Chapter 6Clinical Reasoning, Decisionmaking, and Action: Patricia Benner;1 Ronda G.
Other Databases lists stand-alone databases that include materials relevant to nursing education and career development. The nursing process has been important to nursing practice for a long time. The nursing process has been used as a problem-solving activity to think about a plan of care as the foundation for professional practice in everyday nursing practice.
The nursing process may describe a nursing care plan that provides students with a learning experience that helps them practice critical thinking and decision making skills.
The nursing process is seen as a decision making approach that promotes critical thinking in nursing. This process consists of five phases namely: This resulted in a definition of critical thinking "as the process of purposeful, self-regulatory judgment; an interactive, reflective, reasoning process" Facione The Delphi report described the ideal critical thinker as one who is habitually inquisitive, well-informed, trustful of reason, open-minded, flexible, fair-minded in evaluation, honest in facing personal biases, prudent in making judgments, willing to reconsider, clear about issues, orderly in complex matters, diligent in seeking relevant information, reasonable in the selection of criteria, focused in inquiry, and persistent in seeking results which are as precise as the subject and the circumstances of inquiry permit.
Critical Thinking in the Profession of Nursing The Delphi definitions are consistent with and supportive of KataokaYahiro and Saylor's definition of critical thinking in nursing as "the critical thinking process is reflective and reasonable thinking about nursing problems without a single solution and is focused on deciding what to believe and do".
This definition broadens the concept of critical thinking in nursing to include reflection of thoughts and recognition that there can be various solutions to problems. The nursing process is a scientific-problem solving model using the steps of assessment, nursing diagnosis or problem identification, planning, implementation, and evaluation in a step-by-step process to plan care for patients.
Critical thinking in nursing has long been equated with the nursing process which confines critical thinking to a very linear, narrow, single right solution, problem-solving process.
Critical thinking includes creative thinking, open-mindedness, inquisitiveness, and is not bounded by predefined standards and objectives.
Critical thinking does include knowledge, skills, and attitudes, and it definitely incorporates the important component of the nursing process and problem-solving approach, but it goes beyond to higher-order thinking and is not a synonymous term with "nursing process. Nurses are challenged to "think on their feet" in the multiple, complex, fast-moving environments of today's nursing practice.
The literature repeatedly stresses that nurse must be able to think critically in order to process complex data and make sound clinical judgments in the planning, managing and evaluating of the health care of their patients Raines According to Facione and Facionenursing practice demands fair-mindedness to new evidence and a willingness to reconsider clinical judgments.
It values a focused and diligent approach to ill-structured patient problems, and requires tolerance of multiple perspectives and interpretations when such perspective and interpretations can be supported by reasons and evidence. While the nursing process demands linear thinking to problem solve, critical thinking abilities compel nu ses to challenge assumptions, question the context, look for new ways of doing and thinking, and consider, sift, and evaluate ideas or solutions for their worth and practicality Bumard These abilities are essential for making sound clinical judgments in order to provide safe, effective care to patients.
Kataoka-Yahiro and Saylor feel that to make good nursing judgments, critical thinking must be used. They have identified five components of critical thinking: Component number 3, critical thinking competencies, is divided into three cognitive types: General critical thinking competencies are not unique to nursing but include scientific process, hypothesis generation, problem solving, and decision making.
The specific critical thinking competencies in clinical situations, including diagnostic reasoning, clinical inferences, and clinical decision making, are used in nursing and other clinical disciplines. Finally, the specific critical thinking competency in nursing is the nursing process but it is only one of the competencies and not all-encompassing.
The attitude component is considered a central aspect of a critical thinker and includes confidence, independence, integrity, risk taking, creativity, and fairness.
The fifth component, standards, includes universal intellectual standards such as clarity, specificity, accuracy, relevancy, and significance as well as professional standards such as ethical criteria for nursing judgments and criteria for evaluation and professional responsibility.
The authors also feel there are levels of critical thinking in nursing and have identified them as basic, complex, and commitment. The basic level is an early step and looks for right or wrong or one right answer to complex problems.
Realizing that there are alternative solutions moves the nurse to the complex level, and choosing an action or belief based on an alternative puts the nurse at the highest level of commitment.
Education needs to provide a learning environment that is conducive to critical thinking, giving the students opportunity for flexibility, creativity, support for change, and risk taking. When looking for examples of critical thinking, descriptions of nursing process were found.Aug 21, · Critical thinking is an essential process for the safe, efficient and skillful nursing practice.
The nursing education programs should adopt attitudes that promote critical thinking and mobilize the skills of critical reasoning. 1 CRITICAL THINKING AND NURSING PROCESS "Study without reflection is a waste of time; reflection without study is dangerous."-- Confucius Critical Thinking.
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.
In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care (Heaslip).
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The nursing process is seen as a decision making approach that promotes critical thinking in nursing. This process consists of five phases namely: assessment, diagnosis, planning, implementation and .