The nurse knows that the patient was discharged from the hospital and had five medications ordered. How do patients from other cultures perceive comfort? Critical thinking is embedded in a nurse’s everyday routine. Nursing critical thinking skills drive the decision-making process and impact the quality of care provided,” says Georgia Vest, DNP, RN and senior dean of nursing at Rasmussen College School of Nursing. Critical thinking is not a simple step-by-step, linear process that you learn overnight. The person has to weigh each option against a set of personal criteria (experience, friendliness, and reputation), test possible options (talk directly with the different health care providers), consider the consequences of the decision (examine pros and cons of selecting one health care provider over another), and make a final decision. The nurse reads research articles (collects data) about mucositis and learns that there is evidence to show that having patients keep ice in their mouths (cryotherapy) during the chemotherapy infusion reduces severity of mucositis after treatment. It is a process acquired only through experience, commitment, and an active curiosity toward learning. • Any additional relevant data about requirements in the patient’s daily living, functional capacity, and social resources. How might it change and why? Seek the true meaning of a situation. Technical personnel simply follow direction in completing aspects of care that the professional nurse has identified as necessary. • Knowledge about the clinical variables (e.g., age, seriousness of the problem, pathology of the problem, patient’s preexisting disease conditions) involved in the situation, and how the variables are linked together. Analyze potentially problematic situations; anticipate possible results or consequences; value reason; use evidence-based knowledge. Use knowledge and experience to choose strategies to use in the care of patients. Critical thinking is more than just problem solving. Critical thinking contains a form of discipline, intellectual process of applying skills, and guidance. For example, after turning a patient you see an area of redness on the right hip. A judgment about the likely course of events and outcome of the diagnosed problem, considering any health risks the patient has; includes knowledge about usual patterns of any diagnosed problem or prognosis. The scientific method is a way to solve problems using reasoning. Nurses are responsible for making accurate and appropriate clinical decisions. Complete. At this level answers to complex problems are either right or wrong (e.g., when no urine drains from the catheter, the catheter tip must not be in the bladder), and one right answer usually exists for each problem. With experience you learn to creatively seek new knowledge, act quickly when events change, and make quality decisions for patients’ well-being. Discuss the critical thinking attitudes used in clinical decision making. Facione and Facione (1996) identified concepts for thinking critically (Table 15-2). The specific critical thinking competency in nursing involves use of the nursing process. His health care provider is concerned that the patient will not progress as planned, delaying rehabilitation. They focus clearly on options for solving problems and making decisions rather than quickly and carelessly forming quick solutions (Kataoka-Yahiro and Saylor, 1994). The identified status and situation you assessed about the patient, including data collected by actively listening to the patient regarding his or her health care needs. is a product of critical thinking that focuses on problem resolution. Edwin learns that the patient practices meditation at home. Sometimes an action is to not act or to delay an action until a later time. At times you possibly will be wrong, but consulting with nurse experts gives you feedback to build on future clinical situations. Over time a combination of experience, time spent in a specific clinical area, and the quality of relationships formed with patients allow expert nurses to know clinical situations and quickly anticipate and select the right course of action.