Critical Thinking: you have it or you don't. Agree or disagree?

Nurses Professionalism

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I was told during my brief stint working med surg that you either have critical thinking or you don't. Thoughts?

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I don't think there is a standard definition of "critical thinking", so I'll give my definition.n that they are lacking in the ability to use critical thinking, only that partition of it that relates to nursing.

At least as important as a definition would be some way of measuring critical thinking skills. I get so tired of people saying things like "BSN prepared nurse have better critical thinking skills than nurses with ADNs." Or ICU nurse have better critical thinking skills than ER nurses do". Unless one has a way to measure critical thinking skills such statment are nothing more than opinion.

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It's just more stupidity. Another label of nonsense. I guess someone needs a label or they won't survive.

As in everything, if you put in the time and effort into it, soon you will become proficient. And, as in everything, some become more proficient than others ...yawn.

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Specializes in "Wound care - geriatric care.

Our minds are pliable and always learning so everyone can develop critical thinking if they focus on achieving it. You might be a quick thinking person but if you don't have much experience your critical thinking will be fast but may not be accurate. There are many shades to critical thinking such as speed, judgment, experience, knowledge, prioritization skills, overall in my opinion the most the skill most associated with critical thinking is judgment or the ability to know what's right and what's wrong. Than one have to ask what are we critically thinking about some people might be good at critically think of one think while others may not. In the end you can critically think about your own question.

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Specializes in ICU.
If common sense were common, more people would have it. If more people valued critical thinking because they understood its irreplaceable applicability to best practice, we wouldn't be having this discussion.

This assumes an end goal of maintaining best practice standards, which not all nurses strive for unfortunately.

I think most all nurses use critical thinking - whether they are deciding how to expend as little energy as possible during a shift or connecting the pieces of the best practice puzzle.

As for new nurses....It usually isn't until a novice has mastered some sort of work flow that the lanes of thought open up for the more abstract goal oriented thinking. Once skills and procedures become a matter of rote instead of an exercise in problem solving themselves, the focus can then shift from task orientation to big picture integration. Even the most natural critical thinkers can fall short early in their careers if not allowed to master the work environment before being pressured to perform to an expert standard.

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Specializes in Peds ED, Peds Stem Cell Transplant, Peds.

I think alot comes with experience

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Specializes in Trauma/Tele/Surgery/SICU.

Critical thinking......I still cannot adequately define it. Kind of like Justice Potter who said of obscenity "I can't define it but I know it when I see it." For me it means a sort of fluidity in thinking, common sense, and a pinch of experience thrown in the mix.

I do not think you can say that someone either has it or does not, but I do think that many people have a greater ability naturally than others. Does this mean that someone will NEVER be able to critically think? Not always. Sometimes it is a matter of support and education. It is also true that some people just cannot master it no matter how much education or support they receive. It is also true that there are those who are pretty good critical thinkers most of the time but have those shining moments when you have to wonder if they left their brain at home that day. I count myself as a member of this group.

At my previous job we oriented frequently and in batches of 5 or more. Usually one of the group would quickly distinguish themselves as the strongest and one would quickly distinguish themselves at the bottom. What separated these nurses? Their ability to critically think. As time went by the position in the group may change as some of the others developed their abilities but occasionally we would encounter one or more that stayed stagnant solely because they just could not master critical thinking. So yes time and experience can develop it, improve it, and build on the ability. Some nurses who fall short on one unit may eventually rise to the top on another. The difference can be a slower pace, more experienced nurses as teachers, understanding peers, or management who is truly vested in growing their employees or a combination of these.

It has been my experience that those nurses who possess less than adequate critical thinking skills glob on to protocol with all their might. The protocol is law regardless of the situation! I will give you an example. Post-op unit with a manager who is HUGE on standards of care, skip, leap, etc. DVT prophylaxis was a big deal and nurses learned quickly to push for sub-q heparin or lovenox. We had a couple of nurses who would become personally offended when a patient was not on DVT prophylaxis. They would become irate, try to bully you in report as to why you did not get it and then they would call the first year and get an order. They would then gloat when you returned the next day about how they got the order and you did not! It just did not occur to them that giving heparin to someone with an active head bleed a blood thinner was not a good idea, after all there was a protocol. You could explain it until you were blue in the face but they just would not get it. This led to many of our MD's writing orders like: DO NOT PLACE PATIENT ON HEPARIN, DO NOT REMOVE FOLEY WITHOUT ORDER, DO NOT HOLD LOPRESSOR WITHOUT SPEAKING TO DOCTOR etc. it was pretty sad.

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Specializes in Medical Surgical Orthopedic.

I agree that you have it or you don't. Though as a new grad, you don't have the same pool of knowledge to draw from that an experienced nurse does. I don't care how good you are at putting puzzles together- if there are lots of missing pieces, it's going to be difficult.

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Specializes in FNP, ONP.

Strongly disagree. People grow and learn new skills every day.

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Strongly disagree. People grow and learn new skills every day.

Strongly agree with you.

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Specializes in LTC, assisted living, med-surg, psych.

I believe critical thinking skills are those we develop as we learn to think at a higher level. An example of this is root-cause analysis---for many of us, it's not enough to document that our patient fell and what happened to him as a result; we investigate the incident much like a detective, researching the possible causes, and then going beyond the obvious to get to the precipitating factors so we can try to prevent the next fall.

Yes, some people have an easier time than others in learning these skills, and there are some who never get out of the starting gate---they do everything by rote for their entire lives, and thus do not make good nurses. I think that critical thinking can be taught to some extent; after all, we don't come fresh from nursing school fully equipped with the knowledge that a 20-year veteran possesses. And yes, almost anyone can be taught to insert an IV, drop an NG tube and so forth; but if the basic building materials aren't there---if a person's brain isn't firing on all 8 cylinders, shall we say---it's all but impossible to make him or her understand the rationale behind the task. Therein lies the critical-thinking piece, IMHO.

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Specializes in ICU.
It has been my experience that those nurses who possess less than adequate critical thinking skills glob on to protocol with all their might. The protocol is law regardless of the situation! I will give you an example. Post-op unit with a manager who is HUGE on standards of care, skip, leap, etc. DVT prophylaxis was a big deal and nurses learned quickly to push for sub-q heparin or lovenox. We had a couple of nurses who would become personally offended when a patient was not on DVT prophylaxis. They would become irate, try to bully you in report as to why you did not get it and then they would call the first year and get an order. They would then gloat when you returned the next day about how they got the order and you did not! It just did not occur to them that giving heparin to someone with an active head bleed a blood thinner was not a good idea, after all there was a protocol. You could explain it until you were blue in the face but they just would not get it. This led to many of our MD's writing orders like: DO NOT PLACE PATIENT ON HEPARIN, DO NOT REMOVE FOLEY WITHOUT ORDER, DO NOT HOLD LOPRESSOR WITHOUT SPEAKING TO DOCTOR etc. it was pretty sad.

You raise an interesting point. I think that in order to even begin to be a critical thinker, you have to first be able to accept ambiguity. A natural critical thinker expects more than one answer to a question, more than one solution to a problem, or more than one way of looking at things. A learned critical thinker accepts more than one answer to a question, more than one solution to a problem, or more than one way of looking at things. Those who struggle with critical thinking reject the possibility that there is more than one answer to a question, more than one solution to a problem, or more than one way of looking at things. Plenty of "all or nothing" thinkers out there.

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The ability to critically think has haunted me. I have some of it down, but I think sometimes I go too far in thinking that anything is possible, which brings me back to, only one thing is the best possibly. But I don't think I'm quite there in picking the best one.

Those who struggle with critical thinking reject the possibility that there is more than one answer to a question, more than one solution to a problem, or more than one way of looking at things. Plenty of "all or nothing" thinkers out there.

I agree with you in that this is why some people struggle with it, but not an absolute. You just demonstrated that you reject the possibility of there being different reasons for struggling with critically thinking.

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