The nursing profession tends to attract those who have natural nurturing abilities, a desire to help others and a knack for science or anatomy. But there is another important skill that successful nurses share and it’s often over-looked: the ability to think critically.
Identifying a problem, determining the best solution and choosing the most effective method are all parts of the critical thinking process. After executing the plan, critical thinkers reflect on the situation to figure out if it was effective and if it could have been done better. As you can see, critical thinking is a transferable skill that can be leveraged in several facets of your life.
But why is it so important for nurses to use? We spoke with several experts to learn why critical thinking skills in nursing are so crucial to the field, the patients and the success of a nurse. Keep reading to learn why and to see how you can improve this skill.
Why are critical thinking skills in nursing important?
You learn all sorts of practical skills in nursing school, like flawlessly dressing a wound, taking vitals like a pro or giving an IV without flinching. But without the ability to think clearly and make rational decisions, those skills alone won’t get you very far—you need to think critically as well.
“Nurses are faced with decision-making situations in patient care, and each decision they make impacts patient outcomes. Nursing critical thinking skills drive the decision-making process and impact the quality of care provided,” says Georgia Vest, DNP, RN and senior dean of nursing at Rasmussen College School of Nursing.
Critical thinking is embedded in a nurse’s everyday routine. They flex this mental muscle each day they enter the floor. When you’re faced with decisions that could ultimately mean life or death, the ability to analyze a situation and come to a solution separates the good nurses from the great ones.
How are critical-thinking skills acquired in nursing school?
Nursing school offers a multitude of material to master and high expectations for your performance. But in order to learn in a way that will actually equip you to become an excellent nurse, you have to go beyond just memorizing terms. You need to apply an analytical mindset to understanding course material.
One way for students to begin implementing critical thinking is by applying the nursing process to their line of thought, according to Vest. The process includes five steps: assessment, diagnosis, outcomes/planning, implementation and evaluation.
“One of the fundamental principles for developing critical thinking is the nursing process,” Vest says. “It needs to be a lived experience in the learning environment.”
Nursing students often find that there are multiple correct solutions to a problem. The key to nursing is to select the “the most correct” solution—one that will be the most efficient and best fit for that particular situation. You will often find yourself in situations where there are few “correct” forms of care, but one that is most appropriate. Using the nursing process, students can narrow down their options to select the best one.
When answering questions in class or on exams, challenge yourself to go beyond simply selecting an answer. Start to think about why that answer is correct and what the possible consequences might be. Simply memorizing the material won’t translate well into a real-life nursing setting.
How can you develop your critical thinking skills?
As you know, learning doesn’t stop with graduation from nursing school. Good nurses continue to soak up knowledge and continually improve throughout their careers. Likewise, they can continue to build their critical thinking skills in the workplace with each shift.
“To improve your critical thinking, pick the brains of the experienced nurses around you to help you get the mindset,” suggests Eileen Sollars, RN ADN, AAS. Understanding how a seasoned nurse came to a conclusion will provide you with insights you may not have considered and help you develop your own approach.
The chain of command can also help nurses develop critical thinking skills in the workplace.
“Another aid in the development of critical thinking I cannot stress enough is the utilization of the chain of command,” Vest says. “In the chain of command, the nurse always reports up to the nurse manager and down to the patient care aide. Peers and fellow healthcare professionals are not in the chain of command. Clear understanding and proper utilization of the chain of command is essential in the workplace.”
How are critical thinking skills applied in nursing?
“Nurses use critical thinking in every single shift,” Sollars says. “Critical thinking in nursing is a paramount skill necessary in the care of your patients. Nowadays there is more emphasis on machines and technical aspects of nursing, but critical thinking plays an important role. You need it to understand and anticipate changes in your patient's condition.”
As a nurse, you will inevitably encounter a situation in which there are multiple solutions or treatments and you’ll be tasked with determining the solution that will provide the best possible outcome for your patient. You must be able to quickly and confidently assess situations and make the best care decision in each unique scenario. It is in situations like these that your critical thinking skills will direct your decision making.
You’re now well aware of the importance of critical thinking skills in nursing. Even if you wouldn’t consider yourself a high-caliber critical thinker today, you can work toward strengthening that skill. The more you practice it, the better you will become and the more naturally it will come to you.
Critical thinking isn’t the only component that makes an effective nurse. Learn about how else you can position yourself to climb the ranks in your nursing career in our article, "Nursing Career Advancement: 7 Ways to Stand Out in Your Scrubs."
*This article was originally published in July 2012. It has since been updated to include information relevant to 2017.
"Critical thinking is a desire to seek, patience to doubt, fondness to meditate, slowness to assert, readiness to consider, carefulness to dispose and set in order; and hatred for every kind of imposture." - Francis Bacon (1605)
As parents, we are tasked with instilling a plethora of different values into our children. While some parents in the world choose to instill a lack of values in their kids, those of us that don't want our children growing up to be criminals and various misfits try a bit harder. Values and morality are one piece of the pie. These are important things to mold into a child's mind, but there are also other items in life to focus on as well. It starts with looking both ways to cross the street and either progresses from there, or stops.
If you stopped explaining the world to your children after they learned to cross the street, then perhaps you should stop reading and go back to surfing for funny pictures of cats. I may use some larger words that you might not understand, making you angry and causing you to leave troll-like comments full of bad grammar and moronic thought processes. However, if you looked at the crossing the street issue as I did – as a logical problem with cause and effect and a probable solution – then carry on. You are my target audience.
Or perhaps the opposite is true, as the former are the people that could benefit from letting some critical thinking into their lives. So what exactly is critical thinking? This bit by Linda Elder in a paper on CriticalThinking.org pretty much sums it up:
Through critical thinking, as I understand it, we acquire a means of assessing and upgrading our ability to judge well. It enables us to go into virtually any situation and to figure out the logic of whatever is happening in that situation. It provides a way for us to learn from new experiences through the process of continual self-assessment. Critical thinking, then, enables us to form sound beliefs and judgments, and in doing so, provides us with a basis for a 'rational and reasonable' emotional life. — Inquiry: Critical Thinking Across the Disciplines, Winter, 1996. Vol. XVI, No. 2.
The rationality of the world is what is at risk. Too many people are taken advantage of because of their lack of critical thinking, logic and deductive reasoning. These same people are raising children without these same skills, creating a whole new generation of clueless people.
To wit, a personal tale of deductive reasoning:
Recently I needed a new transmission for the family van. The warranty on the power train covers the transmission up to 100,000 miles. The van has around 68,000 miles on it. Therefore, even the logic-less dimwit could easily figure that the transmission was covered. Well, this was true until the dealership told me that it wasn't, stating that because we didn't get the scheduled transmission service (which is basically a fluid change) at 30,000 and 60,000 miles the warranty was no longer valid. Now, there are many people that would argue this point, but many more that would shrug, panic, and accept the full cost of repairs.
I read the warranty book. I had a receipt that said the fluid was checked at 60,000 but not replaced. A friend on Twitter pointed out the fact that they were using 100,000 mile transmission fluid. So logically, the fluid would not have to be replaced under 100,000 miles if it wasn't needed, right? So why the stipulation that it needed to be replaced at 60,000 and the loose assumption that not doing that would void the warranty? So I asked the warranty guy to show me in the book where the two items are related. Where it explicitly says that if you don't get the service, the transmission isn't covered. There were portions where it said the service was recommended, but never connecting to actual repairs. Finally the warranty guy shrugged, admitted I was right and said the service was covered.
In this case, valid logic equaled truth and a sound argument. I used very simple reasoning and logic to determine that I was being inadvertently screwed. I say "inadvertently" because I truly believe based on their behavior that they were not intentionally trying to screw me. They believed the two items were related, they had had this argument many times before and were not prepared to be questioned. While both the service manager and the warranty guy seemed at least junior college educated, proving my argument to them took longer than it should have between three adults.
However, valid logic does not always guarantee truth or a sound argument. This is where it gets a little funky. Valid logic is when the structure of logic is correct in the way of syntax and semantics rather than truth. Truth comes from deductive reasoning of said logic. For example:
All transmissions are covered parts. All covered parts are free. Therefore, all transmissions are free. This logic is technically valid, and if the premises are true, then of course the conclusion must be true. You can see here however that it's not always true, though in some situations it could be. While the logic is valid, not all transmissions are free, only those covered by the warranty. So based on that, saying all transmissions are free is not sound logic.
To take it one step further:
All Daleks are brown. Some brown things are Cylons. Therefore, some Daleks are Cylons. Sci-fi fan or not, you probably know that this is not true. The basic lesson here is that, while the logic above might seem valid because of the structure of the statement, it takes a further understanding to figure out why it's not necessarily true: That is, based on the first two statements it's possible that some Daleks are Cylons, but it's not logically concludable. That's where deductive reasoning comes on top of the logic. The underlying lesson here is not to immediately assume everything you read or are told is true, something all children need to and should learn.
This is the direct lesson that needs to be passed on to our children: that of not accepting the immediately visible logic. While not all problems are complex enough to require the scientific method, some of them need some deduction to determine if they are true. Take the example above — how many kids would immediately be satisfied with the false conclusion? Sure, it's a bit geeky with the examples, but switch out bears for Daleks and puppies for Cylons. That makes it easier, and takes the actual research out of it (to find out what Daleks and Cylons are respectively) but many people would just accept that in fact some bears are puppies, if presented with this problem in the context of a textbook or word problem.
Maybe I'm being paranoid or thinking too doomsday, whatever, but I think this is an epidemic. Children are becoming lazier and not as self sufficient because their parents have a problem with watching a three year old cry after they tell her to remove her own jeans, or ask her to put away her own toys (yes, organizational logic falls under the main topic). These are the same parents who do their kid's science project while the kid is playing video games. These kids grow up lacking the simple problem solving skills that make navigating life much easier. Remember when you were growing up and you had the plastic stacking toys? Well, instead of toys for early development like that, parents are just plopping their kids down in front of the television. While there is some educational type programming on television, it's just not the same as hands-on experience.
My father is an engineer, and he taught me logic and reasoning by making me solve simple, then complex, problems on my own. Or at least giving me the opportunity to solve them on my own. This helped develop critical thinking and problem solving skills, something a lot of children lack these days. Too often I see children that are not allowed to solve problems on their own; instead their parents simply do it for them without argument or discussion. Hell, I am surrounded by adults every day that are unable to solve simple problems, instead choosing to immediately ask me at which point I have to fill the role that their parents never did and – knowing the solution – tell them to solve it themselves, or at least try first.
One of the things I like to work on with my kids is math. There is nothing that teaches deductive reasoning and logic better than math word problems. They are at the age where basic algebra can come into play, which sharpens their reasoning skills because they start to view real world issues with algebraic solutions. Another thing is logic puzzles, crossword puzzles and first person shooters. Actually, not that last one. That's just the reward.
Since I weeded out the folks that don't teach their kids logic in the first two paragraphs, as representatives of the real world it's up to the rest of us to spread the knowledge. It won't be easy. The best thing we can do is teach these thought processes to our children, so that they may look at other children with looks of bewilderment when other children are unable to solve simple tasks. Hopefully, they will not simply do the task for them, but teach them to think. I'm not saying we need to build a whole new generation of project managers and analysts, but it would be better than a generation of task-oriented mindless office drones with untied shoelaces, shoving on a door at the Midvale School for the Gifted.
h/t to @aubreygirl22 for the logical conversation.
Image: Flickr user William Notowidagdo. Used under Creative Commons License.