Critical Thinking: you have it or you don't. Agree or disagree? - page 2

by LTCnurse11 18,889 Views | 88 Comments

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


  1. 11
    Well, wikipedia defines critical thinking as: "reasonable reflective thinking focused on what to do in a given situation."

    Usually I'm the first one to jump on the common sense bandwagon. And I do still think that common sense beats education every time. But a person can be very street smart, but lack the knowledge base to make the best decisions as a nurse. Also, there's lots of booksmart nurses who lack the common sense to be able to apply all that education for anything beyond trivia and passing tests.

    I think good critical thinking is where common sense and knowledge intersect.


    So, yes, I think a nurse *can* develop their critical thinking skills through experience and study. But the most important factor, common sense, you're born with.
    dudette10, AnonRNC, imintrouble, and 8 others like this.
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    I agree with some of the others that it's a mixture of common sense, probably some "street smarts" too....and a lot of gut instinct.

    Where I work, the patients are mostly physically healthy for the most part. Nurses tend to overlook medical problems since that's not our primary focus in the mental health field.

    I've caught quite a few patients already though in my short time on the job who needed medical attention. I didn't have to do any "critical thinking" really. I just knew (instinct + common sense + nursing knowledge) that something wasn't "right."

    For example, just the other night a patient woke up in the middle of the night, started walking around, and when I called his name, he just had this look on his face and I knew something was wrong. It didn't require any critical thinking for me to realize that something was wrong...I just knew. Now, figuring out WHAT was wrong might have taken some more "critical thinking" once he got to the ER or in the doctor's hands, but knowing that SOMETHING is wrong is the most important thing for nurses to realize and that can't be easily taught. Time and experience probably make a person better at recognizing when something is wrong, but some people are probably born with a better instinct than others. Same scenario....a more experienced nurse was sitting right beside me and thought the patient should just go back to bed and the "look" he had was just because he was disoriented from getting up in the middle of the night. I wish that had been the case, but it wasn't. I wouldn't say that nurse lacks critical thinking, but probably lacks instinct, common sense, or both.
    smartnurse1982 likes this.
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    It isn't black or white, I agree with that.

    Behavior is learned - some might be more apt to be good at something while someone else is not but that doesn't mean things cannot be learned. Especially when it comes to medicine - I started out at age 40 with no medical experience at all. I learned to function well as a nurse by working as a nurse. Time and experience helped hone my skills as a nurse. I think my instincts are good.

    Not that I haven't made any errors in judgment. No one, absolutely no one, is perfect.
    CVON, JB2007, Meriwhen, and 1 other like this.
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    Critical thinking....knowing the difference between when to assume and when to ask.

    I supervise a few of these people.
    MoopleRN and joanna73 like this.
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    I think that critical thinking is about problem solving, and that problem solving skills can be learned. I think the ideal time to teach problem solving is in early childhood, and that parents and teachers have the biggest impact. So no,I don't believe you either have it or you don't. I believe that all people have some problem solving ability, but that the extent of its development falls along a spectrum that is influenced by genetic, organic, environmental, and psychosocial factors.
    metal_m0nk, itsmejuli, and joanna73 like this.
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    I would agree....to a point. I'm not a fan of the "all or nothing" mentality, and life is complicated. Regarding critical thinking, the human brain needs exercise, fuel, and sleep to function properly, and that's just for starters. Critical thinking can be learned and practised, as most other things can. However, I do think that critical thinking is inherently natural for some people, while others really struggle with problem solving, being analytical, planning ahead, etc.
    RNperdiem, Meriwhen, and itsmejuli like this.
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    Critical thinking is what we learn and then practice to make habit. Good nurses develop this skill early and hone it over time.

    We have probably all worked with nurses who have poorly developed critical thinking skills and are more focused on tasks than on the patient.
    dudette10, JB2007, and TheCommuter like this.
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    The current fad of thinking better education is unnecessarily hard, academics are useless eggheads, science is a matter of opinion, and the like has now officially entered this forum.

    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.

    Of course it's something you have to learn, of course it's something that is not necessarily inborn.

    The question is, will the good nurse take the trouble to acquire this very basic skill, or pooh-pooh it because "common sense beats education every time"? Hint: It sure as hell does not. This is why we have the concept of education for nursing, for evidence-based practice, and for autonomy. These are the bases of our Scope and Standards, which, even if you haven't taken the trouble read them, still apply to your practice.

    If you don't believe in that, then why bother with being a nurse? Because you had a drreeeeaaaammmm and a paaaasssssiooonnnnnn? Not enough, no, it's not. Asking whether you agree that you have it or don't isn't the point and isn't even a useful question to ask: Critical thinking is an integral part of the nursing process; you cannot properly fulfill the role of a real nurse without it. You can look it up.
    Clovery, RNsRWe, imintrouble, and 6 others like this.
  9. 1
    I feel critical thinking continues to be fine tune as you grown and learn within your practice. Critical thinking can be learn and we all have a foundation that can be expanded and refined.
    tewdles likes this.
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    Grntea, I believe in your type of thinking. It's not a matter of agreeing or disagreeing but what "critical thinking" really is. My whole purpose in posting this question was to point out how assenine it is to make a statement as such. This so called "all or nothing" mentality was verbalized to me several times during my experience on this particular med surg floor. The nurse manager stated she thought I was too task oriented, slow and overall was concerned with my performance and said "I think you could put a patient at risk". I had a lukewarm relationship with one preceptor in the beginning of my orientation for nights then I was switched around between 2 preceptors for the day shift because my first one stated "I don't think I could train you." That made my anxiety skyrocket. I never, ever caused harm to a patient but I was constantly asking questions. I had minimal experience with IV therapy prior to starting on med surg, that made me uncomfortable. I admit, I was very focused on tasks and just learning to get through my shift. I had never worked an acute unit an was anxious going in and felt like I lacked general support and understanding. At the time of my hire on this floor I was an RN for 9 months. I took that PBDS test and got an "unacceptable" twice. Based on that, my nurse manager decided to say I "lack critical thinking". I looked up my diagnoses, asked questions and overall tried my best to be interested in any and all learning opportunities.

    Anyway, I guess in a round about way I'm saying that I feel that being a critical thinker is created through the nursing practice. Not some special gift. All nurses must work to do this which is why it's called nursing "practice".
    CVON, tewdles, and MrsCuoco like this.


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