Critical thinking

Critical thinking is something you will continue to develop even after graduating from nursing school. How far along are you in your program? You can use the nursing process to help you think through issues. Each school teaches this differently, but in general the steps include; assessing, diagnosing (nurse dx), planning, implementing, and evaluation. Nursing diagnosis handbooks can also help you think through these steps. Lastly, if you have a strong understanding of A&P and pathophysiology you will be better able to think through things, so brush up on those subjects if you need to.

I would recommend practicing critical thinking throughout your day--keep asking yourself why is that? Traffic is quite heavy today, why? Has there been an accident, construction ahead, is it a holiday weekend? And what, if anything can I do about it? Alternate route, turn up the radio, just go home and call out sick? Will I need to get gas?

Like wise this is how you can approach a patient problem. Ms. cholecystectomy complains of pain.Before you run for the narcotics, you need to do a lot more assessing. Where is the pain? What could be causing it? How long since last intervention, what does the patient want?

Or, a patient has a low bp. Why? Meds, shock, dehydrated, that's their normal? And what will you do about it? Call the MD, administer meds, get them something to drink, call a rapid response?

Sometimes you have to think through 2 or more problems, pt is in pain, and their bp is low, and they have a high fever, and their visitor would like a soda.

That is when you need to use nursing prioritization frameworks. ABCs, Mazlows, and my favorite, what is going to kill them first?

LaCharity "prioritization, delegation and assignment" has great examples and there is an entire pdf online for Hargrove - Huttle "prioritization, delegation and management of care"