Please help

blue eyes · Apr 25, 2004

Hello, I'm a 1st yr nursing student writing an essay on critical thinking & analysis and need to discuss why is this competency is important in clinical decision making then describe what model/s are commonly utilised in practice. I've been using Contexts of Nursing by John Daly, Sandra Speed, Debra Jackson, the National competency standards for the Registered Nurse, Decision Making In Nursing:Tools for change by Bailey and Claus plus a variety of Web sites.

But for the life of me I cannot find a thing (examples) on where a nurse would use/apply the critical thinking and analysis (competency unit 5 and 6) in 'everyday situations'.

Chaya, ASN, RN · Apr 25, 2004

Hi I don't know if this fits the textbook definitions but this fits with what I learned as critical thinking a few years back:

a nurse doing fingersticks before dinner had a patient on a sliding scale. The patient did not require any regular insulin coverage but had a scheduled dose for 20 units NPH insulin. On questioning the patient the nurse found she was nauseated, had just vomited a small amount, and felt she would be unable to eat any dinner. The nurse discussed these findings with the doctor and obtained an order to reduce the NPH insulin dose by half, repeat blood sugar by fingerstick at hs, and ensure the pt had an hs snack. The patient's blood sugar was 102 at hs and she was able to hold down a snack of milk and crackers.

Chaya, ASN, RN · Apr 25, 2004

Hi I don't know if this fits the textbook definitions but this fits with what I learned as critical thinking a few years back:

a nurse doing fingersticks before dinner had a patient on a sliding scale. The patient did not require any regular insulin coverage but had a scheduled dose for 20 units NPH insulin. On questioning the patient the nurse found she was nauseated, had just vomited a small amount, and felt she would be unable to eat any dinner. The nurse discussed these findings with the doctor and obtained an order to reduce the NPH insulin dose by half, repeat blood sugar by fingerstick at hs, and ensure the pt had an hs snack. The patient's blood sugar was 102 at hs and she was able to hold down a snack of milk and crackers.

gwenith, BSN, RN · Apr 25, 2004

Try googling "bloom's taxonomy" That shows you the levels of cognitive functioning usually related to testing for exams but it can easily be translated across to skills in nursing.

Under the taxonomy (from memory) it goes lowest to highest recall, comprehension, analysis, synthesis and evaluation. In our everyday working environment we have to assess, analyse, synthesise (bring the data together into new patterns) and finally evaluate outcomes - isn't that critical thinking - now compare that process to the nursing process.

gwenith, BSN, RN · Apr 25, 2004

Try googling "bloom's taxonomy" That shows you the levels of cognitive functioning usually related to testing for exams but it can easily be translated across to skills in nursing.

Under the taxonomy (from memory) it goes lowest to highest recall, comprehension, analysis, synthesis and evaluation. In our everyday working environment we have to assess, analyse, synthesise (bring the data together into new patterns) and finally evaluate outcomes - isn't that critical thinking - now compare that process to the nursing process.