Nurses who utilize good critical thinking skills are able to think and act in areas where there are neither clear answers nor standard procedures. Treatment options, especially for the home health client, can be extensive. There are many points to consider (good and bad), and choosing between treatment options can cause conflict among family members. The nurse in this case must use creativity, analysis based on science, and problem-solving skills—all of which contribute to critical thinking skills.
Assisting an orthopedic client with the proper use of crutches
Administering IV push meds to a critically ill clients
Educating a home health client about treatment options
Teaching new parents car seat safety
"You'll only get worse if you don't do these exercises."
"As soon as you get these into your routine, you'll feel better."
"Here's a marker. See how many circles you can make on this board in 10 minutes."
"Your physician wouldn't have ordered these if they weren't important."
"You'll get bored if you don't learn to be creative."
"Not all of your answers are going to be from your textbook."
"Creativity makes nursing more fun."
"Creativity allows unique solutions to unique problems."
"What other ways of studying could you implement?"
"If you study all the unit outcomes, what effect will that have?"
"What makes you think cramming for a test is an ineffective way to study?"
"If you didn't study for your test, what is the probability you will fail?"
Deductive reasoning is reasoning from the general to the specific. The nurse starts with a framework and makes descriptive interpretations of the client's condition in relation to the framework. Productive cough, crackles, fever, and chills all point to problems with respiratory status
In critical thinking, the nurse also differentiates statements of fact, inference, judgment, and opinion. The nurse will have to ascertain the accuracy of information and evaluate the credibility of the information sources
"If you know what you have, what do you want from us?
"Did you bring your prior tests and results with you, so we don't repeat anything?"
"Why don't you just tell your physician what you think you have?"
"Describe what tests you've had and explain the symptoms of this disorder."
Intellectual integrity requires that individuals apply the same rigorous standards of proof to their own knowledge and beliefs as they apply to the knowledge and beliefs of others. Trying new teaching techniques in the hope that students might respond positively shows that the first educator is willing to question her own practices, just as she would question those of another
Critical thinkers are open to the possibility that their personal biases or social pressures and customs could unduly affect their thinking. They actively try to examine their own biases and bring them to awareness each time they make a decision. Understanding that how things were done and what practices were common may be completely different in the new surroundings is an example of the nurse implementing this attitude
Intellectual courage to challenge the status quo and rituals
Insight into egocentricity
Nurses who can think for themselves and consider different methods of performing technical skills—not just the way they may have been taught in school—develop an attitude of independence.
Intellectual courage to challenge the status quo or rituals
The internal conversation going on within the mind of a critical thinker is filled with questions. The curious nurse may value tradition but is not afraid to examine traditions to be sure they are still valid, as in this case. This nurse is asking valid questions.
Reflection involves being able to determine what data are relevant and to make connections between that data and the decisions reached. The nurse reflects on previous clinical experiences similar to this one and determines if the outcomes of care improved the clients’ conditions.
Context is being considerate of the whole situation—including relationships, background, and environment—and its relevant to the current situation.
Logicalness would ask if the report follows from the evidence. In this case, it does not. However, the nurse is still questioning, which shows she is engaged in critically thinking through the situation.
Trial and error
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