Chapter 2 Critical thinking and Nursing Process

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Nursing involves
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Thinking, Doing & Caring
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What is critical thinking?
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A combination of reasoned thinking, openness to alternatives, an ability to reflect, and a desire to seek truth.
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Examples of critical thinking skills
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1. Objectively gathering information on a problem 2. Recognizing the need for more information 3. Evaluating the credibility/usefulness of information sources 4. Recognizing gaps in one’s own knowledge 5. Listening carefully; reading thoughtfully 6. Separating relevant from irrelevant data and important from unimportant data 7. Organizing or grouping info in meaningful ways 8. Making inferences (tentative conclusions) about the meaning of the info 9. Visualizing potential solutions to a problem 10. Exploring the advantages, disadvantages, and consequences of each potential action
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Why are critical-thinking attitudes important?
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Your attitudes and character determine whether you will use your thinking skills fairly and with an open mind.
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Critical thinking attitudes
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Independent thinking Intellectual curiosity Intellectual humility Intellectual empathy Intellectual courage Intellectual perseverance Fair-mindedness
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Complex Thinking Processes
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Problem-Solving Decision Making Clinical Reasoning
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Why is critical thinking important for Nurses?
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1. Nurses Deal with Complex Situations 2. Clients are Unique 3. Nurses apply knowledge from several fields to provide holistic care so it is applied discipline 4. Nursing can be fast-paced and demanding
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Problem Solving as a complex thinking process
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Identifying a problem and finding reasonable solutions to it. Requires critical-thinking skills such as organizing data, identifying relevant and important data, making inferences, making decisions, projecting consequences of actions, and applying theoretical knowledge to a specific patient context The nursing process is a problem solving process.
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Decision Making as a complex thinking process
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Choosing the best action to take. In nursing , this is usually the action likely to produce the desired patient outcome. Requires thinking skills such as making judgments (e.g. about what is important) and making choices. Important in problem-solving; however, many decisions are made that are not related to problem-solving.
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Clinical Reasoning as a complex thinking process
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Reflective, concurrent, creative thinking about patients and patient care. Clinical reasoning is used in the nursing process. Reasoning is logical thinking that links thoughts together to create meaning.
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Ways Clients are Unique
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1. Individual Differences (care plans must be created and evaluated for each client) 2. Client’s Culture 3. Client’s Role (single mother, Mother with an extended family network, etc. – nurses must take these considerations into account)
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The nursing process is the _________ upon which all professional nursing care is based.
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framework
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Nursing is a ___________ that nurses use to identify and assist clients to meet basic health needs and to achieve optimal wellness.
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problem-solving process
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Nursing is a problem-solving process that nurses use to identify and assist clients to meet ___1___ and to achieve ___2___.
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1. the basic health needs 2. optimal wellness
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The nursing process defines professional nursing as more than…..
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carrying out plan of care as prescribed by physicians or performing routine tasks and procedures.
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The nursing process involves_______.
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critical thinking
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Critical thinking encompasses nurses knowledge of the ___1___ and ___2___ sciences, application of this knowledge for ___3___ individual client and health care situations, and ___4___ regarding clients indications for nursing care.
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1. physical 2. social 3. analyzing 4. decision making
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Name the five steps to the nursing process
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1. Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation
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Define Assessment
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Collection of all applicable subjective and objective data about the client
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Define Diagnosis
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analyzing the collected client data and formulating nursing diagnoses
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Define Planning
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1. Establishing priorities for care 2. Formulating client outcomes and 3. Identifying nursing interventions to achieve these client outcomes.
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Define implementation
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carrying out nursing interventions
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Define evaluation
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Measuring effectiveness of nursing interventions in achieving client outcomes.
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List at least 6 critical thinking skills and attitudes
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planning gathering information recognizing need for more information Evaluating the credibility and usefulness of information recognizing gaps in own knowledge Listening carefully
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Seven Attitudes of the critical thinker
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1. Independent thinking 2. intellectual curiosity 3. intellectual humility (don’t know everything) 4. intellectual empathy 5. intellectual courage 6. Intellectual perseverance (don’t jump to conclusions) 7. Fair-mindedness
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Complex thinking process
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1. problem-solving 2. decision making (for the desired patient outcome) 3. clinical reasoning
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Nurses use critical thinking in these ways
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complex situations uniqueness of clients individual difference cultural differences clients roles Age, personal bias, personalities, previous experience nurses apply knowledge to provide holistic care applied discipline knowledge from other fields nursing is fast-paced
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contextual awareness (deciding what to observe and consider)
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An awareness of what’s happening in the total situation, including values, cultural issues, interpersonal relationships, and environmental influences
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Inquiry (based on credible sources)
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Applying standards of good reasoning to your thinking when analyzing a situation and evaluating your actions
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Considering alternatives
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exploring and imagining as many alternatives as you can think of for the situation
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Analyzing assumptions
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recognizing and analyzing assumptions you are making about the situation and examining the beliefs that underlie your choices
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Reflecting skeptically and deciding what to do
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Questioning, analyzing, and reflecting on the rationale for your decisions
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Types of nursing knowledge
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theoretical knowledge practical knowledge Self-knowledge Ethical knowledge
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Full spectrum nursing is
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a unique blend of thinking, doing, caring and patient situation (or context)
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ADPIE
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Assessment Diagnosis Planning Interventions Evaluation
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Critical thinking
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Reasoned thinking, openness to alternatives, ability to reflect, and a desire to seek truth.
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Different kinds of nursing knowledge are:
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-Theoretical knowledge -Practical knowledge -Self knowledge -Ethical Knowledge
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5 major categories of critical thinking are:
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-Contextual awareness -Inquiry -Considering alternatives -Examining assumptions -reflecting critically
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What is the nursing process?
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-systematic problem-solving process that guides all nursing actions. – helps nurse provide goal-directed client centered care.
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What are the phases of the nursing process?
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-Assessment -Diagnosis -Planning outcomes -Planning interventions -implementation -Evaluation
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Phase 1= Assessment
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Gathering data
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Phase 2=Diagnosis
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Identify clients healths needs.
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Phase 3=Planning outcomes
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Decide what goals u want to achieve with client as a nurse.
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Phase 3b=Planning interventions
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choose interventions to help client achieve stated goals
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Phase 4=Implementation
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action phase; when you carry out or delegate actions you planned.
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Phase5= Evaluation
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judge weather your actions have successfully treated or prevented the client’s health problems
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Full spectrum nursing
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-Thinking -Doing -Caring -Patient Situation
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How does the critical thinking model work?
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Thinking -Theoretical knowledge -Critical thinking Doing -Practical Knowledge -Nursing process Caring -self-knowledge -Ethical knowledge Patient Situation -Patient Data -Patients preferences and context
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How are data used?
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-collaboration -plan for nursing care -ensure clients receive proper care by qualified individuals in a timely matter.
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What are skills of a critical thinker?
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Skills: 1. Objectively gather info 2. Recognize need for more 3. Evaluate credibility 4. Recognize Gaps 5. Listen Carefully 6. Separate data 7. Group Information 8. Make Inferences 9. Visualize potential solutions 10. Explore Consequences of actions
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Why is critical thinking important in general?
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6. It helps you know what is important about each situation, when you need more information, and when you need help to make the best decision.
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critical thinking model
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1. Contextual awareness (deciding what to observe and consider) 2. Inquiry (based on credible sources) 3. Considering alternatives 4. Analyzing assumptions 5. Reflecting skeptically and deciding what to do
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theoretical knowledge
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information, facts, principles, evidence-based theories in nursing and related disciplines, research findings, and rationally constructed explanations of phenomena
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practical knowledge
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processes (knowing what to do) and procedure (how to do it)
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self-knowledge
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personal awareness of you beliefs, values, and cultural and religious biases
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ethical knowledge
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information about moral principles and processes for making moral decisions
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What is caring?
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personal concern for people, events, projects, and things; it allows you to connect with others and to give help as well as receive it
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Five components of caring
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-Knowing the patient -Being with the patient -Doing for activities for the patient when he/she can’t -Enabling the patient to cope -Maintaining belief in the patient

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