Like many professions, nursing is often challenging and fast-paced, demanding a blend of hard and soft skills. Not only must nurses assess patients and perform clinical skills like placing nasogastric tubes, but they also need soft skills such as communication, bedside manners, and teamwork. Critical thinking in nursing is another essential soft skill.

What Is Critical Thinking in Nursing?

Critical thinking skills in nursing refer to a nurse’s ability to question, analyze, interpret, and apply various pieces of information based on facts and evidence rather than subjective information or emotions. Critical thinking leads to decisions that are both objective and impartial. This aspect of clinical practice allows nurses to assess the patient holistically and offer creative solutions.

Critical thinking is not to be confused with clinical reasoning or judgment. Clinical reasoning is the process required to reach the final conclusion, called a clinical judgment. It requires an accumulation of information and experience to weigh different types of knowledge, evidence, and past diagnoses to contribute to your clinical judgment. As such, reflection is a critical component of clinical judgments because it helps nurses understand how an outcome was achieved and how to ensure a positive outcome for similar cases in the future.

To make a further distinction, critical thinking is the cognitive process and clinical reasoning or judgment is the application, backed up with prior knowledge and experience. One is objective while the other is inherently social.

Each piece plays a part in the puzzle, but nurses can only see the whole picture when they are used together.

Why Is Critical Thinking Important in Nursing?

Every patient you’ll encounter as a registered nurse (RN) will differ slightly. Some patients may be excellent about communicating their symptoms and other issues clearly, while others will be more reticent. Some patients have a higher pain tolerance than others. Some may present with co-morbidities that can make patient assessments, diagnoses, and treatments more challenging.

As a nurse, it’s your job to determine exactly what’s going on with each patient and how best to support that patient’s progress toward a favorable outcome. Why is critical thinking important in nursing? Critical thinking skills allow you to evaluate each situation to understand it more thoroughly. This, in turn, will enable you to develop evidence-based clinical judgments that are appropriate for the patient’s unique situation.

Examples of Critical Thinking in Nursing

Now that you know the general answer to the question, “What is critical thinking in nursing?” you may wonder what critical thinking looks like in action. Nurses rely on their critical thinking skills throughout their shifts, so there are many examples of critical thinking in nursing.

A few examples of how critical thinking assists with nursing decision-making include:

• Prioritizing nursing tasks.
• Determining which patients are most critical and, therefore, must be seen first.
• Figuring out which medications to administer first and whether there are any potential interactions or precautions (for instance, if three patients need medications administered at 8 a.m., which patient do you see first?).
• Identifying when a patient isn’t responding as they should to a treatment.
• Determining how to appropriately respond to a patient’s failure to progress as expected.

Key Critical Thinking Skills for Nurses

Critical thinking is often considered just one skill, yet it comprises various discrete skills. To exercise critical thinking skills in nursing, you must master each discrete skill, including those below.

Observation

Observation skills are the foundation of critical thinking in any industry and profession, especially nursing. Nurses need to be observant to identify problems quickly. In some cases, observation skills allow nurses to predict if and when a situation will occur.

Observation is also crucial for nurses because not all patients openly discuss their symptoms. For instance, a patient might assume that pain in the leg could never be related to cardiovascular trouble, so they might not mention it. It’s the nurse’s responsibility to observe whether a patient seems to be experiencing pain, such as if they repeatedly rub their leg.

Critical Analysis

If observation skills allow nurses to collect and process information, critical analysis enables nurses to use the information to draw evidence-supported conclusions. Nurses employ critical analysis to evaluate the situation. Part of this involves identifying which bits of information are important and relevant and then assessing that information objectively.

Inference

Critical thinking skills in nursing include making an inference (an educated guess). After collecting, processing, and analyzing information, nurses can develop inferences based on available information. It is important to recognize when something is an inference versus a conclusion. The latter can be developed when nurses have the information to form an evidence-supported conclusion.

Communication

Nurses rely on communication skills to obtain more information to form a conclusion. They may need to question the patient more closely about an issue, confer with their colleagues, or double-check the patient’s records. In some cases, diagnostic testing may be warranted. These methods allow nurses to develop a firm conclusion and identify possible solutions.

Problem Solving

Problem-solving is part of critical thinking. In any given patient care scenario, several possible clinical responses may exist. The nurse’s job is to identify which response is the most clinically appropriate based on the patient’s unique situation (not only their symptoms but also their co-morbidities, medications, and so on).

Decision-Making

Decision-making is the culmination of critical thinking in nursing, and this is the point where clinical judgment comes into play. Once a nurse has all the available information, thoroughly analyzes the data, confers with colleagues as needed, and identifies clinical responses, they must decide which action to take. At this point, nurses must factor in ethical, diagnostic, and therapeutic dimensions and research-based knowledge afforded to them through experience.

Sometimes, the decision is temporary, pending physician-authorized treatment plan changes. For instance, if a nurse is supposed to administer a medication to a patient but notices their kidney values are not looking robust enough, the nurse may hold off administering the medication if one of the possible side effects is renal failure. The nurse may instead wait for the physician to determine if a change in medication is necessary.

Prioritization

Prioritization is another component of critical thinking in nursing, and it is the result of processing information and drawing a conclusion. For instance, after analyzing available data, a nurse should be able to prioritize which patients to tend to first based on how urgent their clinical situations are.

Personal/Implicit Bias Confrontation

The Joint Commission states implicit biases are “attitudes or stereotypes that affect our understanding, actions and decisions in an unconscious manner.” These biases can negatively impact patient care, so it’s essential to recognize that everyone has them. These implicit biases may concern age, gender, race, sexual orientation, gender identity, religion, weight, drug usage, homelessness, and other personal characteristics.

Implicit biases can manifest in language or actions that make patients feel uncomfortable and may discourage them from seeking the care they need. In some cases, implicit biases can also affect a patient’s treatment plan, potentially leading to life-threatening consequences.

For instance, let’s say a 25-year-old patient, Jane, is taken to the ER with shortness of breath, profuse sweating, and low blood pressure. Because Jane is young and female, the nurse may assume a heart attack isn’t the cause and that her symptoms are instead indicative of a drug overdose. Instead of ordering an EKG, the nurse orders a drug test without even considering the possibility of cardiovascular trouble. This implicit bias in action could prove disastrous for Jane.

How Clinicians Can Strengthen Critical Thinking in Nursing

Nursing students develop critical thinking skills in nursing school, particularly during simulation labs and clinical rotations. However, these skills aren’t learned overnight. Refinement can take years of experience on the job.

You can nurture your critical thinking skills with the following steps:

• Embrace self-reflection by questioning your assumptions and analyzing your thought processes during clinical decision-making.
• Before making a decision, consider whether it’s supported by evidence.
• If a decision is supported by evidence, consider whether it’s genuinely the most clinically appropriate for the patient. Often, patient care scenarios have multiple possible responses.
• When determining which task to address first, consider which patient (and which task for that patient) is most time-sensitive.
• Reflect upon your implicit biases and consider how they might affect your actions and communications.
• Seek the viewpoints of other nurses and team members.
• Be a lifelong learner.

Prepare to Become an Effective Clinician at Xavier University

A solid academic foundation is essential for developing critical thinking skills in nursing. If you’re eager to begin a career in nursing and you have a prior non-nursing college education, you may be eligible to apply to the Accelerated Bachelor of Science in Nursing (ABSN) program at Xavier University in Ohio.

Our ABSN program offers three locations, three start dates each year, and the opportunity to graduate with your BSN in as few as 16 months (after completing prerequisite courses, if necessary). Develop the required academic foundation and polish your critical thinking skills while you work through our comprehensive curriculum.

Begin a meaningful career in nursing that offers versatility and advancement possibilities, along with the chance to help others. Contact our admission counselors today to learn more about our accelerated nursing program.