From my first day of CRNA school there were two phrases I heard constantly, being an “adult learner” and “critical thinking”. But for now I will speak on the latter. As a critical care nurse, I know you are quite familiar with this phrase as well since nurses must make connections and find solutions to problems.
During my time as student nurse anesthetist, I realized being a critical thinker was more important than ever. It was a vital concept which had to be mastered in order to provide safe anesthesia care. A lack of critical thinking at any moment could mean the difference between life and death in some surgical patients.
The nursing process which we learned in nursing school was likely our first introduction to the term critical thinking. I’m pretty sure you remember the nursing process. It is a scientific-problem solving model using the steps of assessment, diagnosis, outcome, identification, planning, implementation and evaluation.
Critical thinking in nursing has long been paired with the nursing process which assumes critical thinking to be linear, narrow and a straightforward process. However, this is far from the truth. As you know critical thinking involves so much more. It includes creative thinking, having an open mind, knowledge and can be overwhelming at times.
Given the complexity of patients today, ICU nurses must be skilled in recognizing changes in their patient’s condition. Therefore, this requires the nurse to be an efficient critical thinker.
So, what is critical thinking?
Critical thinking is the ability to think logically and rationally about a situation and then decide what to do next. It involves you making a decision to the best of your ability with the information you have available.
The process of critical thinking
Critical thinking is an ongoing process which you use subconsciously everyday in your role as a critical care nurse. In addition to using the nursing process, here is another perspective I found to help you to become a better critical thinker and it involves:
- Thinking Ahead: Which occurs when you anticipate what is to come or may happen. For instance, you anticipate supplies when you need to restart your patient’s IV.
- Thinking in Action: This involves you acting according to changes in your patient’s status. This may cause you to adjust your initial plans because this patient now requires you to act immediately.
- Thinking About Your Actions: It is always good to reflect and think back on how your shift unfolded just to see if you could have done something different or what you did worked. I do this a lot as a CRNA. For example, I now keep a nasal airway in the same spot on my anesthesia machine because I once had a patient who obstructed really bad after I extubated them.
I like this perspective because it is simple and can be used in addition to the nursing process. And it can be used in any nursing specialty. So, here are some easy ways to enhance your critical thinking.
How to enhance your critical thinking skills
- Address your personal unconscious biases- Unconscious or implicit bias is described as having an association or attitude that alters one’s perception and often goes unrecognized by that person. As a nurse, it’s hard to admit you might be biased towards a patient. Unfortunately, it happens but the best way to fix this problem is to first recognize it.
- Ask questions- specifically open ended questions. These types of questions allow you to better understand the respondents true feelings and attitudes. It allows you to paint a better picture of the situation which can then lead to finding a solution. Asking questions also helps you gain clarity and better understanding of the issue or problem.
- Be confident in your abilities- In order to increase your confidence as a critical care nurse going forward you need to increase your knowledge base. So if there is a disease process you don’t quite understand, look it up. Or ask the physician or surgeon. There is nothing wrong with doing this. There is nothing wrong with not knowing something but the problem comes in when you think you know everything.
- Learn from others- Whether you are a new nurse or seasoned critical care nurse, a mentoring relationship can make all the difference in your nursing career and even in your life. The great thing is every nurse has valuable insight which they can share. This will allow you to see things from a different vantage point and this will help you become a better critical thinker.
- Cast aside judgement- you should approach every patient and problem with an open mind. Being close minded is a dangerous way of thinking because you essentially ignore all other views, opinions or options.
- Active listening- This Is a critical communication skill which involves hearing as well as processing the information or words spoken. It requires you to pay attention to the patient free of internal or external distractions or interruptions.
Improving your critical thinking is one of the best things you can do for your present nursing career and future nurse anesthesia career. Like with anything, you will refine and enhance your critical thinking through everyday practice and reflection later. And of course this won’t happen overnight, but it can be done by being consistent and intentional.
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