nursing critical thinking

nursing critical thinking

The Importance of Critical Thinking in Nursing

1. Introduction

Critical thinking is a client-centered and evidence-based learning method used to increase the quality of nurses and nursing care. It is a mode of thinking specific to nursing and consists of several modes of thought critical to nursing. These include reflective, skeptical, reasonable, and rational thinking, which is focused on deciding what to believe or do. A nurse who thinks critically uses these modes of thought to contemplate how to precisely improve the client’s state of health. This is in contrast to other problem-solving methods where the thinker may jump straight into a decision without giving thought to the options and the consequences thereof. This client-centered care to improve a situation is backed up by rational, logical, intuitive reasoning. Although different, all the modes of thought hide the “same” critical thinking standard. During the process of critical thinking, ideas should be reasoned, well thought out, and judged. The National League for Nursing (1986) stressed that all these decisions have to be focused on the best possible solution and not on personal bias or a hasty decision. This kind of critical thinking can also comprehend that not all situations have only one answer but may have a range of answers, each with its own effects. During the critical thinking phase, complex problem-solving and decision-making are evident. For this information to be utilized, it must be well reasoned, and the nurse has to be able to clarify it to others. The reasoning process is not an easy path as the thinker may have to be aware that the things they once believed may have to change due to new information or evidence coming to light, always weighing up the benefits and the opportunity cost of what is being done. A critical thinker is able to infer, ask questions, and transfer knowledge to the situation at hand. This is what we mean by creative thinking.

2. Defining Critical Thinking in Nursing

A disciplined critical thinker has a set of criteria and standards for accurate thinking (Alfaro-LeFevre, 2013). Using critical thinking, they resist the temptation to find a simple answer to a complex problem and quickly accept the first or most obvious solution. In practicing critical thinking, the nurse considers all possible solutions and decides on the best solution for each case. The best or right solution requires a high-quality decision, and all alternative solutions are of lower quality. High-quality decisions can be made with a complete knowledge base, and you cannot possess all the information necessary to make the decision at the time, so a commitment to finding the best information available is imperative. This requires seeking information that is relevant to the situation and taking into account all the information available before making a decision. This last step also requires a continual improvement of the quality of one’s beliefs (Paul and Heaslip in Levett-Jones and Hoffman, 2013).

Critical thinking has been described as the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action. It is important because it is the thinking that levels of student to more professional practical of profession. Critical thinking is also described as a process that contributes to patient safety (Paul and Heaslip in Levett-Jones and Hoffman, 2013).

3. Benefits of Critical Thinking in Nursing Practice

Critical thinking is essential to skilled nursing and is therefore essential to nursing education. It is interesting to note that the ANA (American Nursing Association) standards have set forth the framework necessary for critical thinking in the application of the “nursing process.” The nursing process is a systematic, rational method of planning and providing specialized nursing care. Step by step, the nurse must implement a systematic problem-solving process by using critical thinking to decide on the best action to take. The reasoning the nurse employs must be sensitive to the needs and experiences of the patient, the different options available, and the inevitable uncertainties inherent in the situation and how the process can be altered if need be. In this problematic situation the nurse will use evidence-based knowledge by integrating research, clinical knowledge, expert opinion and patient preference to come up with the best solution. The final decision may be affected by many converging and diverging variables, all of which must be weighted in light of the purpose to achieve the best possible solution. Evidence is clear that the ANA’s standards of critical thinking are crucial to the nurse’s decision making and judgment as this directly affects the safety of patient care.

Patient care, an act that requires critical thinking and problem-solving skills to deliver an understanding result. Hospitals are now complex organizations and clients who are now acutely ill with multiple medical problems. Critical-thinking nurses are able to make sense of complex information and are best prepared to make the best decisions and solve problems to provide safe and effective patient care. There is no live practice of nursing until it is practiced in complex situations involving clients in the real world. Critical thinkers from asking the right questions, Socratic questioning, using logic, open-mindedness, and from accepting the diverse opinions of others to not only comprehend and diagnose, but also to plan, implement and evaluate the diagnosis and plan by being self-reflective and being mindful of the outcomes, while incorporating new and more effective approaches in the future.

4. Developing Critical Thinking Skills in Nursing Education

The education, orientation, and continuing education programs for nurses should be designed to encompass and substantially increase cognitive and effective critical thinking skills. Despite differences of opinion, many researchers agree that an in-depth understanding of the intellectual roots and critical thinkers is crucial in the development of critical thinking. This in-depth understanding is the basis for structuring the environment and designing the teaching/learning experience. Simulation in the form of role-playing can be used effectively with adults to improve their thinking skills. The Socratic method (a form of questioning) can be employed at each stage of the process to elicit thinking and knowledge previously gained. Continuing with the ideas of assessment, provision of feedback, and reflection, the nurse can identify areas for improvement and thereby further develop the nursing process and increase the patient’s quality of care. Probability and decision analysis, as mentioned before, in developing critical thinking in new graduate nurses, is an important step, and each stage should be thoroughly guided. All learning experiences must be relevant and applicable to a nurse’s practice. Ineffective problem identification can lead to a situation that still exists today, with practicing nurses taking different actions to solve what they believe is the same problem. To achieve changes in knowledge structures or problem-solving, the teaching must be focused on changing the way the student thinks about a specific issue.

5. Conclusion

Critical thinking has been described as the skill and ability to use one’s nursing background knowledge and experience to try and envision alternatives, recognize and diagnose actual and potential patient problems, as well as determining interventions. At its basic level, it involves a greater awareness of one’s thinking, to analyze and attempt to solve issues systematically. It is reasonable to assume that as a student nurse or a newly qualified registered nurse, the importance of critical thinking is vital and holds a key influence on the health and well-being of those under the care of the nurse. Critical thinking, combined with creativity, will enhance the nurse’s ability to problem solve more efficiently and effectively, often resulting in an improved reflection of the issue at hand, ultimately minimizing the risk of doing any harm. In today’s healthcare environment where the focus is on evidence-based, effective, cost-efficient care, and the aging baby boomer population is in greater need of care, critical thinking is now more important than ever to achieve positive patient outcomes. It is no longer acceptable to pass off someone else’s opinion as fact. Take, for example, pain management. With critical thinking being an essential skill for nurses, a new graduate registered nurse will be able to make clinical judgments and allocate the most appropriate care for their patients. Step 1 in the process is to remove the foreign body or substance. With critical thinking being the foremost skill to learn this simple step, this could potentially save a life, prevent further harm, ease a lot of anguish for a patient and family, and also save a lot of costs to the healthcare system. Step 2 is where the nurse has to understand a specific problem and assess their knowledge and try to locate the best evidence-based practice to apply to the patient’s case. An example of this could be in an area of nursing where there is no pain management therapist; an oncology nurse working autonomously to prescribe and gather the right dosage of non-opioid pain medication for a patient. A critical thinking nurse would weigh up the pros and cons of this drug, look at alternative methods, and seek advice on the best option. Throughout the entire process and the thinking and action of effort into the best possible practice is critical thinking, and ultimately a positive patient outcome is what the nurse is trying to achieve.