What is Critical thinking? The dictionary defines it as “the objective analysis and evaluation of an issue in order to form a judgment “. Critical thinking according to philosophy.hku.hk “is the ability to think clearly and rationally about what to do or what to believe”. Applied to nursing it means having to think soundly and purposefully based on the objective information gathered from the patient and skillfully applying those information towards the best patient outcome.
What Involves Critical Thinking
1. The ability to identify that such situation is critical.
2. The ability to analyze the situation timely based on information gathered.
3. Awareness of how the process goes based on the institutions guidelines ( if at all applicable or depending on the setting). To be able to act upon the critical situation safely, properly and effectively.
4. Knowing how to prioritize.
5. Acknowledging his/her strong skills to be able to identify each and every one’s tasks during the intervening process.
6. Knowing who to call for assistance. Most facilities have a designated team to be called upon for immediate response but it is still very critical for nurses to be aware what firsthand interventions are needed to be done while waiting for those personnels as time is of the essence.
7. The ability to work as a team member.
8. Knowing what critical information to convey to the team and how to properly convey it.
9. Acknowledging the patient and families wishes and privacy.
10. The ability to evaluate the outcomes properly. Some outcomes may not be readily distinguished but some signs or values are important which can be taken into consideration to know whether to change course or keep going with coordination of course by the team.
How Important Is Critical Thinking Skills
The ultimate goal is to save lives and to do it in the most dignified and safe way possible. Our patients lives, well-being and dignity is very important. We as healthcare personnel tend to look past these other areas due to time constraints, lack of help, knowledge, proper training and so many other reasons.
I believe as human beings we should be able to think of our patients, or each individual as unique but at the same time have common needs just like us may it be in a critical or noncritical situation but most especially in a critical situation as they don’t always have a voice!
Prioritization is one of the elements of critical thinking so of course we have to identify the most important interventions to do with mindfulness that the person in critical condition is an individual who needs his/her wishes honored and so as his/her privacy.
There’s a lot to consider in a critical situation that’s why proper training and knowledge is very important.
What Hinders Critical Thinking Skills
In general there’s a lot that hinders critical thinking skills. But in a clinical setting, there’s quite a few that I can point out.
- Nurse’s readiness to embark in a certain patient population. The reality is there’s a lot of new graduate bedside nurses. A lot of senior nurses that are highly skilled and experienced are long gone and have left bedside nursing due to a lot of different reasons. There’s nothing wrong with being a new graduate but they can’t be blamed if a facility or management assigned them to a patient that are very sick for them to take care of.
- Lack of proper mentorship and training. As I have mentioned above, a lot of highly skilled and senior nurses has either left the workforce or left bedside nursing for a different type of nursing job or reasons therefore the slightly experienced nurses who are probably 2-3 years higher in tenure with the new ones are the ones that are mentoring the new graduate nurses.
- Having to deal with a lot of high acuity patients at that given moment. One of the sad reality also in nursing is there’s not enough bedside nurses. (this is another topic to delve into..a painstakingly one if I may say so)
- Feeling of being overwhelmed. Obviously if a nurse has too many patients and is not as experienced with her patient population, being overwhelmed tends to happen.
- Loss of focus. We all go through things in our lives, we all have issues but there are some who seems to not know how to separate personal to work life. Or there are some who are just not cut out to be in a nursing profession.
- Lack of compassion. Same as number five..there are some who are just in the profession to make money and not to care for other peoples lives. (this is very sad)
- Pride. We are human beings that is endowed with different personalities and qualities in which sadly some nurses can’t take the humility to swallow their pride which is very important because at some point we all have to listen to other people’s ideas which maybe critical to that given situation.
- Lack of accountability. For whatever actions we take or do we should be able to be held accountable for them. But sadly there’s a few nurses or other clinical personnel who will try to get away or deny their wrong actions in which the patients suffers.
What are The Factors That assists Good Critical Thinking
1. Learn how to gather facts or data as precise and accurate as possible.
2. Know how to listen to the patient (if patient is still able to speak), family member (that are mostly with patients) and assistants that are mostly the data gatherers i.e. vital signs, urine input and output etc.
3. Be Always aware of patient’s baseline status and their medical histories.
4. Always starts with an accurate as possible and thorough physical assessment.
5. Be wary of face value or firsthand physical presentation as those cans be deceiving.
6. Always check lab values and vital signs. And be very knowledgeable with those values and actions to be done if there’re critical changes.
7. Knowing who to consult in emergencies. This will save time as you can go straight to the proper channel.
8. Be a team player. This saves heartache, disagreements and ultimately patient lives. If a nurse is a good team member, there’s a lot that will be willing to help which in the long run helps our patients.
9. Being mindful and conscientious. This is what’s in your gut. This is doing the best possible action or intervention that could save patients lives.
This topic is very broad and requires a lot of looking into. There’s a lot of discussions about this which I will be dissecting as I go on. The purpose of this blog is to spread light and encourage discussions as to better our patient care in which in this topic is taking care of our critically sick ones.
Feel free to leave your questions and comments below. Thank you!