Nursing Process aids Critical Thinking 1

Critical Thinking Combined With The Nursing Process Increases Clinical Judgment
Christopher Rodeback
Dixie State University















Critical Thinking with nursing process aids judgment.

The Nursing Process is a tool to aid the RN in Critical Thinking.
Organized chaos; thats the phrase that first comes to mind when someone mentions
that they are a registered nurse. A nurses responsibility to the patient is to provide competent
care and understanding during times of need. To do this the nurse has the monumental task of
sifting through mountains of information, analyze it, and then act upon it. A nurse must think
of each situation as being independent of the last as not all situations are the same, a nurse
must be able to think critically and connect the dots to formulate the direction that will
promote a desirable outcome for the patient. This is why a symbiotic relationship between
critical thinking and the nursing process is vital to excellent nursing care and through
implementation can lead to improved judgment. The following is a brief overview of the
nursing process and critical thinking and how together they can lead to good clinical judgment.
A.D.P.I.E
If I were to mention the acronym ADPIE, most of the population would shrug it off as a
mispronounced word, but to the registered nurse, ADPIE is the lifeline that is introduced during
the infancy of their education. This acronym is what is known as the nursing process, and
stands for, assessment, diagnosis, plan, interventions and evaluations with some texts teaching
ADOPIE with O representing outcomes. Paraphrasing the book Fundamentals of Nursing, the
nursing process is a method for the nurse to identify the needs and strengths of the patient,
establish a plan to carry out towards certain goals and evaluate the efficacy of the plan
(Lemone, Lillis, Lynn, Taylor 2011). In an acute care setting this is essentially getting the patient
from point A to point B or in medical terms, admission to discharge.
Critical Thinking with nursing process aids judgment.

Leading of the nursing process is the ability to assess the patients needs and strengths
and this leads to the formulation of a nursing diagnosis, which is step 2. There are three
competencies that are required to diagnose a problem: interpersonal, technical and intellectual
(Lunney 2010). A nurse must be have the confidence to ask questions effectively, often
personal and intimate, and must have the technical aptitude to obtain and interpret correct
information. Once this is done a nurse must be able to process information that they simply do
not know which is known as intellectual thinking.
Once the correct diagnosis is made a plan must be in place to implement interventions
to obtain goals that are set by the nurse. This can be as simple as offering information to the
patient regarding certain disease process and offering emotional support or performing
technical procedures. A set goal is not a concrete goal. Situations will arise that a nurse will
understand that a goal is simply unattainable; this is where responsibility rests on the nurse to
conform the goal to the patient rather than the patient to the goal.
No one patient is the same and not all interventions will work. A nurse must be able to
evaluate the effectiveness of the plan and make changes as necessary. And repeat. The
nursing process, if used effectively is a cyclical process that continues to evolve as the patient
evolves. Whether improving or declining there is always something that can be done for a
patient. This entire process is not autonomous, it takes critical thinking to receive, evaluate and
adjust.
Critical Thinking
Critical thinking is not an aptitude that is singular to nursing. Most if not all professions
require the individual to be able to reason through certain situations and formulate a plan to
Critical Thinking with nursing process aids judgment.

achieve desired results. Fewer of those professions however, have the consequence of death if
a misstep is made. By definition critical thinking is a systematic way to form and shape ones
thinking (Lemone et. Al 2010). As nursing students there is a strong emphasis on thinking
critically for oneself and being able to reach an effective decision even though the decision may
not be the same as the last one. This ever changing role as a nurse is what leads to good critical
thinking skills.
Judgment
Through all of this there will be times that a nurse will be placed in a dilemma in which
multiple outcomes are possible. It is the responsibility of the nurse to weigh the merits of all
options and make a decision. This will require sound reasoning skills and aptitudes that will be
formed throughout a career. It is important to remember that not all outcomes are pleasant
but all decisions can be used to evaluate the nurse and develop stronger clinical judgments.

Putting it All Together
It is a reciprocal relationship between thinking critically and the nursing process. I
wrestled with which one precedes the other; is thinking critically the basis of the nursing
process or is it the information obtained through the nursing process that shapes ones thought
processes that we have come to know as critical thinking. I came to the conclusion that neither
one leads the other. It is a reciprocal relationship between thinking critically and the nursing
process that ultimately forms our judgment as a nurse. This learning is what shapes our
judgment and ultimately shapes us as nurses.

Critical Thinking with nursing process aids judgment.

References
Lunney, Margaret, R.N., PhD. (2010). Use of critical thinking in the diagnostic process. International Journal of
Nursing Terminologies and Classifications, 21(2), 82-8. Retrieved
from http://search.proquest.com/docview/304922117?accountid=27045
Taylor, C.R., & Lillis, C., & LeMone, P., & Lynn, P. (2011). Fundamentals of Nursing: The Art and Science of
Nursing Care. Philadelphia, PA: Wolters Kluwer Health Lippincott Williams & Wilkins