Survey on Critical Thinking

Nurses Safety

Published

Hi AllNurses.com Friends,

Much is said and written about the importance of critical thinking and how it affects the quality of patient care.

Everyone has an opinion:

The National Patient Safety Foundation (NPSF) Discussion Forum:

Jo Ann Klein, MS, RN's commentary on "Critical Thinking in Nursing": "What is critical thinking in nursing? Ask a dozen nurses, and you'll get a dozen different answers. Primarily, critical thinking is a method of problem solving requiring reflective thinking. It is built on an individual's ideals and value system, and is purposeful and goal-directed with the intention of making decisions."

Academic medical center nursing director:

We have a tool to evaluate critical thinking in our new hires.

Competency training participant:

It's just common sense - doesn't everyone do that?

But . . . . in the last 12 months, two almost-identical tragic events occurred in the same ICU area . . . in both cases, 4-5 doctors and nurses made flawed assumptions (e.g., ok to ignore alarming equipment because it must be broken).

Sure, everyone knows that theory and reality are worlds apart. Okay - but surely there's a solution? Or, at least a workaround?

So, what do YOU think? I can use help! Thank you!

Specializes in ICU.

I think the phrase "critical thinking" is too simplistic a term for a complex process of problem solving.

Holding one method of analysis up as the only way of reaching a solution is perhaps, once more tryig to pour everyone into the same mould. Some people are natual at deductive reasoning - some are more lateral. When I was designing curriculums it became obvious that many of my colleages were "top down " thinkers whereas I was a "bottom up" thinker neither of us were wrong but between us we came out with a stronger more coherent curriculum than if we had both thought the same way.

To quote your own advertisement

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Characteristics of critical thinking include the ability to reason, deduce, and induce based upon current research and practice findings. Additional characteristics include being insightful and curious and proactive so that decisions are spontaneous as indicated and reflective for purposes of learning from experience.

The critical thinker is also organized, assesses systematically and purposefully, and draws valid conclusions based upon presented evidence.

Skills that are required in critical thinking include the ability to set priorities by weighing risks and benefits, identification of appropriate interventions, decision-making, and exceptional communication skills. Are you a critical thinker?

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By the sounds of this anyone meeting these standards should place a big S in the centre of thier chests and apply for a position defending Metropolis.

Perhaps I am being too harsh here but I have seen so many texts purporting to offer "the way" and they are thinly disguised exhortations about how we are not meeting the impossible standard of never making a mistake or missing a point.

The texts you are offering for sale probably do have merit but forgive me if I do not see them as the answer to our current problems.

Dear Gwenith,

Thank you for your spirited reply!

Just to clarify: My message includes two quotations.

1. From the NPSF Discussion Forum

2. From JoAnn Klein's article

My comments are not an "advertisement." And, I am not offering "texts for sale."

I apologize for any confusion I created.

Specializes in ICU.

Apologies but when I first read through it did read like an advertisement.

I still stand by my opinions though - In teh real world decision making capabilities are less goverened by inherent or learnt ability than the distrations and confused clinical pictures seen within the hospital setting. These discussions are good for the acedemic exploration of our profession but translating them to the workplace is like showing an episode of the Brady Bunch to an actual blended family.

I have an ongooing concern about the number of academics who write articles and books that in essence say "if only you did it this way all your troubles will be solved" There is no universal panacea for the troubles besetting our profession.

Can we problem solve better - yes! In all probability we can but people have to be motivated to change thier approach to knowledge and that has more to do with the culture of the workplace than an individual. Problem solving will occur where that is encouraged but it will never occur in a culture of bullying back-biting and derision where every decision is second guessed, and it becomes a crime to admit to reading anythign but the lastest "trash" magazine.

Dear Gwenith,

So culture emerges as the primary problem . . .

In my experience, cultural changes are painfully slow. Nevertheless, it's essential to start the wheels of progress.

Change is more easily implemented when:

1. Everyone participates

2. The change(s) that is/are planned will benefit those affected (e.g., make their work easier, faster, more interesting, better results, less expensive, etc.)

3. Changes are implemented slowly

But, enough of my thoughts. What about you? Any strategies?

Thank you!

Well, to answer my own question and raise a few more questions . . .

Today's NY Times (June 7, 2003) has an interesting article, "NASA's Failings Go Far Beyond Foam Hitting Shuttle, Panel Says."

A few key phrases.

"NASA's problems go far beyond falling foam, according to an early outline of the report by the independent panel investigating the accident that doomed the shuttle Columbia and its crew.

The failings include an institutional culture that plays down problems, as well as constraints from Washington that may have reduced the ability to reach space safely.

The outline portrays the fatal Columbia mission as the tip of an iceberg of problems that include communications breakdowns and an increasingly complacent attitude toward warning signs. Budget pressures and administrative shuffles add to the pressure on the National Aeronautics and Space Administration, the report suggests, and may have contributed to the troubles."

Based on this article, I guess "institutional culture," "communication breakdowns," and "complacent attitude" are contributing factors.

Hmmm.

Thoughts?

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