Picture this: you’ve only been on the floor a few months. Today, your congestive heart failure patient is scheduled for pacemaker implantation first thing in the morning. The doctor orders two units of blood before transfer to the OR. You start the first bag with no problem…but after beginning the second bag, your patient’s O2 saturation drops from 95% to 90%. You decide to administer oxygen, but this only brings your patient’s O2 level back up to 91%.
Stop and think. What could be going on with your patient? You pull your patient’s chart to investigate further and notice his I&Os. It turns out that your patient has a positive fluid balance of 2 full liters. You also hear crackles while performing a respiratory assessment. Now what? What intervention is appropriate to raise his O2 level?
It takes critical thinking to determine what could be going on with your patient and what you should do about it. But many novice nurses aren’t skilled in critical thinking, and many flounder with the concept when they get on the floor.
Critical thinking skills are vital to keeping patients safe while maintaining an efficient nursing practice. In general, five components represent each aspect of critical thinking:
Your critical thinking skills begins to develop in nursing school, where you’re exposed to increasingly complex problems, case studies, and, eventually, real patients. But a nurses’ critical thinking ability isn’t fully formed until years after he or she enters clinical practice.
As a nurse advances from novice to expert, his or her critical thinking skills progress. Instead of only theoretical knowledge gained in school, real world experience enhances a nurse’s ability to predict and respond to the unique challenges of patient care. Experience is accrued over time, and each experience boosts a nurse’s proficiency in their chosen specialty. Eventually, critical thinking becomes second nature.
As a new nurse, you can develop your critical thinking abilities, even if you’ve struggled in the past.