Critical Thinking in Nursing Practices

Sep 12, 2024

Critical Thinking and Clinical Judgment in Nursing

Key Concepts

  • Critical Thinking

    • Essential for safe, efficient, and skillful nursing care.
    • Acquired through experiences and active curiosity.
    • Not a linear process and not learned quickly.
    • Develops with more clinical experiences and lab practice.

  • Clinical Judgment

    • Involves using inference, logic, and critical thinking attitudes.
    • Influenced by nurse's experience and knowledge.
    • Requires knowing the patient as an individual.
    • Context and culture of the clinical setting influence judgment.

Integration of Critical Thinking and Nursing Process

  • Interwoven with Nursing Process: ALPEN
    • Assessment (Noticing or Recognizing Cues)
    • Analysis/Diagnosis
    • Planning
    • Implementation
    • Evaluation
  • Various models (Tanner’s, NCJMM) illustrate similar concepts.

Clinical Judgment Models

  • Tanner’s Model focuses on noticing, interpreting, responding, reflecting.
  • NCJMM used by NCLEX, involves recognizing cues, analyzing cues, prioritizing, generating solutions.

Levels of Critical Thinking

  1. Basic: Task-oriented; single solution focus.
  2. Complex: Independent decision-making; creativity.
  3. Commitment: Anticipates needs and accountable; applies all elements of clinical judgment.

Critical Thinking Competencies

  • Scientific Method, Problem Solving, Decision Making: General competencies.
  • Diagnostic Reasoning and Inference, Clinical Decision-Making: Specific to nursing.
    • Use cues to form inferences, not assumptions.

Critical Thinking Attitudes

  • Risk Taking: Question orders that seem incorrect.
  • Discipline: Managing time, being thorough.
  • Humility and Self-awareness: Admit when more information is needed.
  • Creativity and Curiosity: Vital for developing nursing solutions.
  • Responsibility and Accountability: Follow policies and be accountable for actions.

Learning and Reflection

  • Lifelong Process: Use clinical experiences to grow.
  • Reflection: Recall events, examine responses, and learn from experiences.
  • Meeting with Colleagues: Important for reflecting and discussing clinical judgments.

Application in Practice

  • Delegation: Effective communication and follow-up are crucial.
  • Caring for Groups: Analyze and prioritize patient needs effectively.

Additional Resources

  • Textbook Case Studies: Follow examples like the case of Nurse Tanya and Mr. Boston.
  • Highlighting Key Textbook Sections: Important for understanding principles and guidelines.