CRITICAL THINKING

THE ART OF THINKING

One of the most important responsibilities that nurses have is to make correct and
safe decisions in a variety of client care situations. The decisions made by nurses
affect the health status, recovery time, and even the survival or death of a client.
The process by which these decisions are made involves the use of critical thinking.
Critical thinking is based on reason and reflection, knowledge, and instinct derived
from experience.
It has also been defined as “the art of thinking about thinking.” It is both an attitude
about and an approach to solving problems.
Critical thinking helps nurses make decisions about problems for which there are no
simple solutions. Often nurses have to make these decisions with less than complete
information.
 CHARACTERISTICS OF CRITICAL THINKING
Critical Thinking Is Creative
Nurses who think creatively explore new ideas and alternative ways of solving client
care problems.
Creative thinkers are able to bring together bits of knowledge or information that
may initially seem unrelated and formulate them into a plan that leads to effective
decision making and solves the problem by finding connections between the thoughts
and concepts.
 CHARACTERISTICS OF CRITICAL THINKING
Critical Thinking Is Logical, Rational, and Reflective
Although the critical thinking process is often expanded beyond fundamental logical thinking,
it must always be based on rationales and facts rather than emotions or egocentric impulses.
Intuition can play a part in critical thinking when it is recognized as a rational thought
process that brings together and processes a number of factors at the subconscious level
rather than a simple “gut feeling.”
Critical thinkers must take the time to collect as much data as they can and examine them
under the light of reason before making a decision or taking an action.
Logical reasoning Either John Smith or George Jones is to
be given a dose of IV penicillin before
Deductive logic or surgery.
reasoning is a process
There was no order for IV penicillin for
whereby the individual John Smith before surgery.
proceeds from the general
to the particular. The Therefore, George Jones is to be given
IV penicillin before surgery.
conclusions reached by
deductive reasoning based The conclusion is valid. The rationale is that all of
on a valid argument are the information in the conclusion is found in the
certain and true: premises; therefore, the conclusion must logically
follow if the premises are true.
Logical reasoning Mr. Jones has bacterial lobar pneumonia.
Antibiotics are usually used to treat this
disease.
 Inductive logic or reasoning involves
proceeding from the particular to the
Therefore, Mr. Jones should probably be
general. The conclusions reached by
given an antibiotic.
inductive reasoning are probable or
contingent. The conclusion is valid. The rationale is that the conclusion
 Inductive reasoning is more frequently used is uncertain because the use of the word “usually” in the
in health-care situations than deductive premise leaves room for alternative conclusions. For
reasoning because of the wide range of example, what if the cause of the lobar pneumonia was a
variables involved in client care that almost viral infection? Then antibiotics would not be an
always introduce a degree of uncertainty. appropriate treatment for the condition.
 CHARACTERISTICS OF CRITICAL THINKING
Critical Thinking Is Independent
Nurses who think critically are not easily influenced by others with strong opinions.
They demonstrate their autonomy by thinking for themselves and not passively
succumbing to peer pressure or the belief system of the majority.
 CHARACTERISTICS OF CRITICAL THINKING
Critical Thinking Challenges Custom
A healthy, constructive questioning of long-used health-care practices prevents the
nurse from mindlessly providing rote care.
Improvement and advances in health-care practices occur only when nurses
understand the rationale behind the practices, and then accept or reject them based
on evidence that they either do or do not work as intended.2
 CHARACTERISTICS OF CRITICAL THINKING
Critical Thinking Is Free of Bias and Prejudice
Biases are unjustified personal opinions. When a bias, as well as stereotype, is taken
as fact, it becomes a prejudice. A belief is not necessarily true just because it has
been in existence for a long period of time or because many people believe it. To use
effective critical thinking, biases and stereotypes must be identified and eliminated.
 CHARACTERISTICS OF CRITICAL THINKING
Critical Thinking Is Action Oriented
The goal of critical thinking in health care should always be the resolution of a
problem or a method to improve client care.
Critical thinking is used at all levels of the health-care system and is essential to the
formulation and evaluation of policies and procedures, use of effective
communication, and resolution of management and personnel conflicts.
 CRITICAL THINKING SKILLS

Identify the Problem

If the underlying problem has not been identified, then it is almost

impossible to develop a plan to solve it. One way to identify the
underlying problem is to try to restate the issue as a declarative
statement.
 CRITICAL THINKING SKILLS
Gather Pertinent Data
It sometimes happens that when trying to apply critical thinking to the
resolution of a problem, there is only a small amount of information that
relates to the situation. On the other hand, in our information oriented society,
there may be an overabundance of data.
It becomes necessary for the nurse to sort through the data, use the data that
relate to the problem, and reject the data that are extraneous and perhaps
misleading.
Imagine and Explore Alternatives Creatively
Once the nurse has identified the problem and explored the assumptions and rituals,
he or she needs to consider the possible alternatives to care delivery.
This information can be obtained from a variety of sources, such as written reports,
surveys, and published articles.
Information may also be obtained informally from others, such as in discussions with
individuals who work in the field or have dealt with a similar problem before, or via
feedback from the clients who are receiving the care.