Critical Thinking in Nursing – An Indispensable Element

Nursing is a promising and in-demand career for those who love challenges and have a mind to care for the sick & aged. Nurses work and use their skills to promote health, prevent illness, and guide patients in overcoming ailments. The healthcare environment is, constantly, subjected to dynamics which put nurses in demanding situations. In order to provide holistic nursing care and to confront these challenging scenarios, it is mandatory for nurses to develop and improve their nursing skills. When we talk about nursing skills, it is not only communication skills, or powers of observation, or their dedication or sincerity, or their mastery of nursing procedures that nurses ought to possess. Rather, there are other critical skills that ought to be considered. One important skill needed in the nursing profession, in order to administer safe and competent care, is the ability to think critically.

What exactly is Critical Thinking? It is a discipline that focuses on the thinking & reasoning ability of individuals to reach sound conclusions & make competent decisions. It is a discipline that can help nurses think effectively, and reach safe, appropriate, & timely decisions in a clinical setting. It is an active, organized, intellectual process that enables a person to examine their thinking as well as others’ thinking (Funnell & Koutoukidis, 2009).

How does one develop critical thinking skills? Is it inborn or a skill one learnt over time through childhood & nursing school? Critical thinking is an integral part of nursing because it is vital in prioritizing the needs of patients and making clinical decisions for them. To start with, nurses must have a thorough knowledge of nursing content & theories. Next, nurses must develop & hone their ability to understand a clinical situation, and interpret their observations correctly & in a timely manner. Eliminate insignificant, unreliable information, & observations. Explore objective & inferential data using logic in order to reach a rational conclusion. A nurse should rely on valid and pertinent evidence to support her clinical decisions. Next, they must have an inventory of available options when possible, and knowledge of the possible & logical outcomes of each choice. Nurses should develop the quality of active-mindedness that enables them to react to fluid situations & permits them to plan improved nursing interventions.

Let us illustrate with an example. You are a nurse working in a medical unit. Your patient reports feeling hungry but refuses to eat when food is served. What would you do in this situation as a nurse applying critical thinking skills?  In this scenario, the nurse should concentrate on patient needs & must not rely on assumptions. It is easy to believe that the patient is lying by stating that he is not hungry. However, there might be more to the scenario than what meets the eye. Another flaw might be making a presumption that the patient has difficulty swallowing and, consequently, notifying the physician of the need for alternative feeding methods. Some nurses might also force their patient to have food. What, properly, must the nurse do?

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First, understand the situation clearly. Your patient is hungry but is not eating after food is served. Think as a nurse. Use your nursing knowledge and apply it to the situation. Collect required information regarding the patient’s problem. A thorough assessment is the right, first step the nurse should take in this scenario. Talk to the patient, & ask relevant & probing questions as to why he does not want food despite feeling hungry. Based on the information collected & after relevant analysis, the nurse can plan relevant solutions and intervene. Objective assessment is the, key, first step in such a scenario. In this situation, it is vital to know exactly what’s happening to the patient. Is the root of the problem owing to the patient’s present condition, or the treatment he is undergoing, or his overall physiology, or his psychology?

In practical, clinical settings, critical thinking skills are essential in all units whether it be an operating room, an acute care complex, or a community care center. Nurses need to use their critical thinking & nursing skills in interpreting observations & making informed decisions. Critical thinking skills do improve over time and an expert critical thinker has experience, proficiency, patience, and commitment. A novice nurse might face difficulty in the process of critical thinking but with time, dedication, & perseverance, she would find an improvement along with increased knowledge and better insight. It helps to introspect by monitoring, evaluating, questioning, & managing one’s own thought processes.

For this reason, nursing schools emphasize critical thinking exercises in nursing curriculum’s to hone reasoning and other decision-making skills of their future nurses.

In life, we face many problems. Choosing a solution without thinking critically can lead to adverse outcomes. This same is applicable when one cares for a patient. Patients deserve quality care and it is the responsibility of medical professionals to design, plan, and implement right treatments using exceptional reasoning & intellectual skills to achieve healthy outcomes for their patients.