“Knowing a great deal is not the same as being smart; intelligence is not information alone but also judgment, the manner in which information is collected and used.” – Carl Sagan

Critical Thinking

"In acute care hospitals and other health care delivery settings, complexity, change and unpredictability in the environment have left nurses with the increased uncertainty and a perception that critical information for decision making has been lacking.  With the Magnet hospital and other quality initiatives, nurses are coming to expect that they will participate in shared decision making among themselves and other health care providers .  Therefore participation in concert with others in decision making within the health care organization requires that nurses have expertise in critical thinking and problem solving, an expertise that use skills and knowledge, as well as creativity and intuition.  Just a

s intuition is part of expert clinical expertise, intuition plays an important role in developing managerial and leadership expertise" (Huber, 2009, p.93).

Let first start with defining critical thinking in nursing:

"an essential component of professional accountability and quality nursing care.  Critical thinkers in nursing exhibit these habits of the mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open mindedness, perseverance, and reflection.  Critical thinkers in nursing practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting and transforming knowledge" (Huber, 2009, p.94).

How do we start to develop excellence in critical thinking?

The nurse leader Should: 

• Encourage questions 
• Facilitate creative problem solving by having a "idea of the month" to promote innovation
• Use critical pathways to foster proactive approaches to management of clinical problems
• Use concept maps to develop critical thinking through the process of dialogue
• Establish Simulations that promote clinical reasoning 

To personally reflect on this concept, my nursing program has devoted a lot of time to understanding how important it is develop the skill of critical thinking in nursing.  With our patient population and the trend of "sicker and quicker" we as nurses need to be proactive with our clinical practice.  Our program is committed to developing this skill through the use of concept maps in clinical practice; having knowledge of critical pathways for critical care simulations; simulation scenarios built into almost every course; and encouraging us to approach our skills test outs with critical thinking skills instead of a robotic repetitive motion by providing scenarios where the focus is not on the actual skill itself but about taking care of a patient as whole.  This nursing program has encouraged me to have an open mind, to challenge the norm by asking questions, to accept alternative viewpoints, to reflect on present and past information and to anticipate what may happen.  

Reference
Huber, D. H. (2009).  Leadership and nursing care management. 4th edition.  Saunders, Elsevier Health Sciences. Maryland Heights, MO.