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Thinking

Critical thinking in nursing practice

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Critical thinking in nursing practice

QUESTION 1

Assessment is a core component in nursing practice, required for planning, provision of quality and safer patient and family centred care. Patient assessment involves gathering information relating to a patient’s physiological, mental, physical and social status (Craven, & Hirnle, 2012). It helps identify patient current and future needs, and it is important in patient diagnosis, planning care, and exposing threats. The nurse should establish a professional and therapeutic mode of communication to ensure effective assessment through rapport building. Implementing critical thinking in patient assessment helps improve their outcomes by ensuring patient needs are met, and comprehensive patient-centred care is provided.

The assessment processes used in daily nursing practice include comprehensive history taking, comprehensive nursing assessment, focused patient assessment and the use of acronyms. Detailed history taking helps in obtaining patient’s complaints about medical and surgical history, family and social history and also psychological and cultural history (Craven, & Hirnle, 2012). This helps identify risk factors and better planning of care. Physical examination involves employment of techniques such as inspection, palpation, auscultation and percussion, in addition to vital signs and body system examination to obtain comprehensive patient data and a clear view of their general well-being. Focused assessment is determined by patient complaints (Nettina, & Nettina, 2016). It is usually helpful in the admission of a critically ill patient where a general assessment is not possible or can be used in conjunction. Focused assessment help obtain more data on a system for proper management or to rule out disease conditions. Acronyms such as Onset, Location, Duration, Characteristics, aggravating factors, Relieving factor, and Treatment (OLDCARTS) are also used in conjunction with other processes.

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The assessment processes involve a synthesis of information, and critical thinking and judgement are needed to make valuable conclusions. The nurse should have an extensive knowledge base to distinguish between disease signs and normal. A clear understanding of human anatomy and body systems and interpretation of lab values helps in making correct diagnosis. The nurse should develop the habit of using critical thinking skills such as organizing, making inferences and applying theoretical knowledge in a specific patient context (Nettina, & Nettina, 2016). They should accept their prejudices and think critically whenever interacting wit patients. The critical and cognitive processes useful in nursing practice include practical problem solving, open-mindedness, self-regulation, analysis, evaluation and interpretation.

References

. Craven, R. F., & Hirnle, C. J. (2012). Fundamentals of nursing: human health and function. C. Henshaw (Ed.). Lippincott.

Nettina, S. M., & Nettina, S. M. (2016). Lippincott manual of nursing practice. Lippincott Williams & Wilkins

 

 

 

 

 

 

 

QUESTION 2

Employing critical thinking processes in patient assessment improves patient outcomes and quality of care. In my opinion, critical thinking governs confidence in effective decision making. Critical thinking ability and confidence enhance more favourable results, self-confidence, and higher confidence in decision making and problem solving (Fowler, 2018).  Critical thinking skills enable one to trust their intuitions and use evidence-based practice and research to implement a program. Critical thinking in discrimination and prediction; the nurse can perform all patient care despite the discomfort, but when you think critically, use empathy in nursing practice, the task is easily finished. Predicting future patient occurrences helps intervene early, thus avoiding injuries and preventing any health conditions.

In the provided example, Mr. Jones seems anxious about the outcome of his care. It requires a nurse to think critically to identify his problem and address it skillfully. Every day, new challenges are experienced in the healthcare setting. Having sound critical thinking and clinical reasoning (CR) makes a difference in the provision of safe patient care. The critical thinking skills can be improved through reflecting on their thinking, paying attention to new technology and evidence-based approaches, asking open-ended questions that do not limit one’s thinking, and at any patient encounter, think about promoting function (Gross, Takazawa, & Rose, 2017).  They should always implement the three steps of critical thinking, which includes, thinking ahead, thinking in action, and thinking back (reflection).

It was found that 23% of graduate nurses entering nursing practice demonstrate CT and CR skills (Sorensen, & Yankech, 2018). New graduates feel that it is intellectually, emotionally and physically challenging to become competent, critical thinkers. They must be changed to improve the face of nursing. Nurses must be equipped with the right knowledge, skills and attitude needed to be competent in CT, CR, and clinical judgement (CJ).

References

Fowler, L. P. (2018). Improving critical thinking in nursing practice. Journal for nurses in staff development: JNSD: official journal of the National Nursing Staff Development Organization14(4), 183-187.

Gross, Y. T., Takazawa, E. S., & Rose, C. L. (2017). Critical thinking and nursing education. Journal of Nursing Education26(8), 317-323

Sorensen, H. A., & Yankech, L. R. (2018). Precepting in the fast lane: Improving critical thinking in new graduate nurses. The Journal of Continuing Education in Nursing39(5), 208-216..

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