Define critical thinking.

[eriksoln]

OK, another post got me thinking about critical thinking (I sound like a late night talk show host now). Anyway, how do you define it? Have any good examples of things you've done that displays it?

Its such a buzz word nurses use and I cant wrap my mind around it. Every time someone tries to explain it, I just cant help but think........"Thats just doing your job, its not some special form of thinking."

Good example.......someone posted about a new nurse who gave a BP med to someone with an already low BP. The new nurse didnt check the pt's BP before giving it. Then finished the post with something to the effect of "This is task oriented nursing at it worst" or something of that nature.

Now, I look at that, and.......considering myself a task oriented person (why is that considered bad?, isnt the point to get the work done?)......think......."No way, a task oriented person would not skip the task of checking the BP, that was a case of laziness."

Anyone have a description of critical thinking that works. I know a lot of people simply call it common sense. Is that all it really is?

[kayty2339]

Did any of you experienced nurses question your ability to "think critically" when you were in school? This thread has been very interesting, but it's also kind of overwhelming for me. I'm working on my pre-req's right now and plan on getting in the program within the next year. I guess you don't know what your made of until you're actually faced with the situation.

[ghillbert, MSN, NP]

Absolutely. I think most every nurse starts work thinking they know nothing!

A friend of mine did very interesting PhD research about how experienced ICU nurses make their decisions on care in postop cardiothoracic patients. She clearly found that experience has a huge impact on what you do when faced with certain assessment data (and when you get that "something is wrong" feeling). The ongoing focus of her study is to work out how to translate that "knowing" what to do into teaching for new critical care nurses.

To me, the main component to building it is asking why you are doing what you are doing. If there are certain tests ordered, figure out how they relate to the patient's disease state. If you call a doc for orders and they ask certain questions, think about why they want to know those specific things (which may seem only slightly related on first look). Learn from your mistakes and don't repeat them.

[eriksoln, BSN, RN]

Thank you so much Leslie! I have a real problem with nurses who are task-oriented. I thought nursing had evolved beyond that?

The problem is that critical thinking is not buzz word. It is the ability to problem solve, work outside of the box, anticipate problems and formulate different plans of action for dealing with problems. This is a skill all nurses should have and unfortunately there are too many who are "task-oriented".

I work with a LPN who is task oriented. If you give her an assignment, tell her how to do it and give her definite parameters to work with and she will knock it out of the park. Anything that requires her how to figure it out on her own and she is lost. I have to support her a lot and I resent it. We as nurses are supposed to be better than that.

Task-oriented is what causes nurses to focus on completing the physician orders only and never think to assess the patient's teaching and other needs. Task oriented is what leads to preventable complications because the nurse didn't think to teach the patient how to use the IS, cough and deep breathe, ambulate ASAP after surgery and on and on because if the doctor didn't write it, they're not going to do it. Can you tell this is a pet peeve of mine?

I think it has become a buzz word. I think that because, everyone has heard the word (oh my, heard the word, is this a song or something?) but very few can give a concrete, simple explination of what it means.

Thats part of the reason I started this thread. I didnt have a clear, definate picture/definition for "critical thinking". On the other hand, I didnt use the term either. But, you get my meaning. Its used all the time........I wonder if all these people using the word really mean the same thing about it.

I still dont have a definition that I feel comfortable to use the word. I'm getting there tough. Problem is, when I see it, I can point and say "Thats what critical thinking is supposed to mean." But I cant..........write a definition of the word. I can say this too..........I have seen the term abused....badly. There are people who throw the term out like they are masters of the skill and..........eh..........I have my doubts.

Thats why I think its a buzz word...........overused by a lot of people with no clear picture of what they are saying when they use the term.

[leslie :-D]

Thats why I think its a buzz word...........overused by a lot of people with no clear picture of what they are saying when they use the term.

then why is it that those who hear the words "critical thinking", immediately understand?

i for one, 'got it' w/o any ambiguity or gray areas.

the implications of our actions, of lack of, were powerful and frightening, almost from the get go.

there is nothing mindless about nursing.

and ea function/action holds its own set of significant and often critical, outcomes.

leslie

[eriksoln, BSN, RN]

then why is it that those who hear the words "critical thinking", immediately understand?

i for one, 'got it' w/o any ambiguity or gray areas.

the implications of our actions, of lack of, were powerful and frightening, almost from the get go.

there is nothing mindless about nursing.

and ea function/action holds its own set of significant and often critical, outcomes.

leslie

Oh, my arguement is not that nursing does not use critical thinking. Not at all.

I just think there truly isnt a concrete difinition for the term. Its used in so many cases where it obviously doesnt apply.

[leslie :-D]

here ya go...

although somewhat long, all definitions of "critical thinking" were extremely wordy.

critical thinking: to think like a nurse

http://www.criticalthinking.org/resources/he/ctandnursing.cfm

leslie

[eriksoln, BSN, RN]

Ah, now I liked that.

[ToxicShock]

one bp reading and subsequent hold on med, is too early to start questioning.

if the next bp is still low, then i'd start the detective work.:)

but of course, i'd still be monitoring pt inbetween scheduled med times.

leslie

I really like this about "detective work". That really helps me get a better understanding of what critical thinking is all about.

I agree with the OP that it can be difficult to put a concrete definition to. I think it's one of those words that a lot of people know the meaning, but have trouble explaining/defining it in one sentence (like a dictionary would). For example, we all know how to use the word "the", but I wonder how many of us would be able to give a simple, textbook definition of the word.

I've always read that critical thinking is to "think critically", which doesn't seem to help at all since they are using the word to define the word! But if I were to define it, I would say that to have critical thinking skills would be to analyze any give situation, and think of all possible outcomes. The who, what, when, where, why, and how of a situation. "Thinking outside the box" would be a good catchphrase to help define it.

I think a good example of critical thinking would be making a differential diagnosis, which is what they do on the TV show House (for those that don't watch - check it out!).

[eriksoln, BSN, RN]

This reminds me of an exercise where we had to define Zen.

Zen, as I remember, is the skill to take one's experiences and somehow apply them to a situation today, even though said situation is not anything like what we are experienced in.

If that makes any sense.

Maybe Zen and Critical Thinking are very alike.

[jjjoy, LPN]

For me, much of the confusion about what "critical thinking" meant in a nursing context was NCLEX-style test questions and the instructors (some, not all!) who would conclude "you didn't use your critical thinking skills" if you asked for clarification or challenged a test question, even if you displayed that you HAD tried to consider the big picture, HAD considered the rationales and ramifications, etc.

Those instructors (not all!) seemed to imply that IF you used "your critical thinking skills" that everything would fall into place and you'd see the situation the way that they did. Thus, if you had any question or came to a different conclusion that you must not have been thinking critically.

But you CAN think critically and still come to a different conclusion than someone else. Maybe one of you doesn't have enough information or experience, which is likely the case for nursing students, but that's then an issue of information and experience and NOT critical thinking.

And when I came across NCLEX-style test questions that seemed poorly written or unncessarily tricky, and they were often justified as testing "critical thinking" - to which I reply that it may test your ability to think critically about the test questions (eg what is this question *really* asking? is that piece of information just a distraction?) but weren't about testing one's *nursing knowledge* or applying critical thinking to nursing situations.

[sistasoul]

I know this is an old thread but when you are working like a maniac with no lunch or breaks day after day and still get out late this is a recipe for disaster for the nurse. There is so little time to think about things and this is my biggest complaint about nursing. I feel it is unsafe for the patient in this environment and it seems to be the norm on my unit.

[illusion5, ASN]

You asked for a definition so here you go:

Critical thinking is that mode of thinking - about any subject, content, or

problem - in which the thinker improves the quality of his or her thinking

by skillfully taking charge of the structures inherent in thinking and

imposing intellectual standards upon them.