Critical Thinking in Nursing

Critical Thinking in Nursing

Stephen Sweeney

Farmingdale University

Critical Thinking in Nursing

Critical thinking in nursing is consistently used by the professional nurse on a daily basis.  One of the ways critical thinking in nursing can be defined is the process of reviewing many components of the nursing process, synthesizing and adapting this information to improve the patient’s outcomes to meet their specific goals.  This definition is simplistic because the nature of the subject is very complex and it deals with the way individuals process information from a multitude of sources. (Black, 2014).  

The nursing process is an excellent mechanism to developing critical thinking skills as asserted by Black (Black, 2014).  The assessment phase of the initial patient encounter is rich with information to formulate an idea of the proper course of treatment for your patient.  Subjective and objective findings are valuable but they can also contradict each other such as a patient that states that they can not breathe but can speak for ten minutes without barely taking a breath or the patient that has ten of ten abdominal pain and has just finished eating a large Big Mac, soda, and talking on their cell phone.  There is also the individual who states they have severe right lower leg pain and pain when he breathes in, the patient has also provided that he had a surgical procedure two weeks before. His objective data shows oxygen saturation level of 90%, redness and swelling to the right lower extremity.  After blood work results have been processed an elevated D-dimer level is observed, the patient has a Cat scan, which indicates the patient has a pulmonary embolism.  Nursing interventions should include head of bed 45-90 degrees, assess respiratory status for distress, assess oxygen saturation levels, administer o2 if needed, assess cardiovascular status for arrhythmia’s caused by hypoxia, and prepare the patient for anticoagulant therapy.  Nursing diagnoses can be formulated and prioritized for this patient to obtain the desired outcomes and goals.  These diagnoses can change based on the patient’s response to the plan implemented.  Nurses are constantly critically thinking to provide the proper data to achieve the most therapeutic outcomes.

Critical thinking is decidedly different when comparing the novice to the expert nurse.  The novice nurse will strictly follow procedure and tend to be task oriented without being able to synthesize all the data presented to them at once; this may be due to the stress created by being in a dynamic environment.  The expert nurse can be more comfortable with their surroundings letting them appear more confident which helps to quell the patient’s anxiety.  This in return lets the patient feel more trusting and comfortable so that information and treatment can be dispensed.  An interesting way to enhance the novice nurse ability to think critically is via simulation as documented by Madick and Pierce (Madick & Pierce, 2015).  This setting provides the novice nurse with scenarios that are like case studies being performed on high-tech mannequins.  The nurse interprets the information provided by educator simulated through a speaker in the mannequin.  The nurse then provides interventions analytically to help their patient.  The participants afterward can reflect on their experience and gain critical knowledge via feedback from the instructors. Working with simulation enables the novice to practice critical thinking in a less stressful and safe setting while also providing the benefit of problem-based learning and hands-on simulation of real world situations.