Critical Thinking is MUCH more than an NCLEX Buzzword

Critical thinking in nursing is demonstrating the ability to organize thoughts, develop questions, and analyze data in a systematic and logical manner to ensure safe and effective nursing practice. Although nursing students hear the term "Critical Thinking" a lot during their program of study, it’s often a skill that takes experience and practice to master. It is essential to understand that critical thinking is much more than an NCLEX buzzword.

Critical Thinking is MUCH more than an NCLEX Buzzword

In fact, critical thinking is fundamental in helping you pass the NCLEX and becoming a safe and effective nurse!

To emphasize how fundamental critical thinking is to being a proficient nurse, let's take a quick review at the basic systematic foundation in which nurses organize their thoughts and use critical thinking:

The Nursing Process is a five-part systematic decision-making method focusing on identifying and treating responses of individuals or groups to actual or potential alterations in health. The five steps in the Nursing Process are as follows:

Assessment/Analysis

Collecting and analyzing objective patient data through a variety of methods such as interviewing, physical examination, patient response, measurements, and lab specimen collection.

During this phase of The Nursing Process, you are challenged to determine if you have collected and analyzed enough data before moving onto the next step. Whether you are sitting for an exam, or taking care of a patient, you must be certain that you have all of the necessary data to safely move onto creating Nursing Diagnoses.

Nursing Diagnosis

Identifying actual or potential health risks, and defining the severity of health alterations based on the individual needs of the patient.

Not only does creating a nursing diagnosis require you to rely on your body of nursing knowledge, but it also challenges you to anticipate your patient's needs on a holistic level. Using Maslow's Hierarchy of Needs is a great tool you can use when developing your nursing diagnoses. Remember that actual alterations in health take priority, but nurses use critical thinking to also plan for potential risks.

Planning

Creating an individualized nursing care plan to prevent, reverse, slow, or relieve the symptoms and/or progression of illness based on the patient's needs.

When you are in the planning phase, it's important to establish objective and measurable goals for your patients. Identifying interventions, establishing anticipated outcomes, and considering appropriateness and utilization of supportive personnel are all examples of nursing considerations that require critical thinking skills.

Implementation

Strategic delivery of patient care plan and nursing intervention(s) based on the patient's individual needs.

Now we get into the fun part - direct patient care and coordination! During the implementation phase of The Nursing Process, the number one priority is always safety. Not only considering the safety of the patient, but also the safety of you and your colleagues. Being safe when providing direct patient care and coordination requires high level critical thinking skills. From medication administration to teaching patients and family members discharge instructions, you must utilize all the strategies that you've learned during nursing school to ensure safe and effective care. During the implementation phase it is vital that you question everything and assume nothing!

Evaluation

Analyzing the effectiveness of nursing intervention in meeting the patient's individual needs, and meeting anticipated patient outcomes.

Evaluating whether or not our interventions were successful in meeting the patient's needs is one of the most important steps of The Nursing Process. This requires high level analysis critical thinking skills to determine what's next in the patient's care plan. Have we met all of their physical needs? Have we met all of their psychosocial needs? Have they met the goals that were created in the planning phase? Has their status improved, stayed the same, or declined? If the patient has met the anticipated outcomes, then the interventions that were implemented are working, and no changes to the care plan are required. However, if we find that the interventions are not meeting the anticipated outcomes for the patient, then we must go back to assessing the patient for more objective data that will help us in updating the patient's plan of care. Believe it or not, utilizing The Nursing Process when answering NCLEX questions, or when providing direct patient care is a natural progression of critical thinking, and it will help you in making safe and effective clinical decisions. By following the five steps of The Nursing Process, while utilizing additional strategies that you've learned in nursing school, you will be on your way to mastering critical thinking and making sound nursing judgments.

One final word of advice: don't get caught up in the obscurity of certain concepts or buzzwords such as "critical thinking". Instead you should master the systematic tools and strategies that are provided to you. With regular practice and mastery of critical thinking skills, you'll soon find yourself as a valuable addition to the nursing profession!

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Have you struggled with the concept of critical thinking? Do you have any critical thinking strategies you'd like to share? Do you think that critical thinking is effectively taught in nursing school? Please share your thoughts in the comments section below!

NCLEX Columnist

Hi! I am Damion - a Registered Nurse, Educator, Tutor and Writer! I am the owner and operator of TheNurseSpeak.com - a nursing education and consulting company & blog. I love to help nursing students, new graduates and nursing professionals alike to develop strategies for success!

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A slightly more complex versions of that 5-step process might occur if you realize you need to make a differential diagnosis between two possible causes of similar signs and symptoms, and those would require different responses,  so this matters, which directs you to go back and focus on getting different or more specific facts during assessment than you otherwise would.

Specializes in Emergency.

Didn't this once go by "clinical judgement" or am I mistaken?

Specializes in NCLEX Prep Expert - 100% Pass Rate!.
On 2/16/2021 at 1:45 PM, Ray36 said:

A slightly more complex versions of that 5-step process might occur if you realize you need to make a differential diagnosis between two possible causes of similar signs and symptoms, and those would require different responses,  so this matters, which directs you to go back and focus on getting different or more specific facts during assessment than you otherwise would.

Hey there Ray36!

Thanks for adding to the discussion. Yes! You are correct that considering a differential diagnosis is part of critical thinking, and is typically a combination of both the analysis and diagnosis phases of The Nursing Process. This requires specific patient data in order to consider the additional step you've included. A case scenario would demonstrate this effectively. 

Thanks again for your contribution to this very important concept!

-Damion

Specializes in NCLEX Prep Expert - 100% Pass Rate!.
On 2/19/2021 at 6:46 PM, CKPM2RN said:

Didn't this once go by "clinical judgement" or am I mistaken?

Hi CKPM2RN! 

Yes! Critical thinking is the same as clinical judgment, and often includes analysis and differential diagnosis (as mentioned by Ray36 above). 

The problem lies within the fact that I've had HUNDREDS of new grad nurses come to me unable to define the process in which they can demonstrate Critical Thinking, or Clinical Judgment. Therefore, writing and sharing how one should use Critical Thinking (aka The Nursing Process) really helps for nurses to have a systemic application to thinking trough NCLEX questions, patient care, and everyday problems. 

Thanks for adding to this discussion.

-Damion