Salvadora, Edmond V.

BSN
4b3

Critical Thinking and the Nursing Process

LEARNING OUTCOMES After

Although critical thinking has many definitions, one of the most useful
for nursing is from the National League for Nursing (2000): "Critical thinking
in nursing practice is a discipline specific, reflective reasoning process that
guides a nurse in generating, implementing, and evaluating approaches for
dealing with client care and professional concerns" (p. 2). Nurses are
expected to use critical thinking to solve client problems and make better
decisions. Thus, critical thinking, problem solving, and decision making are
interrelated processes, with creativity enhancing the result.
CRITICAL THINKING
Critical thinking is essential to safe, competent, skillful nursing
practice. The amount of knowledge that nurses must use and the continuing
rapid growth of this knowledge prevent nurses from being effective
practitioners if they attempt to function with only the information acquired in
school or outlined in books. Decisions that nurses must make about client
care and about the distribution of limited resources force them to think and
act in areas where there are neither clear answers nor standard procedures
and where conflicting forces turn decision making into a complex process.
Nurses therefore need to embrace the attitudes that promote critical
thinking and master critical-thinking skills in order to process and evaluate
both previously learned and new information. Box 10-
1 lists some reasons supporting the importance of critical thinking.
Nurses use critical-thinking skills in a variety of ways:
• Nurses use knowledge from other subjects and fields. Because nurses deal
holistically with human responses, they must draw meaningful information
from other subject areas (i.e., make interdisciplinary connections) in order to
understand the meaning of client data and to plan effective interventions.
Nursing students take courses in the biologic and social sciences and in the
humanities so that they can acquire a strong foundation on which to build
their nursing knowledge and skill. For example, the nurse might use
knowledge from nutrition, physiology, and physics to promote wound
healing and prevent further injury to a client with a pressure ulcer.
• Nurses deal with change in stressful environments. Nurses work in rapidly
changing situations. Treatments, medications, and technology change
constantly, and a client's condition may change from minute to minute.
Routine actions may therefore not be adequate to deal with the situation at
hand. Familiarity with the routine for giving medications, for example, does
not help the nurse deal with a client who is frightened of injections or with
one who does not wish to take a medication. When unexpected situations
arise, critical thinking enables the nurse to recognize important cues,
respond
quickly, and adapt interventions to meet specific client needs.
• Nurses make important decisions. During the course of a workday, nurses
make vital decisions of many kinds. These decisions often determine the
well-being of clients and even their very survival, so it is important that the
decisions be sound. Nurses use critical thinking to collect and interpret the
information needed to make decisions. Nurses must use good judgment, for
example, to decide which observations must be reported to the primary care
provider immediately and which can be noted in the
client record for the primary care provider to address later, during a routine
visit with the client.
Creativity is a major component of critical thinking. When nurses
incorporate creativity into their thinking, they are able to find unique
solutions to unique problems.C reativity is thinking that results in the
development of new ideas and products. Creativity in problem solving and
decision making is the ability to develop and implement new and better
solutions.
Creativity is required when the nurse encounters a new situation or a
client situation in which traditional interventions are not effective. For
example, a pediatric home health nurse is caring for a 9-year-old girl who
has ineffective respirations following abdominal surgery. The primary care
provider has ordered incentive spirometry (a treatment device that promotes
alveolar expansion). The child is frightened by the equipment and tires
quickly during the treatments. The nurse offers her a bottle of blow bubbles
and a blowing wand. She is delighted with blowing bubbles. The nurse knows
that the respiratory effort in blowing bubbles will promote alveolar expansion
and suggests that she blow bubbles between incentive spirometry
treatments.

Reaction

One of the skills that a nurse should process is to be a critical thinker.

On this ability there will be more aspects to be considered. Prioritization is
one of things that we should know in order to know what to do first and what
kind of patient should we treat. To have a good prioritization, we should have
a good knowledge about different kinds of diseases and what to expect on
that kind of scenario.
 Nurses, especially on the emergency area can also adapt on the
environment. It will be more traumatic for a new nurse to be on the ER. They
cannot deliver the care needed if their mind is not well set.

Nurses should also be decision maker. And to be able to have a good

decision, he or she might have a good knowledge and experience for the
delivering of care. Prioritization can also be a good example for this kind of
character.

The competency of the nurse is not only dependable on the knowledge

itself. But also on the way he or she thinks according to the scene. Common
sense is also vital. Theories for prioritization are also a good basis on the
health care provider. And the most important for me, that is none other than
attitude and how you can interact on the other health care provider.