importance of logic and critical thinking in nursing

The importance of logical thinking for clinical nursing care

Affiliations.

• 1 Universidade Federal do Ceará (UFC) , Hospital Universitário Walter Cantídio. Fortaleza, Ceará, Brasil.
• 2 Universidade Estadual do Ceara (UECE), Centro de Ciências da Saúde, Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde. Fortaleza, Ceará, Brasil.
• PMID: 35920518
• DOI: 10.1590/1983-1447.2022.20200473.en

Objective: To present a reflection on the importance of logical thinking for clinical nursing care.

Method: Reflection paper.

Reflection: The exercise of an effective clinical care brings with it the need for logical thinking and adequate reasoning for safe and effective nursing practices. Therefore, training based on philosophical principles that encourage the increase of logical and critical thinking is considered unquestionable, ensuring professionals the systematization of assistance with the application of the nursing process based on scientific understanding and strong arguments supported by the path of truthfulness, morality, ethics and critical self-reflection in order to value clinical practices.

Final considerations: The importance of logical thinking for nursing care is ratified here, supporting nursing care systematization and the nursing process stages. Thus, nurses can use clinical reasoning skills to deliver a humane, ethical, and effective professional performance.

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The importance of logical thinking for clinical nursing care

La importancia del pensamiento lógico para el cuidado de enfermería clínica.

To present a reflection on the importance of logical thinking for clinical nursing care.

Reflection paper

The exercise of an effective clinical care brings with it the need for logical thinking and adequate reasoning for safe and effective nursing practices. Therefore, training based on philosophical principles that encourage the increase of logical and critical thinking is considered unquestionable, ensuring professionals the systematization of assistance with the application of the nursing process based on scientific understanding and strong arguments supported by the path of truthfulness, morality, ethics and critical self-reflection in order to value clinical practices.

Final considerations

The importance of logical thinking for nursing care is ratified here, supporting nursing care systematization and the nursing process stages. Thus, nurses can use clinical reasoning skills to deliver a humane, ethical, and effective professional performance.

Keywords Nursing; Logic; Clinical decision-making

Presentar una reflexión sobre la importancia del pensamiento lógico para el cuidado de enfermería.

Estudio de reflexión.

El ejercicio de un cuidado clínico efectivo trae consigo la necesidad de un pensamiento lógico y un razonamiento adecuado para prácticas de enfermería seguras y efectivas. Por tanto, se considera incuestionable la formación basada en principios filosóficos que propicien el pensamiento lógico y crítico, asegurando la sistematización de la asistencia y el proceso de enfermería basados en la comprensión científica y argumentos sólidos sustentados en el camino de la verdad, moral, ética. y autocrítica, con el fin de favorecer la valorización de prácticas clínicas.

Consideraciones finales

Se confirma la importancia del pensamiento lógico para el cuidado de enfermería, apoyando la sistematización del cuidado y las etapas del proceso de enfermería. De esta manera, las enfermeras pueden utilizar las habilidades de razonamiento clínico, proporcionando un desempeño profesional humano, ético y eficaz.

Palabras clave Enfermería; Lógica; Toma de decisiones clínicas

Apresentar uma reflexão sobre a importância do pensamento lógico para o cuidado clínico de enfermagem.

Estudo de reflexão.

Pensar em exercer o cuidado clínico eficaz remete à necessidade de um pensamento lógico e raciocínio adequado para a realização de práticas de enfermagem seguras e eficazes. Para tanto, considera-se inquestionável a formação baseada nos princípios filosóficos que estimulem o incremento do pensamento lógico e crítico, assegurando aos profissionais a sistematização da assistência com aplicação do processo de enfermagem a partir do entendimento científico e argumentos sólidos abalizados pelo caminho da verdade, moral, ética e autocrítica, de forma a favorecer a valorização das práticas clínicas.

Considerações finais

Ratifica-se a importância do pensamento lógico para o cuidado de enfermagem fundamentando a Sistematização da Assistência de Enfermagem e as etapas do Processo de Enfermagem. Desta forma, o enfermeiro pode fazer uso do raciocínio clínico propiciando uma atuação profissional humana, ética e eficaz.

Palavras-chave Enfermagem; Lógica; Tomada de decisão clínica

INTRODUCTION

Logic can be defined as a field that studies forms of thought and the art of correctly applying them to the demonstration of the veracity of facts. Thus, logic offers ways for scientific investigation, according to a method, providing criteria of truth. Logical reasoning directs the acts of thought towards the true, avoiding errors or settling doubts 1 1. Nerici IG. Lógica: definição e divisão, verdade e erro. In: Nerici IG, editor. Introdução à lógica. 9. ed. São Paulo: Nobel; 1992. p. 16-25. .

Thought comprises the mental functions of conceiving (formation and apprehension of ideas about an object), of judging (discrimination of the identity or diversity of two concepts) and of reasoning (completion from two or more related, previously known judgments). Nurses are supposed to organize their thinking process in a logical and orderly way to carry out the process of clinical reasoning 2 2. Carvalho EC, Oliveira-Kumakura ARS, Morais SCRV. Clinical reasoning in nursing: teaching strategies and assessment tools. Rev Bras Enferm. 2017;70(3):662-8. doi: https://doi.org/10.1590/0034-7167-2016-0509 https://doi.org/10.1590/0034-7167-2016-0... . Thus, in the scenario of clinical nursing care practice, nursing professionals must use the principles of logic to avoid clinical reasoning errors, allowing the development of criticality, reasoning and judgment skills, as well as adequate decision making 3 3. Brandão ES, Santos I, Lanzillotti RS. Cuidados de enfermagem para conforto de pessoas com dermatoses imunobolhosas: avaliação pela lógica fuzzy. Rev Enferm UERJ. 2018;26:e32877. doi: https://doi.org/10.12957/reuerj.2018.32877 https://doi.org/https://doi.org/10.12957... .

In this regard, clinical care is perceived as the act of caring in a responsible, and ethical way, and the social commitment of professional nurses, through the use of technical-scientific knowledge and showing empathy ( eye level when speaking, careful listening, warmth, etc.), in order to meet the real needs of the patients, considering their particularities, singularities and life history 4 4. Monteiro PV, Barbosa EMG, Nogueira JM, Pereira MLD, Freitas MC, Rodrigues DP. Em busca do cuidado clínico em enfermagem. In: Moreira TMM, Monteiro ARM, Silva LMS, Rodrigues DP, organizadoras. O cuidado clínico de enfermagem [Internet]. Fortaleza: EdUECE; 2015 [cited 2020 Dec 13]. p. 17-35. Available from: http://www.uece.br/ppsacwp/wp-content/uploads/sites/37/2016/04/O-CUIDADO-CLINICO-DE-EFERMAGEM-EBOOK.pdf http://www.uece.br/ppsacwp/wp-content/up... . Exercising effective clinical nursing care refers to the need for logical thinking and reasoning skills to carry out safe and effective nursing practices. Therefore, strategies and experiences that promote the development of logical skills for the correct organization of thought must be incorporated.

Thus, in their care practice, nurses must be familiar with the thinking process that leads to correct clinical reasoning. They must recognize clues and evidence about the situation investigated (conceiving the idea), be able to discriminate between similar situations (make their judgment) and based on general premises that are known, drawing a conclusion using a line of reasoning. Nurses are supposed to accurately interpret human responses, in order to select the appropriate interventions and assess the results achieved 5 5. Silva NFC, Vianna CMM, Oliveira FSG, Mosegui GBG, Rodrigues MPS. Fuzzy Visa: um modelo de lógica fuzzy para a avaliação de risco da Vigilância Sanitária para inspeção de resíduos de serviços de saúde. Physis. 2017;27(1):127-46. doi: http://doi.org/10.1590/s0103-73312017000100007 http://doi.org/10.1590/s0103-73312017000... .

Thus, the following questions about logical reasoning for clinical care in nursing emerge: What is the importance of logical thinking for clinical nursing care? What strategies can help nurses to develop effective and accurate logical thinking? Attempting to find the answers to these questions, this study aims to present a reflection on the importance of logical thinking for clinical nursing care.

This is a reflection paper on the importance of logical thinking for clinical nursing care, deriving from the discipline entitled Philosophy of Science, Nursing and Health, from the doctoral postgraduate course.

Development of logical reasoning based on philosophy to promote clinical care

The evolution of human thought has been influenced over time by philosophical theories, and such contribution is reflected in the development of human behavior. In this context, the insertion of Philosophy in the curriculum is of utmost importance, as the discipline has a crucial impact in educating students to be critical citizens that ask questions and must understand that we are all part of the Universe.

It is necessary to advocate, in conceptual terms, and also to demonstrate in reflection papers and empirical studies that the teaching of Philosophy is very important, as part of an integral education to individuals, at different ages, to help them becoming good and responsible citizens and (future) professionals. Thinking philosophically, or with a philosophical dynamics is essential for responsible, free and conscious action 6 6. Medeiros EO. Filosofia da educação e ensino da filosofia: uma escola de democracia . Trilhas Filosóficas (Online). 2019;12(2):89-100. doi: https://doi.org/10.25244/tf.v12i2.289 https://doi.org/10.25244/tf.v12i2.289 ... . Therefore, philosophical foundations support the improvement of the cognitive skills of perceiving, problematizing, reflecting, conceptualizing and arguing based on real problems/situations, so that individuals think logically and critically, being capable of taking consistent and independent actions.

According to this line of thought, pedagogical projects should be periodically assessed, since, in addition to their guiding principles and axes, their theoretical, philosophical and methodological contribution must be anchored in a meaningful teaching-learning process, to foster the development of competences and skills in the training of professionals in the different fields of health care 7 7. Siqueira HCH, Cecagno D, Medeiros AC, Sampaio AD, Weykamp JM, Pedroso VMS, et al. Insertion of safety education in the academic training of nurses. J Nurs UFPE on line. 2019;13:e239822. doi: https://doi.org/10.5205/1981-8963.2019.239822 https://doi.org/https://doi.org/10.5205/... . In this regard, the interface of the philosophical dimension with Nursing education is essential for the improvement of clinical care, which requires refined logical reasoning and know-how based on scientific experiences.

There are several theoretical models related to the education of nurses, but a discipline called Philosophy, mandatory in the curriculum matrices of some Nursing courses, and which contributes both to professional training and to the lives of human beings, making them capable of critical thinking, is unpretentiously inserted in the health sector 8 8. Silva LH, Dionizio Neto M. A significação da filosofia da educação como disciplina obrigatória à formação do enfermeiro. Revista de Pesquisa Interdisciplinar. 2019;(2 supl.):571-7. doi: http://doi.org/10.24219/rpi.v2i2.0.368 https://doi.org/http://doi.org/10.24219/... . In its historical process, Nursing Science has faced numerous challenges that are imposed on scientific knowledge, including the need for a precise and robust philosophical basis that justifies and legitimizes knowledge in the area to support its assertions 9 9. Guimarães GL, Mendoza IYQ, Corrêa AR, Ribeiro EG, Guimarães MO, Chianca TCM. A proposed evaluation of postgraduate nursing according to Thomas Kuhn. Texto Contexto Enferm. 2020;29:e20190090. doi: http://doi.org/10.1590/1980-265x-tce-2019-0090 https://doi.org/http://doi.org/10.1590/1... .

Nursing, as a science and art, must have its own knowledge structure, as well as a specific terminology to guide the foundations of “how to do” and “how to be” in its daily practices and, consequently, guide its work process with exclusive elements of their professional identity 10 10. Fernandes MC, Silva LMS, Silva MRF, Torres RAM, Dias MSA, Moreira TMM. Identity of primary health care nurses: perception of “doing everything”. Rev Bras Enferm. 2018;71(1):142-7. doi: https://doi.org/10.1590/0034-7167-2016-0382 https://doi.org/https://doi.org/10.1590/... . Regarding professional duties, clinical care deserves considerable attention during graduation so that professionals are able to exercise them based on inductive logical reasoning.

Nurses must develop the ability of logical thinking before their professional practice. Theoretical knowledge that encourages reflection on the phenomena of care must then be stimulated. Thus, for successful achievement of nursing gorals, discourses of teaching institutions must be reformulated, as they often have a mechanical and sociocultural view, according to which nurses are just a tool like any other 8 8. Silva LH, Dionizio Neto M. A significação da filosofia da educação como disciplina obrigatória à formação do enfermeiro. Revista de Pesquisa Interdisciplinar. 2019;(2 supl.):571-7. doi: http://doi.org/10.24219/rpi.v2i2.0.368 https://doi.org/http://doi.org/10.24219/... .

Thus, it is necessary to work intensively to reduce the dichotomies of nursing programs, specifically between theory and practice; training and the reality of professional practice; shift in the role of students from passive to active participants in the teaching-learning process. This enables the formation of an active, purposeful, creative professional, able to analyze, understand the context, who is flexible, capable of logical reasoning, and who permanently seeks for information and contributes to the solution of health problems 11 11. Jiménez-Gómez MA, Cárdenas-Becerril L, Velásquez-Oyola MB, Carrillo-Pineda M, Barón-Díaz LY. Reflective and critical thinking in nursing curriculum. Rev Latino-Am Enferm. 2019;27:e3173. doi: https://doi.org/10.1590/1518-8345.2861.3173 https://doi.org/https://doi.org/10.1590/... . Such professional seeks greater visibility and has a sense of belonging that provides the definition of particular competences, autonomy, recognition and support in decision-making on issues inherent to the profession's obligations 10 10. Fernandes MC, Silva LMS, Silva MRF, Torres RAM, Dias MSA, Moreira TMM. Identity of primary health care nurses: perception of “doing everything”. Rev Bras Enferm. 2018;71(1):142-7. doi: https://doi.org/10.1590/0034-7167-2016-0382 https://doi.org/https://doi.org/10.1590/...

Nurses are supposed to know their professional instruments, both material and mainly intellectual, so that nursing becomes increasingly synonymous with autonomy and professional competence, and that a relationship of constant and effective dialogue is established between philosophy and evidence-based knowledge, which constitute one of the main pillars for the development of nurses' logical thinking 8 8. Silva LH, Dionizio Neto M. A significação da filosofia da educação como disciplina obrigatória à formação do enfermeiro. Revista de Pesquisa Interdisciplinar. 2019;(2 supl.):571-7. doi: http://doi.org/10.24219/rpi.v2i2.0.368 https://doi.org/http://doi.org/10.24219/... . When we philosophize, we learn to think logically, in a journey of reflection, action, admiration and contemplation 6 6. Medeiros EO. Filosofia da educação e ensino da filosofia: uma escola de democracia . Trilhas Filosóficas (Online). 2019;12(2):89-100. doi: https://doi.org/10.25244/tf.v12i2.289 https://doi.org/10.25244/tf.v12i2.289 ... .

In this field of reflection, the need for training based on philosophical foundations, which encourages logical thinking, ethical prudence and self-awareness, is unquestionable, ensuring that professionals systematize rational ideas, based on scientific understanding, and solid arguments supported by the path of truth, morals, ethics and self-criticism, to favor the appreciation of clinical practices.

Logical thinking as a facilitating agent of clinical care: focus on the Systematization of Care and the Nursing Process

Nurses will often experience situations that require skills that involve logical thinking, such as their professional duties in Nursing Care Systematization (NCS) and the Nursing Process (NP) to promote clinical care. NCS is a methodology based on the practice of nurses in the support of management and clinical care in the NP.

NCS is understood as the organization of professional work of nurses concerning method, staff and instruments, enabling the operationalization of the Nursing Process, with a theoretical-philosophical basis. Based on this premise, the theoretical-philosophical foundation encourages the use of cognitive skills of critical and logical thinking by nurses, in the promotion of clinical care consistent with the health needs of the community under the responsibility of these professionals.

Nursing, as a science, has its own scientific method. It gives further rigor to the professional practice. Thus, for a correct systematization of care, health care professionals must use logical resources that support the entire NP 2 2. Carvalho EC, Oliveira-Kumakura ARS, Morais SCRV. Clinical reasoning in nursing: teaching strategies and assessment tools. Rev Bras Enferm. 2017;70(3):662-8. doi: https://doi.org/10.1590/0034-7167-2016-0509 https://doi.org/10.1590/0034-7167-2016-0... . During the implementation of all phases of the NP, nurses apprehend information and evidence (conception) for analysis and syllogism, which leads them to a conclusion, to a choice (judgment), based on the captured elements.

To ensure an effective NP, nurses must develop reasoning and clinical judgment skills, based on scientific knowledge, logical thinking and clinical nursing practice. This process requires intellectual skills and mental processes in diagnostic knowledge and the use of such knowledge. The cognitive process of preparing nursing diagnoses is commonly called diagnostic reasoning 12 12. Costa CPV, Luz MHBA. Nursing scientific production on diagnostic reasoning: integrative review. J Nurs UFPE on line. 2015;10(1):152-62. doi: https://doi.org/10.5205/1981-8963-v10i1a10933p152-162-2016 https://doi.org/https://doi.org/10.5205/... .

Diagnostic reasoning involves the recognition of signs and symptoms of patients, human responses to health and/or disease conditions, analysis and judgment of data and clinical situations that will unfold in a diagnostic statement. It is a complex practice in which nurses make judgments about the patients’ clinical status, identify nursing diagnoses and make decisions. Thus, cognitive ability, clinical knowledge and experience are added to the diagnostic reasoning process, being integrated by the intuitive perception of the situation as a whole 12 12. Costa CPV, Luz MHBA. Nursing scientific production on diagnostic reasoning: integrative review. J Nurs UFPE on line. 2015;10(1):152-62. doi: https://doi.org/10.5205/1981-8963-v10i1a10933p152-162-2016 https://doi.org/https://doi.org/10.5205/... .

Judgment is the flexible and special ability to recognize relevant aspects (data) of an undefined clinical situation, interpret their meanings and give an appropriate response. To make an adequate judgment, nurses must have critical thinking, which involves a set of specific learned skills and attitudes necessary for the development of effective clinical reasoning 2 2. Carvalho EC, Oliveira-Kumakura ARS, Morais SCRV. Clinical reasoning in nursing: teaching strategies and assessment tools. Rev Bras Enferm. 2017;70(3):662-8. doi: https://doi.org/10.1590/0034-7167-2016-0509 https://doi.org/10.1590/0034-7167-2016-0... .

These skills can be divided into three categories: cognitive (analysis, patterning, self-regulation, discernment, information seeking, explanation, inference, interpretation, prediction and knowledge transformation), behavioral (analysis, self-confidence, authentic search, investigation, mind openness and systematization) and habits of mind (understanding, confidence, creativity, curiosity, flexibility, intellectual integrity, intuition, perseverance, intellectual perspective and reflection) 13 13. Crossetti MGO, Goes M. Habilidades de pensamento crítico no processo diagnóstico de enfermagem. In: Herdman TH, editora. PRONANDA: Programa de Atualização em Diagnósticos de Enfermagem. Porto Alegre: Artmed Panamericana; 2016. p. 9-34. . The development of these skills is essential for the construction of the professionals' clinical reasoning. Such reasoning is understood as the process of thinking and decision-making integrated in clinical practice to assist users of health systems 2 2. Carvalho EC, Oliveira-Kumakura ARS, Morais SCRV. Clinical reasoning in nursing: teaching strategies and assessment tools. Rev Bras Enferm. 2017;70(3):662-8. doi: https://doi.org/10.1590/0034-7167-2016-0509 https://doi.org/10.1590/0034-7167-2016-0... .

For explanatory purposes, a study showed that most Brazilian nurses perceived NCS and NP as important, but effective application of these processes in the practice of clinical care is still a gap to be overcome. Similarly, another study in Brazil reported that nursing professors advocated the need for inclusion of a theoretical-philosophical, historical and dialectical proposal in an undergraduate course, supporting a broadened understanding of the NP and its responsible operationalization and using consistent references and robust scientific evidence, based on nurses’ practices in health services and on the current teaching model 15 15. Bitencourt JVOV, Martini JG, Massaroli A, Léo MMF, Conceição VM, Santos MG. Structuring of a proposal for the nursing process theoretical and methodological basis: Professors’ motivations. Texto Contexto Enferm. 2020;29:e20180205. doi: https://doi.org/10.1590/1980-265x-tce-2018-0205 https://doi.org/https://doi.org/10.1590/... .

It is known that the devaluation of theories of care and of the clinical reasoning process is associated to poor knowledge of NCS and NP by health professionals, and it should be emphasized that the recognition of clinical reasoning is essential for a positive attitude, aimed to ensure safer care 14 14. Oliveira MR, Almeida PC, Moreira TMM, Torres RAM. Nursing care systematization: perceptions and knowledge of the Brazilian nursing. Rev Bras Enferm. 2019;72(6):1547-53. doi: http://doi.org/10.1590/0034-7167-2018-0606 https://doi.org/http://doi.org/10.1590/0... . Clinical reasoning in nursing is a complex and dynamic mental process, which occurs both in the identification of situations that demand nursing care and in the selection of the actions necessary to provide care and achieve the health outcomes for which nursing is responsible 2 2. Carvalho EC, Oliveira-Kumakura ARS, Morais SCRV. Clinical reasoning in nursing: teaching strategies and assessment tools. Rev Bras Enferm. 2017;70(3):662-8. doi: https://doi.org/10.1590/0034-7167-2016-0509 https://doi.org/10.1590/0034-7167-2016-0... .

Clinical reasoning in nursing is complex, requiring the use of logic, criticality and interdisciplinary knowledge, as people should receive a holistic assessment. The ability to think can comprise a global analysis of the assisted individual, in the search for effective clinical care. Through the NP, professionals reflect on the problem/ situation experienced by the patients, and finally take action and assess their interventions, through organized actions, seeking to ensure the well-being and health of their patients. Health workers must also observe the legal ethical principles of the profession, as logical and critical thinking means also acting consciously according to the patients' point of view 8 8. Silva LH, Dionizio Neto M. A significação da filosofia da educação como disciplina obrigatória à formação do enfermeiro. Revista de Pesquisa Interdisciplinar. 2019;(2 supl.):571-7. doi: http://doi.org/10.24219/rpi.v2i2.0.368 https://doi.org/http://doi.org/10.24219/... .

Based on the above considerations, it is worth stressing that the teaching-learning process of Nursing on NCS and NP, both in the academic and professional settings, must be continuous and presented in active theoretical-philosophical methods strategies, which encourage the use of cognitive skills of critical and logical thinking, according to a perspective of shared and transformative approach, seeking the practice of clinical care in an interdisciplinary and holistic way, to meet the real health needs of society.

Furthermore, health professionals must use logical thinking resources in NCS and in each stage of the NP, in order to properly carry out, in an ethical and human way, anamnesis and physical examination, in the main nursing diagnoses. This allows for an adequate planning of actions, with effective intervention in clinical care practices, and assessment of the results of the process, in a logical and consistent manner.

The emergence of logical thinking with critical-philosophical reasoning supports safe nursing practices, enabling the provision of effective clinical care, anchored in NCS and the NP.

FINAL CONSIDERATIONS

Thus, the importance of logical thinking for clinical nursing care is ratified here, in the NCS and all stages of the NP, so that nurses use clinical reasoning for the correct planning of their actions, exercising a good judgment to make the right decisions, carrying out nursing interventions based on a scientific method, and thus providing a humane, ethical and effective professional performance, as well as enabling the systematic reassessment of the results obtained in care interventions and the appropriate redirection to previously planned actions.

The lack of nursing studies on approaches that integrate logical thinking and clinical health care may have made it difficult to deliver deep reflections in this paper. However, based on the reflections made in this study, we expect to provide a set of relevant information so that nurses who work in pedagogical functions can understand that the teaching of Philosophy is essential to prompt logical thinking in students. It is also expected that these professionals understand that the quality of clinical nursing care depends on proper training of nursing students during graduation, to help them develop logical, reflective, critical and ethical thinking to be used in their professional practices, in care, management, teaching and research.

• 1. Nerici IG. Lógica: definição e divisão, verdade e erro. In: Nerici IG, editor. Introdução à lógica. 9. ed. São Paulo: Nobel; 1992. p. 16-25.
• 2. Carvalho EC, Oliveira-Kumakura ARS, Morais SCRV. Clinical reasoning in nursing: teaching strategies and assessment tools. Rev Bras Enferm. 2017;70(3):662-8. doi: https://doi.org/10.1590/0034-7167-2016-0509 » https://doi.org/10.1590/0034-7167-2016-0509
• 3. Brandão ES, Santos I, Lanzillotti RS. Cuidados de enfermagem para conforto de pessoas com dermatoses imunobolhosas: avaliação pela lógica fuzzy. Rev Enferm UERJ. 2018;26:e32877. doi: https://doi.org/10.12957/reuerj.2018.32877 » https://doi.org/https://doi.org/10.12957/reuerj.2018.32877
• 4. Monteiro PV, Barbosa EMG, Nogueira JM, Pereira MLD, Freitas MC, Rodrigues DP. Em busca do cuidado clínico em enfermagem. In: Moreira TMM, Monteiro ARM, Silva LMS, Rodrigues DP, organizadoras. O cuidado clínico de enfermagem [Internet]. Fortaleza: EdUECE; 2015 [cited 2020 Dec 13]. p. 17-35. Available from: http://www.uece.br/ppsacwp/wp-content/uploads/sites/37/2016/04/O-CUIDADO-CLINICO-DE-EFERMAGEM-EBOOK.pdf » http://www.uece.br/ppsacwp/wp-content/uploads/sites/37/2016/04/O-CUIDADO-CLINICO-DE-EFERMAGEM-EBOOK.pdf
• 5. Silva NFC, Vianna CMM, Oliveira FSG, Mosegui GBG, Rodrigues MPS. Fuzzy Visa: um modelo de lógica fuzzy para a avaliação de risco da Vigilância Sanitária para inspeção de resíduos de serviços de saúde. Physis. 2017;27(1):127-46. doi: http://doi.org/10.1590/s0103-73312017000100007 » http://doi.org/10.1590/s0103-73312017000100007
• 6. Medeiros EO. Filosofia da educação e ensino da filosofia: uma escola de democracia . Trilhas Filosóficas (Online). 2019;12(2):89-100. doi: https://doi.org/10.25244/tf.v12i2.289 » https://doi.org/10.25244/tf.v12i2.289
• 7. Siqueira HCH, Cecagno D, Medeiros AC, Sampaio AD, Weykamp JM, Pedroso VMS, et al. Insertion of safety education in the academic training of nurses. J Nurs UFPE on line. 2019;13:e239822. doi: https://doi.org/10.5205/1981-8963.2019.239822 » https://doi.org/https://doi.org/10.5205/1981-8963.2019.239822
• 8. Silva LH, Dionizio Neto M. A significação da filosofia da educação como disciplina obrigatória à formação do enfermeiro. Revista de Pesquisa Interdisciplinar. 2019;(2 supl.):571-7. doi: http://doi.org/10.24219/rpi.v2i2.0.368 » https://doi.org/http://doi.org/10.24219/rpi.v2i2.0.368
• 9. Guimarães GL, Mendoza IYQ, Corrêa AR, Ribeiro EG, Guimarães MO, Chianca TCM. A proposed evaluation of postgraduate nursing according to Thomas Kuhn. Texto Contexto Enferm. 2020;29:e20190090. doi: http://doi.org/10.1590/1980-265x-tce-2019-0090 » https://doi.org/http://doi.org/10.1590/1980-265x-tce-2019-0090
• 10. Fernandes MC, Silva LMS, Silva MRF, Torres RAM, Dias MSA, Moreira TMM. Identity of primary health care nurses: perception of “doing everything”. Rev Bras Enferm. 2018;71(1):142-7. doi: https://doi.org/10.1590/0034-7167-2016-0382 » https://doi.org/https://doi.org/10.1590/0034-7167-2016-0382
• 11. Jiménez-Gómez MA, Cárdenas-Becerril L, Velásquez-Oyola MB, Carrillo-Pineda M, Barón-Díaz LY. Reflective and critical thinking in nursing curriculum. Rev Latino-Am Enferm. 2019;27:e3173. doi: https://doi.org/10.1590/1518-8345.2861.3173 » https://doi.org/https://doi.org/10.1590/1518-8345.2861.3173
• 12. Costa CPV, Luz MHBA. Nursing scientific production on diagnostic reasoning: integrative review. J Nurs UFPE on line. 2015;10(1):152-62. doi: https://doi.org/10.5205/1981-8963-v10i1a10933p152-162-2016 » https://doi.org/https://doi.org/10.5205/1981-8963-v10i1a10933p152-162-2016
• 13. Crossetti MGO, Goes M. Habilidades de pensamento crítico no processo diagnóstico de enfermagem. In: Herdman TH, editora. PRONANDA: Programa de Atualização em Diagnósticos de Enfermagem. Porto Alegre: Artmed Panamericana; 2016. p. 9-34.
• 14. Oliveira MR, Almeida PC, Moreira TMM, Torres RAM. Nursing care systematization: perceptions and knowledge of the Brazilian nursing. Rev Bras Enferm. 2019;72(6):1547-53. doi: http://doi.org/10.1590/0034-7167-2018-0606 » https://doi.org/http://doi.org/10.1590/0034-7167-2018-0606
• 15. Bitencourt JVOV, Martini JG, Massaroli A, Léo MMF, Conceição VM, Santos MG. Structuring of a proposal for the nursing process theoretical and methodological basis: Professors’ motivations. Texto Contexto Enferm. 2020;29:e20180205. doi: https://doi.org/10.1590/1980-265x-tce-2018-0205 » https://doi.org/https://doi.org/10.1590/1980-265x-tce-2018-0205

Publication Dates

• Publication in this collection 01 Aug 2022
• Date of issue 2022
• Received 15 Dec 2020
• Accepted 10 Aug 2021

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• http://orcid.org/0000-0003-4487-1193
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• The authors declare that there is no conflict of interest

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Critical Thinking: The Development of an Essential Skill for Nursing Students

Ioanna v. papathanasiou.

1 Nursing Department, Technological Educational Institute of Thessaly, Greece

Christos F. Kleisiaris

2 Nursing Department, Technological Educational Institute of Crete, Greece

Evangelos C. Fradelos

3 State Mental Hospital of Attica “Daphne”, Greece

Katerina Kakou

Lambrini kourkouta.

4 Nursing Department, Alexander Technological Educational Institute of Thessaloniki, Greece

Critical thinking is defined as the mental process of actively and skillfully perception, analysis, synthesis and evaluation of collected information through observation, experience and communication that leads to a decision for action. In nursing education there is frequent reference to critical thinking and to the significance that it has in daily clinical nursing practice. Nursing clinical instructors know that students face difficulties in making decisions related to clinical practice. The main critical thinking skills in which nursing students should be exercised during their studies are critical analysis, introductory and concluding justification, valid conclusion, distinguish of facts and opinions, evaluation the credibility of information sources, clarification of concepts and recognition of conditions. Specific behaviors are essentials for enhancing critical thinking. Nursing students in order to learn and apply critical thinking should develop independence of thought, fairness, perspicacity in personal and social level, humility, spiritual courage, integrity, perseverance, self-confidence, interest for research and curiosity. Critical thinking is an essential process for the safe, efficient and skillful nursing practice. The nursing education programs should adopt attitudes that promote critical thinking and mobilize the skills of critical reasoning.

1. INTRODUCTION

Critical thinking is applied by nurses in the process of solving problems of patients and decision-making process with creativity to enhance the effect. It is an essential process for a safe, efficient and skillful nursing intervention. Critical thinking according to Scriven and Paul is the mental active process and subtle perception, analysis, synthesis and evaluation of information collected or derived from observation, experience, reflection, reasoning or the communication leading to conviction for action ( 1 ).

So, nurses must adopt positions that promote critical thinking and refine skills of critical reasoning in order a meaningful assessment of both the previous and the new information and decisions taken daily on hospitalization and use of limited resources, forces you to think and act in cases where there are neither clear answers nor specific procedures and where opposing forces transform decision making in a complex process ( 2 ).

Critical thinking applies to nurses as they have diverse multifaceted knowledge to handle the various situations encountered during their shifts still face constant changes in an environment with constant stress of changing conditions and make important decisions using critical thinking to collect and interpret information that are necessary for making a decision ( 3 ).

Critical thinking, combined with creativity, refine the result as nurses can find specific solutions to specific problems with creativity taking place where traditional interventions are not effective. Even with creativity, nurses generate new ideas quickly, get flexible and natural, create original solutions to problems, act independently and with confidence, even under pressure, and demonstrate originality ( 4 ).

The aim of the study is to present the basic skills of critical thinking, to highlight critical thinking as a essential skill for nursing education and a fundamental skill for decision making in nursing practice. Moreover to indicate the positive effect and relation that critical thinking has on professional outcomes.

2. CRITICAL THINKING SKILLS

Nurses in their efforts to implement critical thinking should develop some methods as well as cognitive skills required in analysis, problem solving and decision making ( 5 ). These skills include critical analysis, introductory and concluding justification, valid conclusion, distinguishing facts and opinions to assess the credibility of sources of information, clarification of concepts, and recognition conditions ( 6 , 7 ).

Critical analysis is applied to a set of questions that relate to the event or concept for the determination of important information and ideas and discarding the unnecessary ones. It is, thus, a set of criteria to rationalize an idea where one must know all the questions but to use the appropriate one in this case ( 8 ).

The Socratic Method, where the question and the answer are sought, is a technique in which one can investigate below the surface, recognize and examine the condition, look for the consequences, investigate the multiple data views and distinguish between what one knows and what he simply believes. This method should be implemented by nurses at the end of their shifts, when reviewing patient history and progress, planning the nursing plan or discussing the treatment of a patient with colleagues ( 9 ).

The Inference and Concluding justification are two other critical thinking skills, where the justification for inductive generalizations formed from a set of data and observations, which when considered together, specific pieces of information constitute a special interpretation ( 10 ). In contrast, the justification is deduced from the general to the specific. According to this, nurse starts from a conceptual framework–for example, the prioritization of needs by Maslow or a context–evident and gives descriptive interpretation of the patient’s condition with respect to this framework. So, the nurse who uses drawing needs categorizes information and defines the problem of the patient based on eradication, nutrition or need protection.

In critical thinking, the nurses still distinguish claims based on facts, conclusions, judgments and opinions. The assessment of the reliability of information is an important stage of critical thinking, where the nurse needs to confirm the accuracy of this information by checking other evidence and informants ( 10 ).

The concepts are ideas and opinions that represent objects in the real world and the importance of them. Each person has developed its own concepts, where they are nested by others, either based on personal experience or study or other activities. For a clear understanding of the situation of the patient, the nurse and the patient should be in agreement with the importance of concepts.

People also live under certain assumptions. Many believe that people generally have a generous nature, while others believe that it is a human tendency to act in its own interest. The nurse must believe that life should be considered as invaluable regardless of the condition of the patient, with the patient often believing that quality of life is more important than duration. Nurse and patient, realizing that they can make choices based on these assumptions, can work together for a common acceptable nursing plan ( 11 ).

3. CRITICAL THINKING ENHANCEMENT BEHAVIORS

The person applying critical thinking works to develop the following attitudes and characteristics independence of thought, fairness, insight into the personal and public level, humble intellect and postpone the crisis, spiritual courage, integrity, perseverance, self-confidence, research interest considerations not only behind the feelings and emotions but also behind the thoughts and curiosity ( 12 ).

Independence of Thought

Individuals who apply critical thinking as they mature acquire knowledge and experiences and examine their beliefs under new evidence. The nurses do not remain to what they were taught in school, but are “open-minded” in terms of different intervention methods technical skills.

Impartiality

Those who apply critical thinking are independent in different ways, based on evidence and not panic or personal and group biases. The nurse takes into account the views of both the younger and older family members.

Perspicacity into Personal and Social Factors

Those who are using critical thinking and accept the possibility that their personal prejudices, social pressures and habits could affect their judgment greatly. So, they try to actively interpret their prejudices whenever they think and decide.

Humble Cerebration and Deferral Crisis

Humble intellect means to have someone aware of the limits of his own knowledge. So, those who apply critical thinking are willing to admit they do not know something and believe that what we all consider rectum cannot always be true, because new evidence may emerge.

Spiritual Courage

The values and beliefs are not always obtained by rationality, meaning opinions that have been researched and proven that are supported by reasons and information. The courage should be true to their new ground in situations where social penalties for incompatibility are strict. In many cases the nurses who supported an attitude according to which if investigations are proved wrong, they are canceled.

Use of critical thinking to mentally intact individuals question their knowledge and beliefs quickly and thoroughly and cause the knowledge of others so that they are willing to admit and appreciate inconsistencies of both their own beliefs and the beliefs of the others.

Perseverance

The perseverance shown by nurses in exploring effective solutions for patient problems and nursing each determination helps to clarify concepts and to distinguish related issues despite the difficulties and failures. Using critical thinking they resist the temptation to find a quick and simple answer to avoid uncomfortable situations such as confusion and frustration.

Confidence in the Justification

According to critical thinking through well motivated reasoning leads to reliable conclusions. Using critical thinking nurses develop both the inductive and the deductive reasoning. The nurse gaining more experience of mental process and improvement, does not hesitate to disagree and be troubled thereby acting as a role model to colleagues, inspiring them to develop critical thinking.

Interesting Thoughts and Feelings for Research

Nurses need to recognize, examine and inspect or modify the emotions involved with critical thinking. So, if they feel anger, guilt and frustration for some event in their work, they should follow some steps: To restrict the operations for a while to avoid hasty conclusions and impulsive decisions, discuss negative feelings with a trusted, consume some of the energy produced by emotion, for example, doing calisthenics or walking, ponder over the situation and determine whether the emotional response is appropriate. After intense feelings abate, the nurse will be able to proceed objectively to necessary conclusions and to take the necessary decisions.

The internal debate, that has constantly in mind that the use of critical thinking is full of questions. So, a research nurse calculates traditions but does not hesitate to challenge them if you do not confirm their validity and reliability.

4. IMPLEMENTATION OF CRITICAL THINKING IN NURSING PRACTICE

In their shifts nurses act effectively without using critical thinking as many decisions are mainly based on habit and have a minimum reflection. Thus, higher critical thinking skills are put into operation, when some new ideas or needs are displayed to take a decision beyond routine. The nursing process is a systematic, rational method of planning and providing specialized nursing ( 13 ). The steps of the nursing process are assessment, diagnosis, planning, implementation, evaluation. The health care is setting the priorities of the day to apply critical thinking ( 14 ). Each nurse seeks awareness of reasoning as he/she applies the criteria and considerations and as thinking evolves ( 15 ).

Problem Solving

Problem solving helps to acquire knowledge as nurse obtains information explaining the nature of the problem and recommends possible solutions which evaluate and select the application of the best without rejecting them in a possible appeal of the original. Also, it approaches issues when solving problems that are often used is the empirical method, intuition, research process and the scientific method modified ( 16 ).

Experiential Method

This method is mainly used in home care nursing interventions where they cannot function properly because of the tools and equipment that are incomplete ( 17 ).

Intuition is the perception and understanding of concepts without the conscious use of reasoning. As a problem solving approach, as it is considered by many, is a form of guessing and therefore is characterized as an inappropriate basis for nursing decisions. But others see it as important and legitimate aspect of the crisis gained through knowledge and experience. The clinical experience allows the practitioner to recognize items and standards and approach the right conclusions. Many nurses are sensing the evolution of the patient’s condition which helps them to act sooner although the limited information. Despite the fact that the intuitive method of solving problems is recognized as part of nursing practice, it is not recommended for beginners or students because the cognitive level and the clinical experience is incomplete and does not allow a valid decision ( 16 ).

Research Process / Scientifically Modified Method

The research method is a worded, rational and systematic approach to problem solving. Health professionals working in uncontrolled situations need to implement a modified approach of the scientific method of problem solving. With critical thinking being important in all processes of problem solving, the nurse considers all possible solutions and decides on the choice of the most appropriate solution for each case ( 18 ).

The Decision

The decision is the selection of appropriate actions to fulfill the desired objective through critical thinking. Decisions should be taken when several exclusive options are available or when there is a choice of action or not. The nurse when facing multiple needs of patients, should set priorities and decide the order in which they help their patients. They should therefore: a) examine the advantages and disadvantages of each option, b) implement prioritization needs by Maslow, c) assess what actions can be delegated to others, and d) use any framework implementation priorities. Even nurses make decisions about their personal and professional lives. The successive stages of decision making are the Recognition of Objective or Purpose, Definition of criteria, Calculation Criteria, Exploration of Alternative Solutions, Consideration of Alternative Solutions, Design, Implementation, Evaluation result ( 16 ).

The contribution of critical thinking in decision making

Acquiring critical thinking and opinion is a question of practice. Critical thinking is not a phenomenon and we should all try to achieve some level of critical thinking to solve problems and make decisions successfully ( 19 - 21 ).

It is vital that the alteration of growing research or application of the Socratic Method or other technique since nurses revise the evaluation criteria of thinking and apply their own reasoning. So when they have knowledge of their own reasoning-as they apply critical thinking-they can detect syllogistic errors ( 22 – 26 ).

5. CONCLUSION

In responsible positions nurses should be especially aware of the climate of thought that is implemented and actively create an environment that stimulates and encourages diversity of opinion and research ideas ( 27 ). The nurses will also be applied to investigate the views of people from different cultures, religions, social and economic levels, family structures and different ages. Managing nurses should encourage colleagues to scrutinize the data prior to draw conclusions and to avoid “group thinking” which tends to vary without thinking of the will of the group. Critical thinking is an essential process for the safe, efficient and skillful nursing practice. The nursing education programs should adopt attitudes that promote critical thinking and mobilize the skills of critical reasoning.

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The Value of Critical Thinking in Nursing

Gayle Morris

Contributing Writer

Learn about our editorial process .

Updated October 3, 2023

Are you ready to earn your online nursing degree?

Some experts describe a person's ability to question belief systems, test previously held assumptions, and recognize ambiguity as evidence of critical thinking. Others identify specific skills that demonstrate critical thinking, such as the ability to identify problems and biases, infer and draw conclusions, and determine the relevance of information to a situation.

Nicholas McGowan, BSN, RN, CCRN, has been a critical care nurse for 10 years in neurological trauma nursing and cardiovascular and surgical intensive care. He defines critical thinking as "necessary for problem-solving and decision-making by healthcare providers. It is a process where people use a logical process to gather information and take purposeful action based on their evaluation."

"This cognitive process is vital for excellent patient outcomes because it requires that nurses make clinical decisions utilizing a variety of different lenses, such as fairness, ethics, and evidence-based practice," he says.

How Do Nurses Use Critical Thinking?

Successful nurses think beyond their assigned tasks to deliver excellent care for their patients. For example, a nurse might be tasked with changing a wound dressing, delivering medications, and monitoring vital signs during a shift. However, it requires critical thinking skills to understand how a difference in the wound may affect blood pressure and temperature and when those changes may require immediate medical intervention.

Nurses care for many patients during their shifts. Strong critical thinking skills are crucial when juggling various tasks so patient safety and care are not compromised.

Jenna Liphart Rhoads, Ph.D., RN, is a nurse educator with a clinical background in surgical-trauma adult critical care, where critical thinking and action were essential to the safety of her patients. She talks about examples of critical thinking in a healthcare environment, saying:

"Nurses must also critically think to determine which patient to see first, which medications to pass first, and the order in which to organize their day caring for patients. Patient conditions and environments are continually in flux, therefore nurses must constantly be evaluating and re-evaluating information they gather (assess) to keep their patients safe."

The COVID-19 pandemic created hospital care situations where critical thinking was essential. It was expected of the nurses on the general floor and in intensive care units. Crystal Slaughter is an advanced practice nurse in the intensive care unit (ICU) and a nurse educator. She observed critical thinking throughout the pandemic as she watched intensive care nurses test the boundaries of previously held beliefs and master providing excellent care while preserving resources.

"Nurses are at the patient's bedside and are often the first ones to detect issues. Then, the nurse needs to gather the appropriate subjective and objective data from the patient in order to frame a concise problem statement or question for the physician or advanced practice provider," she explains.

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Top 5 ways nurses can improve critical thinking skills.

We asked our experts for the top five strategies nurses can use to purposefully improve their critical thinking skills.

Case-Based Approach

Slaughter is a fan of the case-based approach to learning critical thinking skills.

In much the same way a detective would approach a mystery, she mentors her students to ask questions about the situation that help determine the information they have and the information they need. "What is going on? What information am I missing? Can I get that information? What does that information mean for the patient? How quickly do I need to act?"

Consider forming a group and working with a mentor who can guide you through case studies. This provides you with a learner-centered environment in which you can analyze data to reach conclusions and develop communication, analytical, and collaborative skills with your colleagues.

Practice Self-Reflection

Rhoads is an advocate for self-reflection. "Nurses should reflect upon what went well or did not go well in their workday and identify areas of improvement or situations in which they should have reached out for help." Self-reflection is a form of personal analysis to observe and evaluate situations and how you responded.

This gives you the opportunity to discover mistakes you may have made and to establish new behavior patterns that may help you make better decisions. You likely already do this. For example, after a disagreement or contentious meeting, you may go over the conversation in your head and think about ways you could have responded.

It's important to go through the decisions you made during your day and determine if you should have gotten more information before acting or if you could have asked better questions.

During self-reflection, you may try thinking about the problem in reverse. This may not give you an immediate answer, but can help you see the situation with fresh eyes and a new perspective. How would the outcome of the day be different if you planned the dressing change in reverse with the assumption you would find a wound infection? How does this information change your plan for the next dressing change?

Develop a Questioning Mind

McGowan has learned that "critical thinking is a self-driven process. It isn't something that can simply be taught. Rather, it is something that you practice and cultivate with experience. To develop critical thinking skills, you have to be curious and inquisitive."

To gain critical thinking skills, you must undergo a purposeful process of learning strategies and using them consistently so they become a habit. One of those strategies is developing a questioning mind. Meaningful questions lead to useful answers and are at the core of critical thinking .

However, learning to ask insightful questions is a skill you must develop. Faced with staff and nursing shortages , declining patient conditions, and a rising number of tasks to be completed, it may be difficult to do more than finish the task in front of you. Yet, questions drive active learning and train your brain to see the world differently and take nothing for granted.

It is easier to practice questioning in a non-stressful, quiet environment until it becomes a habit. Then, in the moment when your patient's care depends on your ability to ask the right questions, you can be ready to rise to the occasion.

Practice Self-Awareness in the Moment

Critical thinking in nursing requires self-awareness and being present in the moment. During a hectic shift, it is easy to lose focus as you struggle to finish every task needed for your patients. Passing medication, changing dressings, and hanging intravenous lines all while trying to assess your patient's mental and emotional status can affect your focus and how you manage stress as a nurse .

Staying present helps you to be proactive in your thinking and anticipate what might happen, such as bringing extra lubricant for a catheterization or extra gloves for a dressing change.

By staying present, you are also better able to practice active listening. This raises your assessment skills and gives you more information as a basis for your interventions and decisions.

Use a Process

As you are developing critical thinking skills, it can be helpful to use a process. For example:

• Ask questions.
• Gather information.
• Implement a strategy.
• Evaluate the results.
• Consider another point of view.

These are the fundamental steps of the nursing process (assess, diagnose, plan, implement, evaluate). The last step will help you overcome one of the common problems of critical thinking in nursing — personal bias.

Common Critical Thinking Pitfalls in Nursing

Your brain uses a set of processes to make inferences about what's happening around you. In some cases, your unreliable biases can lead you down the wrong path. McGowan places personal biases at the top of his list of common pitfalls to critical thinking in nursing.

"We all form biases based on our own experiences. However, nurses have to learn to separate their own biases from each patient encounter to avoid making false assumptions that may interfere with their care," he says. Successful critical thinkers accept they have personal biases and learn to look out for them. Awareness of your biases is the first step to understanding if your personal bias is contributing to the wrong decision.

New nurses may be overwhelmed by the transition from academics to clinical practice, leading to a task-oriented mindset and a common new nurse mistake ; this conflicts with critical thinking skills.

"Consider a patient whose blood pressure is low but who also needs to take a blood pressure medication at a scheduled time. A task-oriented nurse may provide the medication without regard for the patient's blood pressure because medication administration is a task that must be completed," Slaughter says. "A nurse employing critical thinking skills would address the low blood pressure, review the patient's blood pressure history and trends, and potentially call the physician to discuss whether medication should be withheld."

Fear and pride may also stand in the way of developing critical thinking skills. Your belief system and worldview provide comfort and guidance, but this can impede your judgment when you are faced with an individual whose belief system or cultural practices are not the same as yours. Fear or pride may prevent you from pursuing a line of questioning that would benefit the patient. Nurses with strong critical thinking skills exhibit:

• Learn from their mistakes and the mistakes of other nurses
• Look forward to integrating changes that improve patient care
• Treat each patient interaction as a part of a whole
• Evaluate new events based on past knowledge and adjust decision-making as needed
• Solve problems with their colleagues
• Are self-confident
• Acknowledge biases and seek to ensure these do not impact patient care

An Essential Skill for All Nurses

Critical thinking in nursing protects patient health and contributes to professional development and career advancement. Administrative and clinical nursing leaders are required to have strong critical thinking skills to be successful in their positions.

By using the strategies in this guide during your daily life and in your nursing role, you can intentionally improve your critical thinking abilities and be rewarded with better patient outcomes and potential career advancement.

Frequently Asked Questions About Critical Thinking in Nursing

How are critical thinking skills utilized in nursing practice.

Nursing practice utilizes critical thinking skills to provide the best care for patients. Often, the patient's cause of pain or health issue is not immediately clear. Nursing professionals need to use their knowledge to determine what might be causing distress, collect vital information, and make quick decisions on how best to handle the situation.

How does nursing school develop critical thinking skills?

Nursing school gives students the knowledge professional nurses use to make important healthcare decisions for their patients. Students learn about diseases, anatomy, and physiology, and how to improve the patient's overall well-being. Learners also participate in supervised clinical experiences, where they practice using their critical thinking skills to make decisions in professional settings.

Do only nurse managers use critical thinking?

Nurse managers certainly use critical thinking skills in their daily duties. But when working in a health setting, anyone giving care to patients uses their critical thinking skills. Everyone — including licensed practical nurses, registered nurses, and advanced nurse practitioners —needs to flex their critical thinking skills to make potentially life-saving decisions.

Meet Our Contributors

Crystal Slaughter, DNP, APRN, ACNS-BC, CNE

Crystal Slaughter is a core faculty member in Walden University's RN-to-BSN program. She has worked as an advanced practice registered nurse with an intensivist/pulmonary service to provide care to hospitalized ICU patients and in inpatient palliative care. Slaughter's clinical interests lie in nursing education and evidence-based practice initiatives to promote improving patient care.

Jenna Liphart Rhoads, Ph.D., RN

Jenna Liphart Rhoads is a nurse educator and freelance author and editor. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Rhoads earned a Ph.D. in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students. Her clinical background includes surgical-trauma adult critical care, interventional radiology procedures, and conscious sedation in adult and pediatric populations.

Nicholas McGowan, BSN, RN, CCRN

Nicholas McGowan is a critical care nurse with 10 years of experience in cardiovascular, surgical intensive care, and neurological trauma nursing. McGowan also has a background in education, leadership, and public speaking. He is an online learner who builds on his foundation of critical care nursing, which he uses directly at the bedside where he still practices. In addition, McGowan hosts an online course at Critical Care Academy where he helps nurses achieve critical care (CCRN) certification.

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Why Critical Thinking Is Important in Nursing

Most nursing professionals have natural nurturing abilities, a desire to give others support, and an appreciation for science and anatomy. Successful nurses also possess a skill that is often overlooked: they can think critically.

A critical thinker will identify the problem, determine the best solution, and choose the most effective method. Critical thinkers evaluate the execution of a plan to see if it was effective and if it could have been done better. 

The ability to think critically has multiple applications in your life, as you can see. But Why is critical thinking important in nursing? Learn why and how you can improve this skill by reading on.

Why Are Critical Thinking Skills in Nursing Important?

Critical thinking is an essential skill for nursing students to have. It’s not something that it can teach in a classroom, and it must be developed over time through experience and practice. 

Critical thinking is the process of applying logic and reason to make decisions or solve problems. The ability to think critically will help you make better decisions on your own and collaborate with others when solving problems – both are essential skills for nurses.

Nursing has always been a profession that relies on critical thinking. Nurses are constantly faced with new situations and problems, which they need to think critically about to solve. 

Critical thinking is essential for nurses because it helps them make decisions based on the available information and their past experiences and knowledge of the field. It also allows nurses to plan before making any changes to be most effective as possible.

It is an essential skill for nurses to have to provide the best care possible. Critical thinkers can comprehend a problem and think about how they can solve it, rather than reactively or automatically.

Critical thinking is a crucial skill for doctors, nurses, and other health care providers.

How can you develop your critical thinking skills?

As you know, learning doesn’t end when you graduate from nursing school. You must continue to grow as a professional and develop your critical thinking skills.

Critical thinkers are better problem solvers than others in the same situation because they examine all the facts before coming up with solutions. They can also take many different perspectives into account when solving problems.

It’s easy for people to come to conclusions too quickly, but those who think critically will avoid this trap by first looking at every possible angle.

When faced with difficult decisions, these nurses won’t just rely on their gut feelings or what seems right according to society’s norms; instead, they’ll analyze all available information carefully until they develop the best solution.

Critical thinking is also crucial because it helps nurses avoid making mistakes in their work by providing them with a way to examine each situation and identify any potential risks or problems that may arise from subsequent actions before they take place.

It’s not enough for you to have empathy if your compassion isn’t backed up by critical thought and understanding of how certain decisions might affect others in various circumstances, so keep learning ways to become more thoughtful about the world around you.

The skills involved in being a good nurse are many and varied, but one thing all nurses need, regardless of what specialty they choose, is critical solid thinking abilities.

Reasons Critical Thinking In Nursing Is Important

Nurses’ experiences often include making life-altering decisions, establishing authority in stressful situations, and helping patients and their loved ones cope with some of the most stressful and emotional times of their lives.  Critical thinking is an essential aspect of nursing.

Following are the reasons:

• Nurses’ critical thinking has a significant impact on patient care 
• Recognizing changes in patient status is essential 
• It’s essential to an honest and open exchange of ideas 
• It enables you to ensure patient safety 
• Nurses can find quick fixes with it 
• Improvements can be made through critical thinking 
• It Contributes to Rational Decision Making

Further critical thinking is essential to nursing because nurses can establish authority in a stressful situation, such as issuing orders or administering care when needed.

This can be difficult because it may require balancing medical expertise with empathy and compassion towards patients’ feelings, leading them to question your judgment at some point in time.

Another reason this skill set is crucial involves making decisions that will have life-changing effects on a patient’s health and well-being.

These are often irreversible choices that only you know how much weight they carry within the context of each situation, so you need to make sure all factors are carefully considered before deciding what action must be taken next without hesitation.

Skills that Critical Thinkers Need

When it comes to critical thinking, some skills are more important than others. Using a framework known as the Nursing Process, some of these skills are applied to patient care. The most important skills are:

Interpretation: Understanding and explaining a specific event or piece of information.

Analysis: Studying data based on subjective and objective information to determine the best course of action.

Evaluation: Here, you assess the information you received. Is the information accurate, reliable, and credible? The ability to determine if outcomes have been fully achieved requires this skill as well.

The nurse can then use clinical reasoning to determine what the problem is based on those three skills. 

The decisions need to be based on sound reasoning:

Provide a clear, concise explanation of your conclusions. Nurses should provide a rationale for their answers.

Self-regulation – You need to be aware of your thought processes. As a result, you must reflect on the process that led to your conclusion. In this process, you should self-correct as necessary. Keep an eye out for bias and incorrect assumptions.

Critical Thinking Pitfalls

It can fall by the wayside when it’s not seen as necessary or when there are more pressing issues.

• Critical thinking is important in nursing because it can fall by the wayside when it’s not seen as an essential or more pressing issue.
• It can be difficult to think critically about complex, ambiguous situations with a shortage of information and time in healthcare settings.
• If we don’t use critical thinking skills, problems might go undetected or unresolved, leading to further complications down the road.

Sometimes nurses can’t differentiate between a less acute clinical problem and one that needs immediate attention. When a large amount of complex data must be processed in a time-critical manner, errors can also occur.

Conclusion:

Nurses cannot overstate the importance of critical thinking. The clinical presentations of patients are diverse. To provide safe, high-quality care, nurses must make rational clinical decisions and solve problems. Nurses need critical thinking skills to handle increasingly complex cases.

• Why Is Research Important in Nursing?
• Why Is the Nursing Process Important?
• Why Compassion is Important in Nursing

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About The Author

Brittney wilson, bsn, rn, related posts.

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