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Critical Thinking And Leadership In Nursing

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.

Beyond thinking

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.

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In recent years, critical thinking skills have been recognized as a necessary component of nursing education. There’s an obvious reason for this: health care today is a complex, high-tech environment, and bedside nurses have to make complex decisions in order to deliver safe, effective patient care.

But by far, the most effective way to expand critical thinking skills is through education.[/caption]

But there’s been a lot less discussion about the critical thinking skills needed by nurse managers, who also must function in a highly complex environment. Many nurse managers have risen to their current positions based on their competence in a clinical role, without any formal training or experience in leadership and management skills. They somehow have to learn to think critically about unfamiliar areas like finance, budgeting, staffing, strategic planning, and quality assurance. Without critical thinking skills, nurse managers can’t make day-to-day decisions strategically, with an eye toward advancing the goals of the organization.

Through critical thinking skills, a nurse manager can become a transformational leader. She or he can challenge assumptions, develop a more robust understanding of a problem’s underlying causes, and generate more creative solutions when using critical thinking. Without these skills, a manager may fall back on reactive, automatic responses to problems – and miss the opportunity to make changes that are visionary and goal-driven.

In 2010, a group of nurse researchers designed a study that would allow them to measure the effects of a manager’s critical thinking skills on the attitude of the floor nurses that person was managing. They concluded that nurse managers with stronger critical thinking skills were better able to create positive practice environments that correlated with higher job satisfaction and better retention of staff nurses. Nurses who work in a positive environment are thought to be less susceptible to the effects of burnout, putting them in a better position to deliver high-quality care and keep patients safe.

A Medscape article about critical thinking skills for nurse managers illustrated, with a hypothetical example, the difference a strong leader can make. It presented a case study about a manager facing a scheduling conflict over the holidays. In the past, staff nurses with seniority were given first choice of days off, leaving more junior nurses dissatisfied. The reactive way of thinking would be continue on with this same policy – without challenging current assumptions about seniority, fairness, and staff satisfaction. Yet a manager with critical thinking skills might look at alternatives that improve staff satisfaction and enhance the goal of self-governance – and then form a unit committee to produce a holiday schedule with sufficient staffing.

To further develop critical thinking skills outside of clinical areas, nurse managers can adopt the following habits:

  • Suspend judgment, and demonstrate open-mindedness for other departments and other views. This allows you to work as a team with other leaders, and to balance the goals and interests of various departments – which benefits the organization as a whole.
  • When confronted with a problem or situation, seek out the truth by actively investigating a problem or situation.
  • Ask questions about anything you may not fully understand and never be afraid to admit to a lack of knowledge. Gathering data in this way is crucial to making informed decisions, and to building a full understanding of both your organization and the current industry environment.
  • Reflect on your own thinking process and the ways in which you reach a conclusion. Identifying a personal bias is the first step toward eliminating it, allowing you to move toward more objective or multi-dimensional ways of thinking.
  • Look for a mentor with more experience than you have and join professional organizations, in order to gain experiential knowledge and build a network of colleagues whom you could turn to for advice when needed?

The Medscape article mentioned above also describes this innovative way to further develop critical thinking skills:

One way nurse managers can develop critical thinking is to start writing in a reflective journal. Establishing a consistent routine of writing at least weekly in a journal can improve critical thinking (Profetta-McGrath, 2005). Writing about critical incidents, complex situations that require decision making, as well as emotions and feelings about interactions and events stimulate analysis, synthesis, judgment, and creativity that are components of critical thinking. Through the process of writing, connections are made between theory and practice. Patterns of behaviors are recognized and a hypothesis may be formed that can lead to a change in practice (Profetta-McGrath, 2005).

But by far, the most effective way to expand critical thinking skills is through education. When you acquire a broader view of health care, from a systems and policy perspective, you equip yourself to make strategic decisions at the managerial or executive level. Highly effective nurse leaders know this, and have made education their ally.

American Sentinel’s online MSN, nursing management and organizational leadership specialization degree is designed for experienced nurse professional who seek to develop both management and leadership skills. Through case studies and hands-on course work, nurses examine the various human resource challenges facing an organization as well as the dynamic nature of the strategic planning and management processes.

Tagged as leadership, MSN