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UNIT 1 How Nurses Think
c. Erin is caring for a young man who has had orthopedic surgery after a skiing accident. She is unable to hear his blood pressure when she attempts to take his vital signs. He is alert and able to converse with her. Because she is unable to hear the blood pressure, she records “0” in the client record. d. As you are walking down the hall on the hospital unit, you hear a patient call out, “Nurse!” When you enter the room, you notice that the bedside is crowded with equipment. The patient is receiving several fluids intravenously, and a unit of blood is hanging from the IV pole. Because you have limited clinical experience, you say to the patient, “I’ll get you some help.” 3. For each of the following concepts, use critical thinking to describe how or why it is important to nursing, or patient care. Note that these are not to be merely definitions. Caring Theoretical knowledge
Critical-thinking skills
Practical knowledge
Critical-thinking attitudes
Ethical knowledge
Clinical reasoning
Reflection
What Are the Main Points in This Chapter?
➤ Nursing involves thinking, doing, and caring, and all are equally important. ➤ Critical thinking is a combination of reasoned think- ing, openness to alternatives, an ability to reflect, and a desire to seek the truth. ➤ Critical thinking involves both attitudes and cognitive skills and is used in all aspects of nursing practice. ➤ Critical-thinking attitudes include intellectual auton- omy, intellectual curiosity, intellectual humility, intel- lectual empathy, intellectual courage, intellectual perseverance, fair-mindedness, intellectual integrity, and confidence in reasoning. ➤ Practical knowledge (knowing what to do and how to do it) and theoretical knowledge (knowing why) are equally important in nursing. ➤ Critical thinking and the nursing process are interre- lated but are not identical. ➤ Your ability to think critically depends on your theo- retical knowledge about critical thinking, your moti- vation to practice it, and your amount of nursing knowledge.
➤ Clinical reasoning requires the nurse to synthesize knowledge and information from various sources and incorporate experience to develop a plan of care for a particular patient or scenario. ➤ Clinical judgment is the decision or conclusion made by the nurse in response to the patient scenario requiring action. ➤ Clinical judgment requires the nurse to assess or rec- ognize evidence of the client’s problems, interpret the problems or what is happening, prioritize a response, implement an intervention or action, evaluate the out- come, and make modifications based on the outcomes presented and continual sequence of the process. ➤ The National Council of State Board of Nursing (NCSBN) Clinical Judgment Model (CJM) measures whether the tester taking the NCLEX has the degree of clinical judgment and decision-making abilities to be a safe practitioner. ➤ In full-spectrum nursing, the nurse applies think- ing, doing, and caring to the patient situation to help achieve positive patient outcomes.
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