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Critical Thinking and The Nursing Process

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Title: Critical Thinking and The Nursing Process


1
Critical Thinking and The Nursing Process
  • Raquel D. Esguerra RN, MAN, CCRN

2
What is critical thinking?(general definition)
  • intellectually disciplined process.
  • based on observation, experience, reflection,
    reasoning /or communication.
  • analyzing, synthesizing, conceptualizing,
    applying, /or evaluating information.
  • produces a belief or action.

3
What is critical thinking?(in the context of
nursing)
  • entails purposeful, informed, outcome-focused
    thinking that requires careful identification of
    key problems, issues and risks involved.
  • is driven by patient, family and community needs.
  • is based on principles of nursing process and
    scientific method.
  • use both logic and intuition, based on knowledge,
    skills and experience.
  • is guided by professional standards and ethic
    codes.
  • is constantly re-evaluating, self-correcting and
    striving to improve.

4
Why focus on critical thinking?
  • Things arent what they used to be, or what they
    will be.
  • Patients are sicker, with multiple problems.
  • More consumer involvement (patients and
    families).
  • Nurses must be able to move from one setting to
    another.
  • Rapid change and information explosion require us
    to develop new learning and workplace skills.
  • 5 Consumers and payers demand to see evidence of
    benefits, efficiency and results.

5
Why focus on critical thinking?
  • Todays progress often creates new problems that
    can not be solved by old ways of thinking.
  • Redesigning care delivery and nursing curricula
    is useless if students and nurses dont have the
    thinking skills required to deal with todays
    world.
  • It can be done-it doesnt have to be that
    difficult.
  • 1 Your ability to focus your thinking to get the
    results you need can make the difference between
    whether you succeed or fail in this fast-paced
    world

6
CREATIVITY
  • a major component of critical thinking
  • thinking that results in development of new ideas
    and products
  • required when a nurse encounters a new situation
    or a client situation in which traditional
    interventions are not effective
  • Requires knowledge of the problem to come up with
    a creative solution

7
With creativity, nurses - - -
  • Are generally flexible and natural
  • Generate many ideas rapidly
  • Create original solutions to problems
  • Tend to be independent and self-confident, even
    when under pressure
  • Demonstrate individuality

8
How Nurses Use Critical Thinking
  • Use knowledge from multiple subjects and fields.
  • Deal with change in stressful environments.
  • Make important, life impacting decisions.

9
Critical Analysis
Skills in Critical Thinking
Inductive Reasoning
Deductive Reasoning
10
Critical Analysis
  • The application of set of questions to a
    particular situation or idea to determine
    essential information and ideas and discard
    superfluous information and ideas
  • Socratic questioning
  • Box 15-1, Text p. 246
  • Can be used during end-of-shift report, planning
    care, discussing a clients care with colleagues

11
Inductive reasoning
  • Generalizations are formed from a set of facts or
    observations
  • Example
  • Symptoms dry skin, poor turgor, sunken eyes,
    dark amber urine
  • What do you think is wrong with this client?

12
Deductive reasoning
  • Reasoning from general to specific
  • Example the nurse starts from a conceptual
    framework (Maslows Hierarchy of Needs) and makes
    descriptive interpretations of clients condition
  • Given a medical diagnosis, the nurse makes
    nursing diagnoses

13
Give an Example of
  • A fact
  • An inference
  • A judgment
  • An opinion

14
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15
Attitudes that foster Critical Thinking
  • Independent thinking
  • Fair-Mindedness
  • Insight into Egocentricity vs. Sociocentricity
  • Intellectual Humility Suspension of Judgment
  • Intellectual Courage
  • Integrity
  • Perseverance
  • Confidence in Reason
  • Interest in Exploring Thoughts and Feelings
  • Curiosity

16
When do Nurses Use Critical Thinking?
  • To prioritize nursing actions
  • To resolve conflict
  • To implement change
  • To analyze situations
  • To solve problems
  • To make decisions

17
The Nursing Process
  • systematic
  • rational
  • method for planning and provision of
    individualized nursing care

18
How do you solve problems?
  • Trial and error?
  • Intuition?
  • Research process and scientific method or
    modified scientific method?

19
Decision making process
  • Identify the purpose
  • Set the criteria
  • Weigh the criteria
  • Seek alternatives
  • Examine alternatives
  • Project
  • Implement
  • Evaluate the outcome

20
Developing Critical-Thinking Attitudes and Skills
  • Self-Assessment
  • Think about a decision you made that you later
    regretted. Analyze the attitudes you had at that
    time and your thinking process. What could you
    have adjusted in your thinking that would have
    achieved a better outcome?

21
Tolerating Dissonance and Ambiguity
  • Nurses should increase their tolerance for ideas
    that contradict previously held beliefs, and they
    should practice suspending judgment (tolerating
    ambiguity for a time)
  • Need to say I dont know and be comfortable
    with it until further information is available or
    known

22
Seeking Situations Where Good Thinking is
Practiced
  • Nurses should attend conferences in clinical or
    educational settings that support open
    examination of all sides of the issue and respect
    for opposing viewpoints

23
Creating Environment that Support Critical
Thinking
  • Nurse leaders should actively create a
    stimulating environment that encourages
    differences of opinion and fair examination of
    ideas and options
  • As leaders, nurses should encourage colleagues to
    examine evidence carefully before they come to
    conclusions, and to avoid group think, the
    tendency to defer unthinkingly to the will of the
    group
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