An Introduction to Critical Thinking in Nursing


Suppose you were outside in the early morning with three children ages 5, 9, and 13.  It’s a mostly blue sky but with several large white fluffy clouds in the sky.  You ask the 5 year old, “Will it rain today?”  The child looks up at the sky and sees clouds and his teacher told him rain comes from clouds so he replies, “Yes.”


You ask the 9 year old the same question.  She looks up and sees the clouds and knows rain comes from clouds but these clouds are too white and fluffy.  In her experience, rain only comes from gray clouds.  She replies, “No, It will not rain today.”


You ask the thirteen year old, “Will it rain today?”  He looks up and sees the clouds and knows it’s probably not going to rain anytime soon.  He whips out his phone and checks the radar and the local news forecast.  “There is a 20% chance of rain this afternoon.” he declares and adds, “You might want to grab an umbrella just in case.”


Critical thinking is about having a question like, Will it rain today?  or  What type of care does my patient need today?  We all draw on our current knowledge and past experiences to come up with our best, most logical answer.   All three children did just that.  Actually, the teenager wasn’t satisfied with his own current knowledge.  Also, given his past experiences he knew that the weather can be much different later in the day.  Part of critical thinking is using your judgement to to try to realize if you actually have enough knowledge to sufficiently answer the question.


The first child used his knowledge and the second used her knowledge and past experience.  Note that all the children, each at a different age (or stage) felt very confident in their answers.


Suppose you brought a first year, a second year and a fourth year nursing student for the first time on a pediatric unit.  You tell them their patient is a 7 year old boy on total bed rest.  You ask the first year student, ”Is this patient at risk for skin breakdown or bed sores?”  The first year student read in her book that patients on total bed rest are at risk for skin breakdown and bed sores.  She replies, “Yes.”


You ask the second year student, “Is this patient at risk for skin breakdown or bed sores?”  The second year student knows total bed rest is indeed a risk factor for bed sores but he also has spent time with seven-year-olds and knows how difficult it is for them to sit still.  He knows prolonged pressure without moving in bed causes bed sores and doesn’t think this will be an issue.  He replies, “No.”


The fourth year student agrees with the second year student however he is not comfortable with formulating an opinion with the limited information given.  He wants more details.  Is the patient immobile?  Incontinent?  Conscious?   Does the patient have any casts, or any other devices attached to him that could be rubbing causing breakdown?  The fourth year student feels he can’t answer that question to the best of his ability.  His advanced critical thinking leads him to realize he needs to seek out more clues to formulate a well thought out answer.


You Will Get There


The more knowledge and experiences you have to draw from the easier critical thinking in nursing will come to you.  Watch out for being too confident and satisfied with your answers as our novice critical thinkers were.  It’s best to run your thought process by your instructor and ask, “Is there anything I’m not taking into consideration that I should be concerned about?”  Ask lots of questions!  Always offer help to others as often as your time allows.  The more you help, the more you learn.


 See also Critical Thinking in Nursing ⇒

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