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What does critical thinking involve in nursing practice
Components of critical thinking in nursing
Components of critical thinking in nursing
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Introduction Throughout the years, critical thinking has been defined, interpreted, and implemented in a variety of professions. The nursing profession demands the use of critical thinking for the safety of patients and staff members. With plenty of practice, it can be taught and learned, but it is key that the learning process starts at the beginning of nursing school.
Exploring Critical Thinking
Describing Critical Thinking in Nursing Critical thinking in nursing can be viewed and described in many different ways, but in general, has the same effect in nursing situations and outcomes. Authors Wilgis and McConnell believe that critical thinking is a purposeful, analytic understanding, and evaluation of information, that is then used
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This requires effective thinking, examination, individual and team thinking, seeing the situation in different perspectives, and then using every aspect combined to create a strategic plan. He explains it as purposeful thinking. Critical thinking enhances decision-making by providing an easy to follow guide that leads you to the best possible action (Brunt, 2005). Richard Paul, director of the Center for Critical Thinking, sees critical thinking as the skill of thinking, about your thinking, while you are doing so to improve your thinking. He sees it as a continuous process that is never ending. Critical thinking does not end when a decision has been made because there should then be thinking critically about what may happen next or how the decision could be tweaked for a better outcome. He believes one should be constantly thinking and reflecting on the process used to think critically (Staib, …show more content…
I realized that before trying to get an order for supplemental oxygen, I would try to implement nursing interventions first. I thought about the reasons that would contribute to her shortness of breath and low oxygen saturation. Because of her medical diagnosis, I knew that her lungs might have an impaired gas exchange.
I auscultated her lungs, which were diminished with crackles in the bases bilaterally. Key interventions for low oxygenation are coughing and deep breathing, sitting straight up, breathing in through the nose and out the mouth, and using the incentive spirometer. If none of the above interventions improved the oxygen saturation, then oxygen would have to be administered.
I had the patient sit up with the head of the bed raised. I wondered if she was able to cough up any of the mucus or fluid that was sitting in her lungs. She told me that she did have a productive cough. I taught her the importance of coughing and deep breathing, and explained that it would help clear her lungs up so that she could get more oxygen circulating in her body. After coughing a few times and taking a deep breath in through her nose, she was able to pull up some of the mucus and her oxygen saturation reached
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
Fluid volume overload within the intervascular space can cause shortness of breath, fluid within the lungs, engorged neck veins, increased blood pressure and heart rate with a bounding pulse. As blood volume increases so will blood pressure and heart rate. Impaired gas exchange related to pulmonary congestion causes crackles within the lung fields. If oxygen saturation is low the nurse should supply supplemental oxygen. The nurse would raise head of the bed at least thirty degrees or higher to promote breathing and reduce cardiac pressure. Having the patient cough and breath deep can pop open alveoli to clear lung passages. Once the patient is comfortable and in safe position the nurse can call the doctor. The nurse should anticipate another dose of diuretics, such as furosemide. This treatment will decrease respiratory rate and blood pressure by reducing the amount of sodium and fluid within the body. Breath sounds will improve as crackles decrease. Maintaining appropriate fluid volume stabilizes blood pressure, cellular metabolism and proper nutrition gained or wastes lost. Supplemental oxygen if oxygen saturation is low and the nurse has already supplied the patient with oxygen. (Ignatavicius & Workman,
Rubenfeld, M. G., & Scheffer, K. B. (2015). Critical thinking tactics for nurses: Achieving the IOM competencies (3rd ed.). [VitalSource Bookshelf Version]. http://dx.doi.org/9781284059571
Define a critical thinking task that your staff does frequently (Examples: treat high blood sugar, address low blood pressure, pain management, treat fever, etc.). Create a concept map or flow chart of the critical thinking process nurses should take to determine the correct intervention. Include how much autonomy a nurse should have to apply personal wisdom to the process. If the critical thinking process was automated, list two instances where a nurse may use “wisdom” to override the automated outcome suggested. Note the risks and benefits of using clinical decision-making systems.
Personally I understand that critical thinking is a way of using several concepts to identify solutions and determine a course of action to solve patient’s care problem. Every patient that comes to the hospital is looking up to the health care team to solve the problem with which they are presenting; therefore the nurse must be able to explore all avenues to solve their care problems.
The author Vincent Ruggiero defines critical thinking in his book Beyond Feelings: A Guide to Critical Thinking, as a “search for answers, a quest.” It is the idea that one does not accept claims, ideas, and arguments blindly, but questions and researches these things before making a decision on them. From what I learned in class, critical thinking is the concept of accepting that there are other people and cultures in this world that may have different opinions. It is being able to react rationally to these different opinions.
Sorensen, H. J., & Yankech, L. (2008). Precepting in the Fast Lane: Improving Critical Thinking in New Graduate Nurses. Journal Of Continuing Education In Nursing, 39(5), 208.
According to Paul, Ennis and Norris (1990), critical thinking is defined as the disciplined, intellectual process of applying skilful reasoning as a guide to belief or action. Heaslip (1993) stated that critical thinking in nursing for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care. Jones and Brown (1991) defined critical thinking in nursing is the use of technique analysis, questioning, interpretation, and reflection to resolve patient care issues. It also meant that a variant of the scientific method used for decision-making in the medical field. Furthermore, Potter and Perry (2004) state that it is the ability to think critically through the application of knowledge and experience, problem solving and decision making is central to
"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.
Yildirim, B. & Ozkahraman, S. (2011). Critical Thinking in Nursing and Learning Styles. 1. Retrieved from http://www.ijhssnet.com/journals/Vol_1_No_18_Special_Issue/15.pdf
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal Of Nursing Terminologies & Classifications,21(2), 82-88. doi:10.1111/j.1744-618X.2010.01150.x
What is not easily recognized is the fact that the very fabric of life is dependent on the ability to think properly and make good decisions. Improper thinking is costly in the quality of life and monetarily. The result of a critical thinker that has worked to cultivate proper thinking skills includes: the ability to ask vital questions and to identify problems with clarity. A critical thinker also collects relevant information while effectively interpreting it, thinks with an open mind, uses alternative systems of thought, and understands how to communicate while working to formulate a strong solution. In summary, critical thinking is self-disciplined, self-monitored, and self-corrective thinking. Above all else, the standards of excellence are rigorous, and it entails the prospect of overcoming the challenge of sociocentrism and
Critical thinking and decision-making are related in more ways than people think. This paper will define critical thinking and decision-making according to the book Whatever It Takes. It will also present a personal definition of critical thinking and decision-making from the author of this paper. The relationship between the two will be explained as well as the benefits of being a critical thinker. The author of this paper will also show how critical thinking is present in his organization and how he implements critical thinking techniques on a daily basis.
Critical thinking means accurate thinking in the search of appropriate and dependable knowledge about the world. Another way to describe it is sensible, insightful, responsible, and skillful thinking that is focused on deciding what to believe or do. Critical thinking is not being able to process information well enough to know to stop for red lights or whether you established the right change at the supermarket.
Critical thinking regularly involves the capability to interpret information and make knowledgeable decisions based on such information. Additionally, problem solving is frequently theorised as the use of critical thinking skills towards the effective solution of a specific problem or towards a specific end goal. Critical thinking is the disciplined art of ensuring that you use the best thinking you are capable of in any set of circumstances. The general goal of thinking is to figure out some situation” (Critical Thinking, 2001, p.1), solve some problem, answer some questions, or resolve some issue. It also is a process in which a person pursuits reliable and pertinent information about the world. Critical thinking is often described as reasonable, ruminative, trustworthy, and a well-practiced form of thinking that assists people with deciding what they should believe in and what actions should be taken. A practiced critical thinker will ask good questions, collects pertinent data, categorizes common characteristics, logically reasons with the new data and then he or she will come to a trustworthy and dependable conclusion. Critical thinking makes use of many processes and procedures. Some processes include but is not limited to asking questions, making judgments, and identifying