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Autor: anton 13 April 2011
Words: 701 | Pages: 3
CRITICAL THINKING IN NURSING
Critical thinking is defined as a reasonable, reflective thinking that is focused on deciding what to believe or do (Baker 1996).. It is an attitude of inquiry that involves the use of facts, principles, theories, abstractions, deductions, interpretations, and evaluation of arguments (Matthews, Gual 1979). The National League of Nursing anticipated the need to move from the nursing process to critical thinking in 1983 when it emphasized that nursing graduates should be able to think critically. It also included critical thinking as a criterion for baccalaureate program accreditation.Due to current nursing shortages, cost containment and high expectations for quality nursing care, there is a urgent need for nurses to recognize and act upon organizational and system problems.
Critical thinking is essential for nurses working in perioperative care. It is a vital part of nursing care. The nurses scope of practiced has expanded therefore the demand for critical thinking, the ability to solve problems, and ability to make sound judgments has also increased. Some things included in critical thinking for my workplace include:
Ð’â€¢ identifying and solving patient care problems
Ð’â€¢ putting into operation surgery departments' missions
Ð’â€¢ directing and contributing to strategic planning
Ð’â€¢ creating an atmosphere that allows staff to make sound decisions by following their gut feelings
Ambulatory surgery care occurs in a decreased time frame, which means we must be able to perform tasks quickly and efficiently to ensure a positive patient outcome. Some skills required include ability to gather information from patients and family, make accurate judgments, use critical thinking skills and prioritize. Patients are to be considered as a whole, the goal of the care being provided, the best way to meet the goal, and how we can provide the most positive outcomes for patients.
There are many opportunities to demonstrate critical thinking in a SDS/PACU unit. For example, when a patient is pre-admitted there are certain procedures and tests that must be performed on the patient. All females of childbearing age require a pregnancy test 72 hours before the scheduled surgery date. By performing this simple test a woman who may be pregnant and not know may have the surgery canceled by the surgeon so that the fetus does not receive medication that could potentially harm the fetus.
In the PACU, we monitor our patients using a 3 lead heart rhythm, monitor blood pressure, pulse, heart rate and oxygen level every five minutes. If a person's pulse suddenly becomes elevated and their blood pressure drops, it is our job to know that this may be a sign of bleeding which can lead to shock. Therefore, this patient may need to return to the operating room to stop the bleeding or it could mean the patient needs an increase of fluids. It is our job to notify the physician in a timely matter so that these life-threatening signs do not become fatal. These examples illustrate critical thinking a nurse may use to identify potential problems and decide appropriate actions.
Critical thinking can be best described as that higher order of reasoning used in reaching professionally informed judgments in high stakes, time restrained, and novel-problem situations (Facione 1996). Since nurses are accountable on a daily basis for the quality of care provided to the patients, we must interpret data, explore possible avenues for the solution, propose alternative solutions to a problem, and then make a clear concise decision that is best for the patient. Poor thinking can be fatal to our patients therefore, it is important for our nurses to become skilled in a higher level of thinking and reasoning abilities in order to practice sound clinical judgment.
Baker, C. R. Reflective learning: A teaching strategy for critical thinking,(1996) Journal of Nursing Education 35 19-22.
Facione, N.C, Facione P.A Assessment design issues for evaluating critical thinking in nursing.(1996) Holistic Nursing Practice v10 n3 41(13)
Fawcett,D.L. The Ambulatory Surgery Unit as a Learning Experience.(1999) Association of Operating Room Nurses Journal v70 i5 782
International Nursing Index, sv nursing process (1980). New York: American Journal of Nursing.
Matthews, C.A., Gual, A.L. Nursing diagnosis from the prospective of concept attainment and critical thinking, (1979)Advances in Nursing Science 2 17-26.
Tanner, C.A. Critical thinking: Beyond nursing process. Journal of Nursing Education (2000). 39(8):338-9.