Critical Thinking In Nursing Case Study

"Critical thinking is the ability to think systematically and reflect on the reasoning process used to ensure safe nursing practice. Therefore, critical thinking skills are helpful in making appropriate decisions and quality nursing care (Zarifsanaiey, Amini, & Saadat, 2016, p.2). With the in mind let us review model case which introduces a 70-year-old male who came to see a Certified Outpatient Diabetes Educator with concerns of elevated blood sugars for last two days. As the nurse reviews patient's history she also investigates if there were any recent changes in medications, physical activity, diet, and reviews patient's understanding of the importance of injections site rotation and monitoring for an expiration date of insulin itself. Therefore, a nurse proceeds to examine the insulin pump download and immediately realizes that the patient has not been changing his insertions site every three days as often instructed which definitely could be a reason behind persistent hyperglycemia due to inadequate insulin delivery.

Moreover, upon assessment, nurse educator knows that this individual did not follow Diabetes Ketoacidosis (DKA) prevention protocol which includes manual insulin injections to correct high blood sugar values and monitoring urine for ketones using provided strips.

Under those circumstances, a nurse asks the patient to recheck blood sugar which was reported as 450, and upon further examination, she discovers that he has been complaining of nausea, polydipsia, and polyuria indicating the beginning of DKA. Subsequently, she decides to refer him to Emergency Room for treatment and evaluation plus arranges a meeting after client's discharge for additional education regarding insulin pump management and treatment of

hyperglycemia.
In this example, the nurse exhibits knowledge acquired through additional training in diabetes self-management and competency in the area by possessing professional certification defining her as an expert. Thus, she also shows the ability of thorough analysis of insulin pump download data as well as interpretation of all symptoms and comes to the conclusion that this individual needs immediate medical attention before his condition deteriorates. Furthermore, she makes an essential decision to arrange an education session to assure that this situation never occurs again. In this case, the antecedent was fundamental knowledge acquired through education about hyperglycemia and its complications. However, the consequence as well empirical referent of measurement could be summarized by exceptions patient care which prevented this patient from serious illness which could lead to a prolonged hospitalization.
Borderline Case
On the other hand, in the borderline case will present the same patient with exact problems and symptoms. However, the nurse who has professional qualifications to provide comprehensive care decides not to repeat blood sugar in the office and while making her judgment based on insulin pump download only revealing values no higher than 350 ultimately sending a patient home with additional insulin pump adjustments and DKA prevention education. Unfortunately, next morning patient came to Emergency Room with abdominal pains which required hospitalization and treatment of dehydration exhibiting poor decision making skills.
Contrary Case
Finally, the contrary case will revolve around the same individual as mentioned in previous scenarios. But, here the client decides to seek guidance from a Primary Care Nurse who graduated one year ago and is considered a novice in her professional career. Therefore, a nurse had no knowledge of insulin pump management and related to life-threatening diabetes complications, which ultimately reflected poor skills in analysis of patient’s symptoms. As a result, she was not capable of making an accurate decision regarding patient care which caused the deterioration in his condition and prolonged admission since he was sent home with instructions to come back if blood sugar does not improve by the next morning.
Conclusion
In conclusion, the critical thinking is a process which requires well-developed cognitive abilities in problem recognition, clinical decision- making, prioritization, clinical implementation and reflection (Turkel, Marvelous, Morrison, Sigletary, 2016). Although this skill is primarily developed through practice and acquired experience, there is evidence that initial training in critical thinking should be initiated by educators as early as in nursing schools. Therefore, the responsibility to promote and provide proper training system to recognize the importance of critical thinking lays on the lap of Advanced Nursing Practice. Moreover, it is imperative to keep in mind that as Benner's theory identifies stages in career development through one's achievements in professional arena critical thinking never cease to continue to grow. Thus, the expert nurses ought to take under their professional wings novice professionals to promote, encourage and guide through a clinical learning process to be well prepared, competent workforce facing evolving and challenging healthcare.
With that in mind, the critical thinking concept has been my passion for last few years because I have experienced the caring attitude of expert nurses in my beginning professional years as well as the unconcerned approach which has motivated me to follow the footsteps of the ones who made a positive impact on my career. Therefore, I am not only aware of critical thinking to be one of the essential aspects of nursing profession, but it has become in my eyes the most involved and vibrant concept reaching numerous areas of