FUNDAMENTALS OF NURSING

• The process of intentional higher level of thinking to define a client’s problem, examine the evidence-based practice in caring for the client, and make choices in the delivery of care

  CRITICAL THINKING
• The cognitive process that uses thinking strategies to gather and analyse client information, evaluate the relevance of the information, and decide on possible nursing actions to improve the client’s physiological and psychosocial outcomes

  CLINICAL REASONING
• requires the integration of critical thinking in the identification of the most appropriate intervention that will improve the clients condition.

  CLINICAL REASONING
• Guides nurses in assessing, assimilating, retrieving, and or discarding components of information that affect patient’s care.

  CLINICAL REASONING
• qOften defined in practice-based principles, such as nursing and medicine as the (application of critical thinking to the clinical situation.)

  CLINICAL REASONING
• 1.An essential skill needed for the identification of client problem and the implementation of interventions to promote effective care outcomes. 2.Helps nurses to develop new insights regarding practice that may lead to changes in their approach to practice. 3.Metaphorical bridge between information and action. 4.Fuels the intellectual artistic activity of creativity.

  PURPOSE OF CRITICAL THINKING
• 1.Nurses uses knowledge from other subject and fields.2.Nurses deal with change in stressful environment.3.Nurses make important decisions.4.Generate many ideas rapidly.5.Be generally flexible and natural, that is, able to change view points or directions in thinking rapidly and easily.6. Create original solutions to problems.7.Be independent and self confident even when under pressure.8.Demonstrate individuality.

  NURSES USES C THINKING IN VARIOUS WAYS
•   CRITICAL ANALYSIS

    - Application of a set of questions to a particular situation or idea to determine essential information and ideas and discard unimportant information and ideas.

    -use of socratic questioning
• INDUCTIVE AND DEDUCTIVE REASONING

    -INDUCTIVE: Generalizations are formed from a set of facts or observations.

    - moves from specific examples to generalized conclusion

    -deductive: reasoning from general premise to specific conclusions
• 3. MAKING VALID INFERENCES, DIFFERENTIATING FACTS FROM OPINIONS

  4. EVALUATING THE CREDIBILITY OF INFORMATION SOURCES

  5. CLARIFYING CONCEPTS

  6. RECOGNIZING ASSUMPTIONS TECHNIQUES IN C THINKING
• FACTS: can be verified through investigation

  Example: blood pressure is affected by blood volume
• INFERENCES: Conclusions drawn from the facts; going beyond facts to make a statement about something that currently known

  Example ; if blood volume is decrease, the blood pressure will drop
• JUDGMENTS: Evaluation of facts or information that reflects values or other criteria; type of opinion

  Example: it is harmful to the client’s health if the blood pressure drops to low
• OPINION: beliefs formed overtime; includes judgment that may fits facts or maybe erroneous

  Example: Nursing intervention can assist in maintaining the client’s blood pressure within normal limits
•  -it is  a mental activity in which a problem is identified that represents unsteady state. -it requires a nurse to obtain information that clarifies the nature of the problem and suggest possible solutions. -the carefully evaluates the possible solution and choose the best one to implement.

  PROBLEM SOLVING
• Trial and error

  A number of approaches are tried until a solution is found
• Intuition


  • Understanding or learning of things without the conscious use of reasoning
  • Also known as 6th sense, hunch, instinct, feeling or suspicion
• Clinical judgment

  A decision making process to ascertain the right nursing action to be implemented at the appropriate time in the client's care
• Experience is important in improving intuition


  The rapidity of judgment depends on the nurse having seen similar client situations many times before
• Research process


  A formalized logical, systematic approach to problem solving
• 2. FAIR-MINDEDNESS

    - Critical thinkers make impartial judgments. They assess all view points with the same standards and do not base their judgments on personal or group bias or prejudice.
•  1. INDEPENDENCE

  -Critical thinkers consider seriously a wide range of ideas, learn from them, and then make their own judgment about them. 
• 3. INSIGHT TO EGOCENTRICITY

    -Critical thinkers are open to the possibility that their personal biases or social pressures and customs could unduly effect their thinking. They actively try to examine their own biases and bring them to awareness each time they think or make a decision.
• 4. INTELLECTUAL HUMILITY

    -means having an awareness of the limits of one’s own knowledge. Critical thinkers are willing to admit that they do not know; they are willing to seek new information and to rethink their conclusions in light of new knowledge.
• 5. INTELLECTUAL COURAGE TO CHALLENGE THE STATUS QUO AND RITUALS

    - With an attitude of courage, a nurse is willing to consider and examine fairly his or her own ideas or views, specially those to which the nurse may have a strongly negative reaction. This type of courage comes from recognizing that beliefs are sometimes false or misleading.
• INTEGRITY

    - Intellectual integrity requires that individuals apply the same rigorous standards of proof to their own knowledge and beliefs as they apply to the knowledge and beliefs of others.
• CONFIDENCE

    - Critical thinkers believe that well-reasoned thinking will lead to trustworthy conclusions
• PERSEVERANCE

    - Critical thinkers show perseverance in finding effective solutions to client and nursing problems. The nurse needs to continue to address the issue until it is resolve.
• CURIOSITY

    - The mind of a critical thinker is filled with questions.