By Christina Orlovsky, contributor
Perhaps the most obvious aspect of the nursing profession is
bedside care. At the heart of the matter, however, is another aspect that’s just
as important: critical thinking.
Critical thinking is at the core of safe nursing practice and all educators
should incorporate it into their nursing curricula, according to the book Critical Thinking in the Emergency Department: Skills to Assess, Analyze and Act.
“Critical thinking should start at the very beginning of a nursing school education because it is an application that is necessary for all nurses,” according to the book's contributing author, Polly Gerber Zimmermann, RN, MS, MBA, CEN, an assistant professor in the department of
nursing at Harry S. Truman College in Chicago. "Sicker patients are always changing, and the critical-thinking nurse can make quick decisions rather than following a treatment recipe,” she said. “Responding to how the patient is responding instead of just to the illness itself.”
Zimmermann cited a definition of critical thinking as careful, deliberate, outcome-focused (results-oriented) thinking that is mastered for a context. She added that critical thinking is based on scientific method and the nursing process, and requires a high level of knowledge, skills and experience.
“In the practical world of clinical nursing, critical thinking is the ability of nurses to see patients’ needs uniquely and respond appropriately, beyond or in spite of others,” she said.
It's All About Priorities
One aspect of critical thinking that Zimmermann emphasized is prioritization. “Nurses not only need to know what to do, but the importance and order in which things should be done," she said, adding that this is one of the most important aspects of nursing care today, although it is often missing from practice.
“What’s happening today is that there are a lot of data but no wisdom,” she said. “People are doing a lot of collecting, but no analyzing to recognize a pattern and do the prioritization. These things are essential: be looking for and making sure the worst case scenario and complications aren’t happening.”
Tip for New Nurses
Zimmermann added that nurses who are skilled in critical thinking often act in a way that distinguishes them from other nurses—even those with much more experience under their belt.
“We make a joke that nurses who don’t use critical thinking have one year of experience 10 times over,” she said. “You need to keep current with literature, do your own quality assurance and read what other providers are saying. You need to be able to pick up what’s wrong and then do the right thing for the right reason.”
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