Nursing Education – The Importance Of Critical Thinking

In the nursing profession, more now than ever, the ability to think critically is essential. The responsibilities of a Registered Nurse have increased over the years. In correlation with this increase in responsibility comes the additional increase in educational prerequisites and core requisites required to achieve a degree in Nursing. The ANA (American Nursing Association) Standards has set forth the framework necessary for critical thinking in the application of the “nursing process". The nursing process is the tool by which all nurses can equally become proficient at critical thinking. The nursing process contains the following criteria:

1. Assessment

2. Diagnosis

3. Planning

4. Implementation

5. Evaluation

It is in the application of each of these processes that the nurse may become proficient at critical thinking. It is important to look at the components that describe critical thinking in nursing, The table below lists components that define the critical thinking process. There is much more that goes into critical thinking than what is listed in the table. The table is a rough draft of the process.

CRITICAL THINKING COMPONENTS

Entails purposeful, informed, outcome focused thinking, that requires careful identification of specific problems and other physiological and psychological factors that affect the clients position on the health and wellness continuum.

The process is driven by the client, the client’s family and other health team members who are also collaborating in ensuring essential client care.

Specific educational knowledge base and level of experience in applying that knowledge in client care. (Nursing School to graduate nurse to experienced nurse) As the level of experience of the nurse increases so will the scientific knowledge base that the nurse applies.

Proficiency in the application of the institutions standards, policies and procedures.

Application of the humanistic standards of caring in conjunction with the nursing process, to holistically treat the clients response to an actual or perceived illness.

Constant evaluation and re-evaluation of the nursing process to determine the clients level of wellness

Nurses learn critical thinking via application with experience. Experience is the best teacher. But it is equally important to know that the process is being applied correctly. Many institutions will ensure that this pathway is followed by enlisting new nurses in a eight to ten week orientation program. During this time the new nurse will learn about the polices and procedures of that institution and what type of documentation is used for charting purposes. Also, the new nurse will have an experienced mentor who they will follow and who will evaluate their performance as well.

Documentation is an essential part of the critical thinking process for the nurse. Every institution places emphasis on documentation. It is said, “that if it is not documented, then it was not done". Since the nursing process is a scientific process. In scientific research, all things are documented. In this documentation, researches can look back to see if the results were due to interventions and whether or not the interventions were successful or have to be altered. The documentation process helps the nurse accomplish the same goals. Many times procedures are used that have unproven efficacy.

In it is this framework of critical thinking and documentation that such procedures can be either continued or eliminated, depending on the efficacy of the research. In other words, does the procedure actually improve, help or otherwise jeopardize the client’s health. An example of the critical thinking process and scientific reasoning is in the efficacy of taking a rectal temperature of new born infants. Currently, this procedure is still widely accepted. However the scientific approach is to ask the following, is the procedure safe, is it necessary, and can an axillary temp be used in place of the rectal temp? In answering these questions, the nurse can better evaluate whether the efficacy of taking a rectal temp on a infant should be continued.

This is just one example of how the critical thinking process is used within the nursing profession. The scientific approach using critical thinking helps the nurse develop evidence based practice. It is through “evidence based practice" that the Joint Commission on Accreditation of Health Care Organizations (JCAHO) rates the performance of hospitals. Further research is still continuing in delineating the intricacies of the nursing process and the integration of critical thinking. All health care professionals are encouraged to pursue this type of research in their practice to ensure the quality of client care and enhance the validity of their profession.

Learn more about nursing education at The NET Study Guide.
Ceated by Robyn Knapp

Registered

nurses

(RNs), regardless of specialty or work setting, perform basic duties that include treating patients, educating

patients

and the public about various

medical conditions

, and providing advice and emotional support to patients’ family members. RNs record patients’ medical histories and symptoms, help to perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation.

RNs teach patients and their families how to manage their illness or injury, including post-treatment home care needs, diet and exercise programs, and self-administration of medication and physical therapy. Some RNs also are trained to provide grief counseling to family members of critically ill patients. RNs work to promote general health by educating the public on various warning signs and symptoms of disease and where to go for help. RNs also might run general health screening or immunization clinics, blood drives, and public seminars on various conditions.

RNs can specialize in one or more patient care specialties. The most common specialties can be divided into roughly four categories—by work setting or type of treatment; disease, ailment, or condition; organ or body system type; or population. RNs may combine specialties from more than one area—for example, pediatric oncology or cardiac emergency—depending on personal interest and employer needs.

RNs may specialize by work setting or by type of care provided. For example, ambulatory care nurses treat patients with a variety of illnesses and injuries on an outpatient basis, either in physicians’ offices or in clinics. Some ambulatory care nurses are involved in telehealth, providing care and advice through electronic communications media such as videoconferencing or the Internet. Critical care nurses work in critical or intensive care hospital units and provide care to patients with cardiovascular, respiratory, or pulmonary failure. Emergency, or trauma, nurses work in hospital emergency departments and treat patients with life-threatening conditions caused by accidents, heart attacks, and strokes. Some emergency nurses are flight nurses, who provide medical care to patients who must be flown by helicopter to the nearest medical facility. Holistic nurses provide care such as acupuncture, massage and aroma therapy, and biofeedback, which are meant to treat patients’ mental and spiritual health in addition to their physical health. Home health care nurses provide at-home care for patients who are recovering from surgery, accidents, and childbirth. Hospice and palliative care nurses provide care for, and help ease the pain of, terminally ill patients outside of hospitals. Infusion nurses administer medications, fluids, and blood to patients through injections into patients’ veins. Long- term care nurses provide medical services on a recurring basis to patients with chronic physical or mental disorders. Medical-surgical nurses provide basic medical care to a variety of patients in all health settings. Occupational health nurses provide treatment for job-related injuries and illnesses and help employers to detect workplace hazards and implement health and safety standards. Perianesthesia nurses provide preoperative and postoperative care to patients undergoing anesthesia during surgery. Perioperative nurses assist surgeons by selecting and handling instruments, controlling bleeding, and suturing incisions. Some of these nurses also can specialize in plastic and reconstructive surgery. Psychiatric nurses treat patients with personality and mood disorders. Radiologic nurses provide care to patients undergoing diagnostic radiation procedures such as ultrasounds and magnetic resonance imaging. Rehabilitation nurses care for patients with temporary and permanent disabilities. Transplant nurses care for both transplant recipients and living donors and monitor signs of organ rejection.

RNs specializing in a particular disease, ailment, or condition are employed in virtually all work settings, including physicians’ offices, outpatient treatment facilities, home health care agencies, and hospitals. For instance, addictions nurses treat patients seeking help with alcohol, drug, and tobacco addictions. Developmental disabilities nurses provide care for patients with physical, mental, or behavioral disabilities; care may include help with feeding, controlling bodily functions, and sitting or standing independently. Diabetes management nurses help diabetics to manage their disease by teaching them proper nutrition and showing them how to test blood sugar levels and administer insulin injections. Genetics nurses provide early detection screenings and treatment of patients with genetic disorders, including cystic fibrosis and Huntington’s disease. HIV/AIDS nurses care for patients diagnosed with HIV and AIDS. Oncology nurses care for patients with various types of cancer and may administer radiation and chemotherapies. Finally, wound, ostomy, and continence nurses treat patients with wounds caused by traumatic injury, ulcers, or arterial disease; provide postoperative care for patients with openings that allow for alternative methods of bodily waste elimination; and treat patients with urinary and fecal incontinence.

RNs specializing in treatment of a particular organ or body system usually are employed in specialty physicians’ offices or outpatient care facilities, although some are employed in hospital specialty or critical care units. For example, cardiac and vascular nurses treat patients with coronary heart disease and those who have had heart surgery, providing services such as postoperative rehabilitation. Dermatology nurses treat patients with disorders of the skin, such as skin cancer and psoriasis. Gastroenterology nurses treat patients with digestive and intestinal disorders, including ulcers, acid reflux disease, and abdominal bleeding. Some nurses in this field also specialize in endoscopic procedures, which look inside the gastrointestinal tract using a tube equipped with a light and a camera that can capture images of diseased tissue. Gynecology nurses provide care to women with disorders of the reproductive system, including endometriosis, cancer, and sexually transmitted diseases. Nephrology nurses care for patients with kidney disease caused by diabetes, hypertension, or substance abuse. Neuroscience nurses care for patients with dysfunctions of the nervous system, including brain and spinal cord injuries and seizures. Ophthalmic nurses provide care to patients with disorders of the eyes, including blindness and glaucoma, and to patients undergoing eye surgery. Orthopedic nurses care for patients with muscular and skeletal problems, including arthritis, bone fractures, and muscular dystrophy. Otorhinolaryngology nurses care for patients with ear, nose, and throat disorders, such as cleft palates, allergies, and sinus disorders. Respiratory nurses provide care to patients with respiratory disorders such as asthma, tuberculosis, and cystic fibrosis. Urology nurses care for patients with disorders of the kidneys, urinary tract, and male reproductive organs, including infections, kidney and bladder stones, and cancers.

Finally, RNs may specialize by providing preventive and acute care in all health care settings to various segments of the population, including newborns (neonatology), children and adolescents (pediatrics), adults, and the elderly (gerontology or geriatrics). RNs also may provide basic health care to patients outside of health care settings in such venues as including correctional facilities, schools, summer camps, and the military. Some RNs travel around the United States and abroad providing care to patients in areas with shortages of medical professionals.

Most RNs work as staff nurses, providing critical health care services along with physicians, surgeons, and other health care practitioners. However, some RNs choose to become advanced practice nurses, who often are considered primary health care practitioners and work independently or in collaboration with physicians. For example, clinical nurse specialists provide direct patient care and expert consultations in one of many of the nursing specialties listed above. Nurse anesthetists administer anesthesia, monitor patient’s vital signs during surgery, and provide post-anesthesia care. Nurse midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care. Nurse practitioners provide basic preventive health care to patients, and increasingly serve as primary and specialty care providers in mainly medically underserved areas. The most common areas of specialty for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and gerontology; however, there are many other specialties. In most States, advanced practice nurses can prescribe medications.

Some nurses have jobs that require little or no direct patient contact. Most of these positions still require an active RN license. Case managers ensure that all of the medical needs of patients with severe injuries and illnesses are met, including the type, location, and duration of treatment. Forensics nurses combine nursing with law enforcement by treating and investigating victims of sexual assault, child abuse, or accidental death. Infection control nurses identify, track, and control infectious outbreaks in health care facilities; develop methods of outbreak prevention and biological terrorism responses; and staff immunization clinics. Legal nurse consultants assist lawyers in medical cases by interviewing patients and witnesses, organizing medical records, determining damages and costs, locating evidence, and educating lawyers about medical issues. Nurse administrators supervise nursing staff, establish work schedules and budgets, and maintain medical supply inventories. Nurse educators teach student nurses and also provide continuing education for RNs. Nurse informaticists collect, store, and analyze nursing data in order to improve efficiency, reduce risk, and improve patient care. RNs also may work as health care consultants, public policy advisors, pharmaceutical and medical supply researchers and salespersons, and medical writers and editors.

Working Conditions	[About this section]	Back to Top

Most RNs work in well-lighted, comfortable health care facilities. Home health and public health nurses travel to patients’ homes, schools, community centers, and other sites. RNs may spend considerable time walking and standing. Patients in hospitals and nursing care facilities require 24-hour care; consequently, nurses in these institutions may work nights, weekends, and holidays. RNs also may be on call—available to work on short notice. Nurses who work in office settings are more likely to work regular business hours. About 23 percent of RNs worked part time in 2004, and 7 percent held more than one job.

Nursing has its hazards, especially in hospitals, nursing care facilities, and clinics, where nurses may care for individuals with infectious diseases. RNs must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. RNs who work with critically ill patients also may suffer emotional strain from observing patient suffering and from close personal contact with patients’ families.

Company doctor and nurse services

can have a significant impact on performance and productivity within your organisation, as well as being a highly appreciated employee benefit.

Reduces time away from work
Helps keep your staff at optimum health

Easily tailored to your staff's needs
Appreciated by your staff
Highly experienced practitioners
Nursing support

Instead of visiting their own GP, your employees will be able to see a doctor based on-site or nearby. This reduces the need to take time off and results in less disruption to the working day. These advantages can be easily illustrated:

Case 1: a key revenue generator takes time off to see her local doctor, 30 miles from the office, resulting in a whole morning of non-productivity. She has to wait two days for the appointment, whilst soldiering on under par.

Case 2: a project team member takes an afternoon off to see his home doctor - upsetting the team's performance or even halting its work entirely.

Compare these scenarios with the 15-minute appointment time needed to consult an on-site BUPA doctor and you can appreciate the potential benefits of the service to both the company and its employees.

Case study: Reducing the cost of lost time away from work to see the doctor, dentist or physiotherapist

From Undecided To Decided – A College Journey

Getting ready for college is much more than choosing the school, roommate and what hotspot is your favorite. There are many things to consider and one that is commonly overlooked, sometimes for years. Many students spend their younger and teenage years boasting what they want to be when they grow up, but when they get to college they can not make up their minds. For some, this is a panic because there are only so many basic classes that a student can take before it begins costing them. Even sometimes a few of the basics are specific or may not be required for a particular degree plan. There is nothing wrong with being undecided in the beginning, however as your college career advances, you need to make decisions about how you will spend the rest of your college life. Here are some of the basics about an undecided major and tips on choosing which degree plan to pursue.

Asking yourself a series of questions can assist in deciding on the exact path in college. There are many and even specialties in certain fields so really examining your knowledge as well as desires will assist in this important decision. You probably have narrowed the question down to maybe a specific field or may be struggling with more than one field. Could it be possible to combine the two, sometimes this makes for an excellent and highly demanded employee. Consider the following:

What is your passion – sometimes your passion may not be clear until you accidentally stumble upon something. This is present in stories such as the young lady that had always dreamed of being a teacher. As a child, she would line up her dolls and teach them the lessons she had learned that day at school. This was her plan and nothing could stand in her way, until a tragedy in the family. After her grandmother was diagnosed with cancer and she watched as she withered away, she had a notable thought. Watching how the medical profession, primarily the nurses made her grandmother comfortable and held her hand through the many long procedures changed her life forever. After very little thought or consideration the college application changed and today she is a successful nurse working in the Pediatrics field. Holding the hands of countless children while they too undergo some uncomfortable, but necessary medical treatments, is the happiest she has ever been.

Positive Attributes – Regardless of training some people are just better at some things than others. It is wise if you choose what you want to be when you grow up around something that you excel at. If you are a math whiz then you may want to consider business, accounting or some form of engineering. If it is people skills that you possess, how about a counselor, social worker or some other community helper. Generally, these individuals have exceptional listening skills, empathetic and have always been drawn to lend a helping hand. What about those that are excellent at getting the point across and are great at teaching. A teaching degree or some other form of educational career such as a diagnostician or administrator would be great. If running to the side of an injured or sick individual is your passion then pursuing a nursing degree is an exceptional idea. Nursing is not only about patching a boo-boo or holding a hand, it is about saving lives, educating patients and most of all making them feel better. Nurses are in high demand because of the nursing shortage in the United States, and God bless the nurses of this world!

Job Assessment or Placement – If your job placement assessment turned out like mine then you are in the wrong field. Keep in mind that just because your scored out at a particular field, does not mean that it is your life's career. Be careful with only using this test, because it is not 100% guaranteed. You must follow your heart and keep to something that you can feel good about doing. Because you are good at doing a particular job does not mean that it is something you want to wake up to for the next thirty years or so. Choosing a career field is a big decision and must be based on a variety of things, not just a test.

Your Parents & Their Accounting Degree- some career fields work better for some than others. You can not and should not base your career choice on what your parents have in mind for you unless it is something that you want to do. All too often college students fall into a trap of going to school for someone else and then hating their job for the rest of their lives. It is very important that you pursue the career field that interests you. A job should be a passion, something that you are ready to go and do, not dreading a forty-hour workweek that seems like hell.

Staying Undecided – It is perfectly acceptable to remain in an undecided plan until you have made your decision. There is not a huge rush to make a decision after you receive your acceptance letter. In fact many students enter one department and change two or three times before graduation. The important part of getting a college education is the fact that you are bettering your life regardless of the academic path you choose.
by Gene Grzywacz

Career Options For The Ambitious Nurse Entrepreneur

Nurses are taking control of their careers by exploring options other than the traditional roles of yester-year. Independent RN Contractors are storming the healthcare field. There was a time when nurses were hesitant about cutting the ties from the employer not true today. More and more nurses are now enjoying the many benefits of self-employment. Nurse Contractors are now a large part of the nursing industry thanks to the ambitious nurse entrepreneurs. Nurses have realized the many advantages of cutting the middleman out of nursing.

An Independent Nurse Contractor is one who practices outside the customary role of an employee of another; as an alternative they elect to work as an independent contractor. You will set the terms of your services limited only by need and your ability to negotiate. An Independent contractor can contract his or her nursing services directly with a healthcare facility or with a patient and continue bedside practice. A contractual agreement is drawn up between you and the institution. You will be able to negotiate your compensation, hours worked and length of time your services will be needed. The contract is similar to those used by nursing agencies and travel companies outlining the services to be provided, the responsibilities of both the healthcare facility and the nurse, and the length of time the services are to be provided. Nurses contract their nursing services out to a huge assortment of fields in the Healthcare Industry; Home Health, Nursing Homes, Hospitals, Rehab Centers and Doctors Offices just to name a few.

You may elect to practice as Sole Proprietors, Limited Liability Company or with others in a group using a variety of legal entities. These could include public corporations, partnerships, or other structures that professionals commonly use such as a common term “registrars” .It is actually something that nurses have been doing all along. Think about it, when you work for an agency you are doing the same thing except now you are eliminating the middle man and enjoying the all the benefits without them taking a large piece of the pie.

Any nurse can start a business, including two-year graduates and diploma nurses. No advance degrees are necessary unless your business includes diagnosing and treating medical problems. State nurse practice acts do no prohibit a nurse from starting up their own business as an Independent Nurse Contractor. Independent nurse contractor is one who contracts with a healthcare facility for nursing services. A contractual agreement is drawn up between you and the institution. You will be able to negotiate your compensation, hours worked and length of time your services will be needed. There is no prohibition in any Nurse Practice Act that prohibits your practicing as an independent contractor.

The advantages of business ownership are rewarding and challenging and far exceed the risks. No more Bosses, You are now your own chief. Dedication, ambition and long hours can increase your income, rather than increasing profits for someone else. Starting A Nursing Agency and working as an Independent Nurse Contractor is one that more and more nurses are turning to for career fulfillment. Nurses are finding that they can double or even triple their income; increase their choices as to how often when and where to work, gain professional autonomy and increase over all job satisfaction. So get rid of the “middle man” and enjoy all the benefits offered in this exciting Nursing Career Opportunity.

Visit http://www.independentrncontractor.com

Get everything needed to start up your business today