Critical Thinking in Nursing

Thinking Ahead

The five critical thinking indicators that I am most comfortable with using when facing a situation requiring judgments are: self-aware, reflective and self-correction, honest and upright, open and fair-minded, and proactive. To avoid the results of an agreement or unwanted conclusion, a reasoned judgment should be reflected upon before acted on. It’s best to use specific indicators to help with problem solving. Indicators may assist with analyzing, acquiring, or altering the quality of thinking. When I think about critical thinking, I deliberate using self-discipline and reflection.

Self-awareness is an important indicator to me because it is the major component to personal growth. Having the confidence to know your strengths and weaknesses helps with challenges, achievements, and goals. It gives clarity knowing there is room for improvement and to be able to accept feedback/contributions from others to succeed. Reflective and self-correction is an indicator that I find myself using often. I feel it runs hand and hand with self-awareness. This particular trait shows that a person can reflect on a situation or problem, use specific feedback, correct it and have the potential to use what was learned and apply it to future mistakes or situations. Having this characteristic helps with having self-control when fixing a situation.

Honest and upright is a way of handling situations in an open-minded and accurate way. Standing up for what is right in a professional way is a form of respect in the work field. I stand for having integrity because it gives the traits of accountability and dedication. Being open and fair-minded but tolerant gives one the opportunity to be open to new suggestions and listen to others. This event shows great quality in teamwork when you’re willing to exchange information with others and apply it together. Lastly, Proactive allows flexibility, and the time to process for a better outcome. Being self- directed puts you in a situation to have full control and arrange to avoid the obstacles to come.

Case Study

The scenario I chose was the 72-year-old retired chiropractor who has a history of dementia, secondary fractured femur repair, and is refusing the care he needs. In this scenario I would stop to think about what I can do to help this patient. The first thing I feel that is important is using communication. I would be open-minded and view the situation from the patients’ point of view to see what I can do to gain my patients trust and reassurance. None of our communication should be forced or feel pushy for the patient, the process is to help understand why the patient is refusing and to try to co-operate with their decision.

Giving explanations, being repetitive, and building a relationship can make the patient feels secure and safe. Another approach I would try is to talk to the daughter. If the patient is only friendly or comfortable with his daughter, it may be best to communicate with her as well. In many situations’ dementia patients show comfort to the people close to them or whom they trust, remember, and feel safe with. His daughter can be able to explain why her dad feels the way he does, or she may be able to communicate with him to see if we can get the care he needs. If the patient still rejects help or refuses treatment it would be my job to accept the decision, no matter if I don’t agree.

Thinking Back

After reading this scenario and thinking it through, I found that I did not apply my indicators as I thought I would. Based on the indicators that I originally chose they all did not fit this specific scenario. While working through the scenario the only indicator that I used out of my 5 was being open and fair-minded. Having a patient refuse any type of treatment and not knowing why puts you in a situation that needs to be reevaluated before processing. I felt that it was best to go into the situation when an open mind so that I can observe the patient’s point of view. There could be a lack of valuable information or understanding. “What is most important from the medical point of view may not be most important from the patient’s point of view, because goals and values may differ.” (Right to Refuse Treatment) By knowing the patient’s point of view can help me as a nurse have respect for their decision or opinions if I am making sense of their reasoning.

Factors that supported my critical thinking were effective communication, curious and inquisitive, and being flexible. My main approach was to focus on communication. When using effective communication and being a good listener, it shows deep understanding of the patients’ circumstances and feelings on their care. By asking questions and gathering new information to broaden my knowledge on why the patient doesn’t want to be treated, practices my curious and inquisitive indicator. I also chose another route due to the patient having dementia; this inhibitor shows flexibility.

I figured if I changed my direction to communicate with the daughter it could possibly give me the best results. My focus was to find an approach that will help to assist the patient the best. The factors that impacted my ability to use critical thinking was the patient’s safety. “From ensuring patient safety to being able to detect changes in patient status, analytic skills turn average nurses into extraordinarily capable caretakers.” (Luna) When focusing on the patient’s status, it helps to anticipate the patients’ needs.

One improvement or approach I could have used is conducting a practical tip that could assist my patient to participate and engage. By doing so my patients’ participation may increase more and it enables me to make my task more effectively. I believe setting up a specific care plan for the patient could help reduce his frustration and help me focus more on his individual care. “If you don’t have a sincere desire to improve — to find ways to broaden your knowledge and skills and make current practices more efficient and effective — you’re not thinking critically.” ('Improve your critical thinking and reasoning skills'). I find critical thinking to be very essential in the nursing field.

References

1. Alzheimer's and dementia care: Tips for daily tasks. (2019, May 7). Retrieved March 14, 2020, from https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers-caregiver/art-20047577
2. Luna, A. (n.d.). Home. Retrieved March 13, 2020, from https://www.onwardhealthcare.com/nursing-resources/seven-reasons-critical-thinking-in-nursing-is-important/
3. Oncourse Learning. (2020, March 8). Improve your critical thinking and reasoning skills. Retrieved from https://resources.nurse.com/daisy-improve-critical-thinking-reasoning-skills
4. Right to Refuse Treatment. (n.d.). Retrieved March 12, 2020, from https://vtethicsnetwork.org/medical-ethics/right-to-refuse-treatment

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