Chapter 2: Critical Thinking and the Nursing Process

What Are the Phases of the Nursing Process ?

Assessment Diagnosis Planning outcomes Planning interventions Implementation Evaluation

Five Major Categories of Critical Thinking (critical thinking model)

Contextual awareness Inquiry Considering alternatives Examining assumptions Reflecting critically

Why Is Critical Thinking Important for Nurses?

Nurses apply knowledge to provide holistic care Nursing is an applied discipline Nursing uses knowledge from other fields Nursing is fast-paced

Different Kinds of Nursing Knowledge

Theoretical Practical Self Ethical

What Is Critical Thinking?

A combination of Reasoned thinking Openness to alternatives Ability to reflect A desire to seek truth

Implementation

Action phase when you carry out or delegate actions you previously planned

Inquiry

Based on credible sources Applying standards of good reasoning to your thinking when analyzing a situation and evaluating your actions

Planning interventions

Choose interventions to help client achieve stated goals

Theoretical Knowledge

Consists of information, facts, principles, and evidenced-based theories in nursing and related disciplines. It includes research findings and rationally constructed explanations of phenomena. You will use it to describe your patients, understand their health status, explain your reasoning for choosing interventions, and predict patient responses to interventions and treatments.

A nurse who is newly employed at a hospital questions a standard of patient care that does not seem to follow evidence-based practice. The critical thinking attitude she is exhibiting is termed a. Independent thinking b. Intellectual humility c. Intellectual courage d. Fair-mindedness

Correct answer: A Critical thinkers are not afraid to question things. They do not proceed with a questionable action simply because "that's the way it's always been done."

College courses such as Microbiology and Human Growth and Development present content that is considered part of theoretical nursing knowledge. a. True b. False

Correct answer: A Knowledge gained in these courses helps the nurse develop a more holistic and complete plan of patient care.

The most correct definition of "critical thinking" is a. A problem-solving process that enable's one to show others they are wrong b. An examination of one's own beliefs in order to defend them intelligently c. Purposeful, analytical thinking that results in a reasoned decision d. Rational thinking that results in obtaining the one correct answer

Correct answer: C Most definitions of critical thinking include the concept of it being "purposeful" and deliberate. It is more than just problem solving and is not used exclusively to defend one's beliefs. Critical thinking enables a person to see that there may be more than one correct answer.

Planning outcomes

Decide goals you want to achieve with your nursing activities

Contextual awareness

Deciding what to observe and consider. An awareness of what's happening in the total situation, including values, cultural issues, interpersonal relationships, and the environmental influences.

What Is Full-Spectrum Nursing?

Definition A unique blend of thinking, doing, and caring for the purpose of effecting good outcomes from a patient situation

Considering alternatives

Exploring and imagining as many alternatives as you can think of for the situation

Evaluation

Final phase: Judge whether your actions have successfully treated or prevented the client's health problems

Assessment

First phase: Data gathering

Context

For care, environment, relationships, culture, resources, supports

Practical Knowledge

Knowing what to do and how to do it. Consists of processes like the decision process and the nursing process, and procedures like how to give an injection, and is an aspect of nursing expertise.

Ethical Knowledge

Knowledge of obligation, or right and wrong. Consists of information about moral principles and processes for making moral decisions.

Nursing is an Applied discipline

Nurses deal with complex, ill-defined, and sometimes confusing problems--- not well defined ones such as defined in the math book. This means that nurses must apply their knowledge, not just memorize and regurgitate facts.

Nursing is fast-paced.

Nurses often deal with demanding situations. The patient's condition may change hour to hour or even minute to minute. Knowing the routine may not be adequate. Critical thinking is essential to respond appropriately under stress.

Nursing users knowledge from other fields

Nurses use information from chemistry, physiology, psychology, social sciences, and other disciplines to identify and plan interventions for patient problems. Nursing plays an important role within a multidisciplinary approach to patient care.

How Is the Nursing Process Related to Critical Thinking?

Nursing is a problemsolving process that uses many individual critical thinking skills

Patient Data

Physical, psycho social, and spiritual

Reflecting critically and deciding what to do

Questioning, analyzing, and reflecting on the rationale for your decisions

Analyzing assumptions

Recognizing and analyzing assumptions you're making about the situation and examining the beliefs that underlie your choices

Diagnosis

Second phase: Identify client's health needs

Self Knowledge

Self-understanding. You must be aware of your beliefs, values, and cultural and religious biases. This kind of knowledge helps you to find errors in your thinking and enables you to tune in to your patients.

Patient Preferences

What would the patient like?

Patient situation

• Patient data • Patient preferences • Context

Doing

• Practical knowledge • Nursing process

Caring

• Self knowledge • Ethical knowledge

Thinking

• Theoretical knowledge • Critical thinking

What are the model concepts? (Full Spectrum Nursing)

• Thinking • Doing • Caring • Patient situation