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Importance of Critical Thinking in Nursing

Nursing students graduate with a collection of clinical skills in hand. They have mastered asepsis (hand washing, sterile gloves, dressing changes, etc.), health assessments (such as checking vital signs), and hygiene (such as bathing a patient). They can move and position a patient, administer medication, insert an IV line, monitor and interpret an electrocardiograph, and much more.

Clinical skills are clearly essential for RNs. But the practice of nursing requires more than task-based proficiencies. Critical thinking is an essential ingredient in providing quality care.

RNs enrolled in the RN to BSN program at Northern Kentucky University (NKU) take courses that prepare them at advanced levels for today’s changing healthcare systems. Coursework across diverse areas helps students hone critical thinking skills in leadership, public policy and health informatics. The program also emphasizes research and the quality of evidence in nursing.

What Is Critical Thinking?

Critical thinking is not unique to nursing. In fact, from an early age, most of us have been taught how to use critical thinking to become better readers, using clues in the text to make logical connections and draw conclusions. defines critical thinking as “clear, rational, open-minded and informed by evidence.” In “Critical Thinking in the Medical Surgical Unit,” Shelley Cohen, RN, MSN, CEN, shares Dorothy Del Bueno’s definition of critical thinking. Del Bueno, RN, EdD, devised the Performance-Based Development System, a nursing competency assessment. She defined critical thinking through four questions:

  1. Can the nurse recognize the patient’s problem?
  2. Can the nurse safely and effectively manage the problem?
  3. Does the nurse have a relative sense of urgency?
  4. Does the nurse do the right thing for the right reason?

How Does Critical Thinking Fit Into Clinical Practice?

In nursing, critical thinking is essential to the evidence-based practice that drives improved patient care. Cohen explains that nurses develop the ability to think critically by:

  • Gathering knowledge.
  • Gaining experience.
  • Reading the literature.
  • Reviewing medical charts to continually improve quality.

Take the simple case of a healthcare provider who ordered acetaminophen for a patient. Cohen points out that a nurse might go beyond being a “robonurse,” questioning the order because the patient has hepatitis C. In nursing, what appears to be a simple procedure may be anything but. In this case, the acetaminophen could put the patient at risk. Here, the use of critical thinking in clinical decision-making may have prevented harm.

It would be tough to think of a job that did not require critical thinking. As one indication, a search on for job listings with the keyword “critical thinking” turned up over 94,000 job listings, including nursing jobs.

In “Fostering Soft Skills Is a Must for Nurse Leaders” (American Nurse Today), Maureen Kroning, RN, MSN, EdD, points out that nurse leaders rarely have to address clinical skills with employees. More common is the need for coaching, and sometimes disciplinary action, when RNs have problems with skills such as critical thinking.

As patients’ needs continue to become more complex, hospitals need nurses who can keep up — from caring for patients with chronic illnesses to using informatics to enhance decision-making. With RN to BSN programs like NKU’s, nurses can develop the critical thinking skills required to effectively meet that need. In the process of advancing their education, BSN-prepared nurses are also likely to gain a competitive edge in employment.

Learn more about NKU’s online RN to BSN program.


HCPro: Critical Thinking in the Medical Surgical Unit

Nurse Journal: The Value of Critical Thinking in Nursing + Examples

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