester challenged me to examine my current thought process and skill level. This has revealed my weak areas of practice and allowed me to begin working to improve the skills. Initially, the metacognition was very difficult for me to grasp and put into words. It required a lot of extra effort in order to think about the way in which I think. Yet even through the struggle, I believe the process helped me to grow (not only as a nurse, but also as a person) and learn more about my thought process. In addition, this reflection paper has revealed an immense amount of insight as to how I think and process information. I believe that I have developed a deeper understand of how to become a better thinker, which will translate into my personal life as well as improving my job performance as a nurse. As I read through the provided grading levels for critical thinking, I believe that my practice is at level IV. The description of this level states that the person understands the basics of critical thinking and has developed a strong foundation when it comes to the practice of the skill. A level IV critical thinker is also able to critically think and act most of the time, with some intermittent breaks in thought process. I believe that my evidence for choosing this level is based upon the examples that I have given thus far, as well as the insight and honesty that I have provided on the subject. I know critical thinking is a skill upon which I can always improve. I do not think there will ever come a day in my nursing career, when I can honestly state that I have no more information to learn or ways to improve my critical thinking skills. As of recently, I believe that my critical thinking skills at work have improved my ability to anticipate, be proactive, and problem solve have improved noticeably. I do believe that I have developed a steady and firm groundwork of critical thinking that I will be able to continue to expand throughout the rest of my nursing career. As I look at other nurses who have been practicing for 20 plus years, I do see that there thinking is on an entirely different level than mine. It is clear, precise, thorough, calm, and includes great intellectual suggestions of which I am not yet able to think. Yet I believe that watching and listening to other experienced nurses is helping me to develop a greater sense, knowledge, understanding, of the critical thinking process. I hope one day to achieve critical thinking at a level V, and continue learning and growing from that point. I believe that the goal

3 is most definitely attainable, with years of practice and a commitment and desire to advance my current skills.