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I don't think there is a standard definition of "critical thinking", so I'll give my definition. In my world, critical thinking is not innate but, rather a learned system to process information to reach a reasonable and logical conclusion.This ability is gained by education, instruction, and (mostly) by experience. Most people, I believe, are born with the ability to learn critical thinking. The ability to put two and two together, or assemble the pieces of a jigsaw puzzle.
We all use critical thinking in our daily lives to some extent. Whether driving a car, building a boat, or setting a budget. In the nursing profession, we learn to watch a patient's behavior, V/S, and reactions to drugs. Few people ( I would guess) enter nursing school with the assumption that they will be guarding against physician errors. Yet, every time we receive a new order that is exactly what we do. We learn this trait by education and experience.
Some of us, no doubt, never attain the breakthrough point where we are able to deduce what is going on internally with our patients. This doesn't mean that they are lacking in the ability to use critical thinking, only that partition of it that relates to nursing.
My experience with patient care relating to critical thinking has drawn together through various experience in long term care, EMS and a little med surg. Surprised to hear the nursing manager speak to the fact that you either have critical thinking or you don't. Mind you this person has only been a nurse for 5 years and only worked that floor in the hospital.
After two years of nursing school and almost 10 years as an RN,
I STILL don't know the exact definition of "critical thinking". Sad, huh?
In my opinion, it involves a lot of common sense. Something that
indeed, a lot of people simply do not have. Take my mother in law,
for instance.
Take my mother in law, please!! (ba-da-bum!)
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.
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.
LTCnurse11
69 Posts
I was told during my brief stint working med surg that you either have critical thinking or you don't. Thoughts?