NURSING PROCESS  Nurses deals with the change in

stressful environment – condition

 Critical Thinking may rapidly change and routine
- process of intentional higher protocol may not be adequate to
level of thinking to define a cover every situation
client’s problem, examine  Nurse make important decisions –
evidence-based practice, and nurses use critical thinking and
make choices in the delivery clinical reasoning to make
of care judgements about client’s care
 Clinical Reasoning
- cognitive process that uses CREATIVITY
thinking strategies to gather
and analyze client - Thinking that results in the
information, evaluate the development of new ideas and
relevance, and decide on products
possible nursing action to - Ability to develop and implement
improve the client’s new and better solution for health
physiological and care outcomes
psychosocial outcomes - Required when the nurse
encounters a new situation which
 10 affective components traditional interventions are not
- Confidence effective
- Contextual perspective TECHNIQUES IN CRITICAL THINKING (3)
- Creativity
- Inquisitiveness  Critical analysis
- Intellectual integrity - The application of a set of
- Intuition questions to a particular
- Open-mindedness situation or idea to determine
- Perseverance essential information and
- Reflection ideas and discard
 7 skills unimportant information and
- Analyzing ideas
- Applying standard  Inductive reasoning
- Discriminating - Moves from specific
- Information seeking examples to a generalized
- Logical reasoning conclusion
- Predicting  Deductive reasoning
- Transforming knowledge - Moves from general to the
specific conclusion
PURPOSE OF CRITICAL THINKING
APPLYING CRITICAL THINKING TO
 Nurses use knowledge from other
NURSE PRACTICE
subjects and fields – reflect on
knowledge derived from other  Nurse process
disciplinary subject areas
 - Creative approach to thinking TYPES OF STATEMENT (4)
and doing to obtain,
categorize, and analyze  Facts – verified through
client data and plan action investigation
- Systematic, rational method  Inference – conclusions drawn from
of planning and providing facts
individual nursing care  Judgments – evaluation of facts
and information
PHASES OF NURSING PROCESS  Opinions – belief formed over time
and may fit facts or be erroneous
 Assessing
 Diagnosing ATTITUDE THAT FOSTER CRITICAL
 Planning THINKING (9)
 Implementing’
 Independence
 Evaluating
- Critical thinkers consider
PROBLEM SOLVING seriously a wide range of
ideas, learn from them, and
- Mental activity in which a problem is then make their own
identified that represents an judgements about them
unsteady state  Fair-mindedness
- Obtain information that clarifies the - Assess all viewpoints with
nature of the problem and suggest the same standards and do
possible solutions not base their judgements on
personal bias or prejudice
 Trial and Error  Insight to Egocentricity
- Number of approaches are - Are open to possibility that
tried until a solution is found their personal biases or
- Can be dangerous because social pressures and
the client might suffer harm customs could unduly affect
 Intuition their thinking
- Problem solving approach  Intellectual Humility
that relies on a nurse’s inner - Willing to admit what they do
sense not know
 Clinical Judgement - Willing to seek new
- Decision-making process to information and to rethink
ascertain the right nursing their conclusion in light of
action to be implemented at new knowledge
the appropriate time  Intellectual Courage to Challenge
the Status Quo and Rituals
RESEARCH PROCESS - Consider and examine fairly
his or her own ideas or
- Formalized, logical,
views, especially those to
systematic approach to
which the nurse may have a
problem solving
strongly negative reaction
  Integrity
- Requires that individuals
apply the same rigorous
standards of proof as they
apply to the knowledge and
belief of others
 Perseverance
- Show perseverance in
finding effective solutions to
client and nursing problems
 Confidence
- Well-reasoned thinking will
lead to trustworthy
conclusions
- They cultivate an attitude of
confidence in the reasoning
process
 Curiosity
- The mind of critical thinker is
filled with questions
COMPONENTS OF CLINICAL
REASONING (2)
 Cognitive Processes
- Based on the knowledge of
aspect of client care
- Learned through reading
and applying health-related
literature
 Metacognitive Processes
- Reflective thinking and
awareness of the skills
learned by the nurse in
caring for the client
- Reflects on the clients status,
and through the use of
critical thinking skills
determine the most effective
plan of care
CLINICAL REASONING (6)
- Ability to reason about a clinical
situation as it unfolds
 Setting Priorities
o Nurse have to think quickly
to resolve problems
o Needs to be dynamic or
flexible because the clinical
environment can change
quickly, requiring changes in
priorities
 Developing Rationales
o The nurse transfers nursing
knowledge to the clinical
situation to justify the plan of
care
 Learn How to Act
o Must know how and when to
respond in a clinical situation
by recognizing what is most
urgent or significant
 Clinical Reasoning-in-Transition
o Ability to recognize subtle
changes in a client’s
condition over time’
o Develop a sense of what is
most important in each
changing clinical situation
and remember that the
primary focus is on the
client’s well-being
 Responding to Changes in the
Client’s Condition
o Detect changes in the
client’s condition recognize a
change in priorities, adjust
nursing care, and alert the
primary care provider
 Reflection
o Key to the success of clinical
reasoning
o Identifies factors that
improved client care and
that required changing or
elimination
 o Thinks back on the
intervention implemented
and whether they were
effective

CONCEPT MAPPING (MIND MAPPING)

- Technique that uses a graphic

depiction of nonlinear and linear
relationship to represent critical
thinking
- Context dependent and can be used
to develop analytical skills
- Provide an opportunity to visualize
things in your own way
- Quicker than note taking and
highlight key ideas

TYPES OF CONCEPT MAPS

 Hierarchical map
- Arranged in a hierarchical
pattern and typically
constructed in a descending
order of importance
 Spider maps
- Interrelatedness of the
concept and its attributes in
the map
 Flowchart maps
- Linear diagrams
demonstrating sequence or
cause-and-effect relations
 System maps
- Inputs and outputs illustrate
relationships among the
concept and its attributes