Not so long ago, nurses were task-workers who simply carried out doctors’ orders and followed a fixed set of rules. Today, they are skilled and capable professionals whose expertise is essential to patient care and public health initiatives. It’s been a long road. And it’s clear that developing critical thinking skills has helped to bring about this transformation within the profession during the last half century.
So what exactly is critical thinking? There are a multitude of definitions – some of them very complex – so the Foundation for Critical Thinking (2010) has assembled some of them on its website. This one is our favorite:
Critical thinking is the ability to recognize problems and raise questions, gather evidence to support answers and solutions, evaluate alternative solutions, and communicate effectively with others to implement solutions for the best possible outcomes.
It’s not hard to apply this definition to nursing, is it? Nurses do all those things every day! It can be made even more specific to nursing by saying that critical thinking is a systematic approach to the nursing process that employs all the steps above to bring about excellent clinical outcomes while enhancing patient safety and patient satisfaction.
Critical thinking is definitely a skill that develops over time and as you gain more experience. But that doesn’t mean it’s absent in young or less experienced nurses. In fact, critical thinking skills are what make young nurses effective while they are gaining on-the-job experience. A less experienced nurse with keen critical thinking skills will be able to strategize and manage all sorts of new situations, while dealing effectively with everyone involved – the patient, family members, physicians, and other care team members.
When do you need critical thinking?
If you consider critical thinking to be multi-dimensional thinking, it becomes clearer when it’s most effectively employed. Multi-dimensional thinking means approaching a situation from more than one point of view. In contrast, one-dimensional thinking tackles the task at hand from a single frame of reference. It definitely has its place in nursing – one-dimensional thinking is used when nurses chart vital signs or administer a medication.
Critical thinking skills are needed when performing a nursing assessment or intervention, or acting as a patient advocate. As a patient’s status changes, you have to recognize, interpret, and integrate new information in order to plan a course of action. For example, what would the course of action be if an elderly patient became confused from his medications, was unable to understand instructions, and put himself at risk for falls? There may be no single “right” answer – you have to weigh all of the variables, prioritize goals, and temper next steps with empathy and compassion.
Critical thinking also involves viewing the patient as a whole person – and this means considering his own culture and goals, not just the goals of the healthcare organization. How would you handle a teenage girl who comes into your clinic asking for information about STDs? What about a seriously hypertensive patient who admits he can afford his medication, but doesn’t believe it is important that he take it every day without fail?
Critical thinking forms the foundation of certain nursing specialties, like case management and infection control. These areas require strategizing, collaborative relationships, and a multi-dimensional approach to tackling a problem (like preventing unnecessary hospital readmissions or discovering the source of an infection outbreak, for example). And of course, nurse managers use critical thinking skills every day as they keep their units running smoothly.
So what’s the next step?
To develop your critical thinking skills, you can:
- Suspend judgment; demonstrate open-mindedness and a tolerance for other cultures and other views.
- Seek out the truth by actively investigating a problem or situation.
- Ask questions and never be afraid to admit to a lack of knowledge.
- Reflect on your own thinking process and the ways you reach a conclusion.
- Indulge your own intellectual curiosity; be a lifelong learner.
- View your patients with empathy and from a whole-person perspective.
- Look for a mentor with more experience than you have; join professional organizations.
- Advance your nursing education.
The best way to develop your critical thinking skills and empower yourself with knowledge is through an online RN to BSN or RN to BSN/MSN degree. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in nursing education, nursing informatics, and executive leadership.
Written by Bruce Petrie, Ph.D., VP, Research and Institutional Effectiveness
Revised July 2017Tagged as nursing skills
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