NURS 6001-7
Week 6
Discussion Post
Critical thinking is a crucial ingredient to becoming an excellent nurse. The Nurse Journal (2018) points out six key components in becoming seasoned at critical thinking. A nurse needs to be precise, complete, logical, accurate, clear and fair. To be proficient in these areas takes years of practice. We also must remember; in a nurse’s role, critical thinking could make the difference between life and death.
Patricia Benner’s theory (2011) states there are five levels of nursing. Everyone starts out as a novice and goes all the way to expert. With these different levels, the nurse becomes more skilled at critical thinking and eventually reaches the expert level. However, even at this level, expert nurses still learn so much from new nurses. I have heard nurses with more experience tell a less experienced nurse, “We have always done it this way.” The Nurse Journal (2018) states that these illogical processes should be avoided. Things are always changing and we have new technology that may change the way we practice. A newer nurse may have the latest knowledge that a more seasoned nurse has not heard of yet. So, the clinician has to be flexible and be open to change.
In preparing for this discussion post, I began remembering back through my nursing career. I remember my first day in the hospital as a new nurse. I was petrified. I remember being focused on checking my tasks off I needed to complete during the day. I was on a surgical floor and paid close attention to vital sign like any prudent nurse would do. I was very careful to use my “book training” to make sure I wasn’t missing anything, such as elevated temp for fever. I was careful to get all my surgical patients moving, because that’s what I learned in school. I did not want them getting pneumonia or a clot after surgery.
At some point, I am not sure when, these things just came second nature to me. I began focusing on how the patient looked. I just started going with my “gut” more and more. Not that I didn’t still pay close attention to vital signs and all the other things I did when I was a new nurse. It just changed over time. I began to be able to tell when something was off. I remember thinking about one of my patients, that person just doesn’t look right. Sometimes, I could not put my finger on it, but I always seemed to be able to tell if a patient was going south.
One of the last patients I cared for before I transferred to home health was a seventeen-year-old girl. She had been traveling home from a trip. She was in a car wreck and came up to surgical floor after surgery. She was just a few years younger than me and we instantly developed a friendship. She was on my floor for a week. I came in after being off for two days and knew something was not right. I verbalized my fears to the doctor that something was wrong. After being berated by him, I told my clinical supervisor what my fears were. She took the time to go over the patient’s chart with me to make sure we were not missing anything. When I came back the next day, they told me she had died in the night. After this, I learned to never doubt that feeling nurses get when something is off.
Home Health is an excellent setting to develop one’s critical thinking skills. I found the autonomy of home health nursing to be exhilarating. Granted, it could be frustrating at times, especially not being able to get in touch with a patient’s doctor or getting orders in a timely manner. I learned to use my critical thinking skills and rely on my own judgement. I would sometimes have to send patients to the emergency room due to not being able to reach the doctor. I sent one patient in and he ended up having an MI and was taken into surgery an hour after he was hospitalized.
Critical thinking is the ability to be able to stay calm in a situation that may be very chaotic and be able to read the signs and symptoms and figure out what is going on based on education and experience. Not every patient presents with the same symptoms. While the new nurse may not know that, once you have experienced a different set of circumstances, you use that in your daily practice to be more clinically competent.
A nurse’s journey for knowledge is never ending. All nurses should be looking for better, more efficient ways of doing things. Especially in this time of payment linked with quality. We should all strive for excellence and should ask ourselves are we performing the “right care, at the right place and the right time” (Patient-Centered Primary Care Collaborative, 2018).
References
Murphy, J.A., (2011.) A Place to Grow Students’ Critical Thinking Behaviors. Home Health Care
Management & Practice, 24(2), 67-72. doi: 10.1177/1084822311423809
Nurse Journal. (2018.) The Value of Critical Thinking in Nursing. Retrieved from
https://nursejournal.org/community/the-value-of-critical-thinking-in-nursing/
Patient-Centered Primary Care Collaborative. (2018). Right Care, Right Place, Right Time. Retrieved
from https://www.pcpcc.org/newsletter/week-review-right-care-right-place-right-time-0
