Not so long ago, nurses were task-workers who simply carried out doctors’ orders and followed a fixed set of rules. Today, they are skilled and capable professionals whose expertise is essential to patient care and public health initiatives. It’s been a long road. And it’s clear that developing critical thinking skills has helped to bring about this transformation within the profession during the last half century.
So what exactly is critical thinking? There are a multitude of definitions – some of them very complex – so the Foundation for Critical Thinking (2010) has assembled some of them on its website. This one is our favorite:
Critical thinking is the ability to recognize problems and raise questions, gather evidence to support answers and solutions, evaluate alternative solutions, and communicate effectively with others to implement solutions for the best possible outcomes.
It’s not hard to apply this definition to nursing, is it? Nurses do all those things every day! It can be made even more specific to nursing by saying that critical thinking is a systematic approach to the nursing process that employs all the steps above to bring about excellent clinical outcomes while enhancing patient safety and patient satisfaction.
Critical thinking is definitely a skill that develops over time and as you gain more experience. But that doesn’t mean it’s absent in young or less experienced nurses. In fact, critical thinking skills are what make young nurses effective while they are gaining on-the-job experience. A less experienced nurse with keen critical thinking skills will be able to strategize and manage all sorts of new situations, while dealing effectively with everyone involved – the patient, family members, physicians, and other care team members.
When do you need critical thinking?
If you consider critical thinking to be multi-dimensional thinking, it becomes clearer when it’s most effectively employed. Multi-dimensional thinking means approaching a situation from more than one point of view. In contrast, one-dimensional thinking tackles the task at hand from a single frame of reference. It definitely has its place in nursing – one-dimensional thinking is used when nurses chart vital signs or administer a medication.
Critical thinking skills are needed when performing a nursing assessment or intervention, or acting as a patient advocate. As a patient’s status changes, you have to recognize, interpret, and integrate new information in order to plan a course of action. For example, what would the course of action be if an elderly patient became confused from his medications, was unable to understand instructions, and put himself at risk for falls? There may be no single “right” answer – you have to weigh all of the variables, prioritize goals, and temper next steps with empathy and compassion.
Critical thinking also involves viewing the patient as a whole person – and this means considering his own culture and goals, not just the goals of the healthcare organization. How would you handle a teenage girl who comes into your clinic asking for information about STDs? What about a seriously hypertensive patient who admits he can afford his medication, but doesn’t believe it is important that he take it every day without fail?
Critical thinking forms the foundation of certain nursing specialties, like case management and infection control. These areas require strategizing, collaborative relationships, and a multi-dimensional approach to tackling a problem (like preventing unnecessary hospital readmissions or discovering the source of an infection outbreak, for example). And of course, nurse managers use critical thinking skills every day as they keep their units running smoothly.
So what’s the next step?
To develop your critical thinking skills, you can:
- Suspend judgment; demonstrate open-mindedness and a tolerance for other cultures and other views.
- Seek out the truth by actively investigating a problem or situation.
- Ask questions and never be afraid to admit to a lack of knowledge.
- Reflect on your own thinking process and the ways you reach a conclusion.
- Indulge your own intellectual curiosity; be a lifelong learner.
- View your patients with empathy and from a whole-person perspective.
- Look for a mentor with more experience than you have; join professional organizations.
- Advance your nursing education.
The best way to develop your critical thinking skills and empower yourself with knowledge is through an online RN to BSN or RN to BSN/MSN degree. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in nursing education, nursing informatics, and executive leadership.
Written by Bruce Petrie, Ph.D., VP, Research and Institutional Effectiveness
Revised July 2017Tagged as nursing skills
The nursing profession tends to attract those who have natural nurturing abilities, a desire to help others and a knack for science or anatomy. But there is another important skill that successful nurses share and it’s often over-looked: the ability to think critically.
Identifying a problem, determining the best solution and choosing the most effective method are all parts of the critical thinking process. After executing the plan, critical thinkers reflect on the situation to figure out if it was effective and if it could have been done better. As you can see, critical thinking is a transferable skill that can be leveraged in several facets of your life.
But why is it so important for nurses to use? We spoke with several experts to learn why critical thinking skills in nursing are so crucial to the field, the patients and the success of a nurse. Keep reading to learn why and to see how you can improve this skill.
Why are critical thinking skills in nursing important?
You learn all sorts of practical skills in nursing school, like flawlessly dressing a wound, taking vitals like a pro or giving an IV without flinching. But without the ability to think clearly and make rational decisions, those skills alone won’t get you very far—you need to think critically as well.
“Nurses are faced with decision-making situations in patient care, and each decision they make impacts patient outcomes. Nursing critical thinking skills drive the decision-making process and impact the quality of care provided,” says Georgia Vest, DNP, RN and senior dean of nursing at Rasmussen College School of Nursing.
Critical thinking is embedded in a nurse’s everyday routine. They flex this mental muscle each day they enter the floor. When you’re faced with decisions that could ultimately mean life or death, the ability to analyze a situation and come to a solution separates the good nurses from the great ones.
How are critical-thinking skills acquired in nursing school?
Nursing school offers a multitude of material to master and high expectations for your performance. But in order to learn in a way that will actually equip you to become an excellent nurse, you have to go beyond just memorizing terms. You need to apply an analytical mindset to understanding course material.
One way for students to begin implementing critical thinking is by applying the nursing process to their line of thought, according to Vest. The process includes five steps: assessment, diagnosis, outcomes/planning, implementation and evaluation.
“One of the fundamental principles for developing critical thinking is the nursing process,” Vest says. “It needs to be a lived experience in the learning environment.”
Nursing students often find that there are multiple correct solutions to a problem. The key to nursing is to select the “the most correct” solution—one that will be the most efficient and best fit for that particular situation. You will often find yourself in situations where there are few “correct” forms of care, but one that is most appropriate. Using the nursing process, students can narrow down their options to select the best one.
When answering questions in class or on exams, challenge yourself to go beyond simply selecting an answer. Start to think about why that answer is correct and what the possible consequences might be. Simply memorizing the material won’t translate well into a real-life nursing setting.
How can you develop your critical thinking skills?
As you know, learning doesn’t stop with graduation from nursing school. Good nurses continue to soak up knowledge and continually improve throughout their careers. Likewise, they can continue to build their critical thinking skills in the workplace with each shift.
“To improve your critical thinking, pick the brains of the experienced nurses around you to help you get the mindset,” suggests Eileen Sollars, RN ADN, AAS. Understanding how a seasoned nurse came to a conclusion will provide you with insights you may not have considered and help you develop your own approach.
The chain of command can also help nurses develop critical thinking skills in the workplace.
“Another aid in the development of critical thinking I cannot stress enough is the utilization of the chain of command,” Vest says. “In the chain of command, the nurse always reports up to the nurse manager and down to the patient care aide. Peers and fellow healthcare professionals are not in the chain of command. Clear understanding and proper utilization of the chain of command is essential in the workplace.”
How are critical thinking skills applied in nursing?
“Nurses use critical thinking in every single shift,” Sollars says. “Critical thinking in nursing is a paramount skill necessary in the care of your patients. Nowadays there is more emphasis on machines and technical aspects of nursing, but critical thinking plays an important role. You need it to understand and anticipate changes in your patient's condition.”
As a nurse, you will inevitably encounter a situation in which there are multiple solutions or treatments and you’ll be tasked with determining the solution that will provide the best possible outcome for your patient. You must be able to quickly and confidently assess situations and make the best care decision in each unique scenario. It is in situations like these that your critical thinking skills will direct your decision making.
You’re now well aware of the importance of critical thinking skills in nursing. Even if you wouldn’t consider yourself a high-caliber critical thinker today, you can work toward strengthening that skill. The more you practice it, the better you will become and the more naturally it will come to you.
Critical thinking isn’t the only component that makes an effective nurse. Learn about how else you can position yourself to climb the ranks in your nursing career in our article, "Nursing Career Advancement: 7 Ways to Stand Out in Your Scrubs."
*This article was originally published in July 2012. It has since been updated to include information relevant to 2017.