critical thinking with ventilator pt

[destiney]

Has any one ever had a client care situation in which you were involved that required critical thinking of a pt with a ventilator. How did you resolve the situation? Not sure I did my best. Guess I'm just wondering compard to what I did to what you did and would have done differently if you werent 100% satisfied of your interventions

Im a new nurse and i'm worried about getting this whole relationship between the nursing process and critical thinking? Its was smooth untill I actually became a nurse, I still have lot to learn.

Do you use any of your values to get you through the day? How are you guys influenced by particular situations that come up? How did you resolve the situation? What critical thinking elements did you use and what would you do differently in the future? My mom says I'm reading too much into nursing, but i really need to think out these things, they help alot.

[tbanurse]

I think you need to be a little more specific on what you're looking for. There are so many different scenarios with a patient on a vent that could happen. Besides the patient's diagnosis, there are vent settings specific for that patient (why...?), safety issues (what if...?), patient and family education (coping...?), current medications (side effects...?), as well as what's going on physiologically with this person (which can lead to...?). All of this in encompassed in the critical thinking that you need to be doing in order to provide safe, competent care!

[Daytonite, BSN, RN]

critical thinking is used everyday as a nurse in every thing we do. critical thinking is how we solve problems. very simply, critical thinking is making judgments based on facts rather than making random guesses based on nothing. the basic strategy behind critical thinking is as follows, you must:

• know and consider the normal anatomy and physiology
  
• know and consider abnormal anatomy of the disease in question
  
• know and consider the resulting signs and symptoms when the disease occurs and how it proceeds from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
  
• know and consider how the doctor diagnoses and treats the disease in question
  
• know nursing interventions for the signs and symptoms of the medical disease the patient has
  
• know and consider the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
  
• ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. nursing like other disciplines treats the problem/signs and symptoms.
  

the nursing process is our tool to help us. it is how we solve problems, even problems outside of nursing. it is our rational thinking approach to solving situations. it consists of 5 steps. this is an example of how it works:

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

[casperx875x]

I'm curious as to what the situation was...

If I've never had an experience before or am not sure what else to do for the patient, I run to the experienced nurses and ask their opinion. Lucky for me, I have awesome coworkers, who would drop everything to help me.