NCLEX,  Nurse,  Nursing education,  Nursing Profession,  Nursing School

All shift long nurses use critical thinking skills

Every day, all shift long, nurses are using critical thinking skills in their job no matter where they work. The stronger those skills are, the higher the quality of care they provide to their patients. Even from the start of the shift and prioritizing the tasks at hand, the ability to problem-solve and make decisions on the fly are critical to each of the nurse’s assigned patients and to those s/he will interact with for other nurses throughout the shift.

As nurses know, everything can turn on a dime without warning. Some things are never anticipated such as falls and codes and other incidents especially to patients who don’t fit the pattern. Responding to the change, reorganizing, re-prioritizing, and delegating all require sound critical thinking skills. Nurses who have weak and almost non-existent critical thinking skills will continue to struggle and their level of patient care will suffer.

Testing format helps enhance critical thinking skills

Many have been critical of the way the NCLEX has evolved with the use of questions which have more than one appropriate answer, but only one is most correct. Nursing schools have adapted the same format of testing to improve and enhance student’s critical thinking skills and problem-solving abilities. This in turn will help prepare them for passing the NCLEX and to be better nurses. For many who are entering the nursing profession, problem solving, and critical thinking does come naturally. For others, the struggle is real, but with time and practice, most will have the lightbulb burn brightly by the time they graduate and pass the licensing exam.

Critical thinking skills in action

From the time your shift begins decisions need to be made to organize your day. These include which patients to attend to first, what tasks take priority, and which can be done later, and which medications need to be passed and what time. Factors to consider are what you learned in report from the previous shift, any new orders that have just come in, new admissions to be added, what you assess as you make rounds and who’s call lights are ringing. It is always advisable to pad your proposed schedule’s time frames to allow for the unexpected. Know what things you must do at specific times and schedule them. Build around this. Anticipate changes and problems especially for the sicker patients and consider what you can do to avoid complications as well as plan for the inevitable changes. Assess the strengths and weakness of those team members to whom you might easily delegate to and those you cannot. Armed with this knowledge, you’ll have a great start to your shift.

One thing that will help improve your critical thinking skills is to have an inquisitive mind. Encourage this and approach situations with what if scenarios. Be curious. Ask questions, collect information, and evaluate the answers.

Use the Nursing Process

Use the nursing process to guide your critical thinking process. Always remember to include all five steps: Assessment, Diagnosis (nursing), Plan, Implementation, and Evaluation. In the real world, you will not be writing a full-fledged care plan, but you should be able to use the process mentally to quickly problem-solve and make decisions that will benefit your patient. Remember never make assumptions for your patient. Assess and record your observations. Understand that a patient’s belief systems and values my differ from yours. Learn to acknowledge your personal biases and leave them at home. Make decisions based on evidence and knowledge. Consult with your team and build your self-confidence.

Evaluate and learn from your experiences

Self-reflection will allow you an opportunity to learn from the experience. Was it successful? What worked? Could it have been better? What failed or didn’t work well? What have you learned that will help you improve your patient care? Practice will always make you better. Critical thinking is a self-driven process. It’s not something that can be taught. It is cultivated and improved through experience and understanding successes and failures.

Strong critical thinking skills lead to improved patient outcomes and job satisfaction.

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Papathanasiou IV, Kleisiaris CF, Fradelos EC, Kakou K, Kourkouta L. Critical thinking: the development of an essential skill for nursing students. Acta Inform Med. 2014 Aug;22(4):283-6. doi: 10.5455/aim.2014.22.283-286. Epub 2014 Aug 21. PMID: 25395733; PMCID: PMC4216424.