Judi Kulus, VP of Curriculum Development, AADNS

How can I encourage my nurses to confidently engage their critical thinking skills to ensure accurate assessments and optimal care for residents?

Critical thinking was perfectly described by the late Richard Paul as “thinking about your thinking, while you are thinking, to make your thinking better.”

As nurses, we often fail to think effectively and solve the puzzles of our residents’ care needs as they arise because we have failed to eliminate distractions. Interruptions such as phone calls, visitors and emails may be hard to avoid, but they are detrimental to effective focus and concentration.

Encourage your nurses to “timebox” their assessment and care-planning processes, eliminating distractions for designated periods. Remind them to gather and organize all data, ask thorough follow-up questions, and assess all information with fresh eyes before jumping to solutions.

Caution nurses to be aware of their own biases and to avoid simply following the status quo. Biases are often the result of our cultural, ethnic and religious backgrounds in addition to our training, knowledge and experience. We need to be open to new possibilities and not assume that we know exactly what is happening or should happen for the resident.

For example, a resident with brain tumors was clear-minded one day and confused the next. A nurse assumed the brain tumors were causing the confusion. But the resident was allergic to fentanyl. The confusion was easily reversed.

Assessment guides and clinical protocols provide a road map to critical thinking processes. But never let go of thinking for yourself. Refusing to follow a process blindly is one of the hallmarks of good thinking.

Please send your nursing-related questions to Judi Kulus at [email protected].