Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
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How to Enhance Critical Thinking Skills of Paediatric Critical
Care Nurses in Clinical Practice
Miss Barbara McManus RGN, RCN, H.Dip, BSc, MSc
Clinical Nurse Manager II
Paediatric Intensive Care Unit
Our Lady’s Children’s Hospital
Crumlin
Dublin 12
Ireland
+ 353 (0) 1 409 6100
barbaramcmanus@olhsc.ie
Introduction
The health care environment is both stimulating and challenging,
due to changes in advanced technology and demographics. This is
particularly evident in the critical care setting, where patient acuity
has intensified, presenting a multitude of complex conditions
(Simpson and Courtney 2002). The critical care nurse is required to
make quick judgements, use clinical reasoning skills and respond
appropriately to life-threatening conditions.
Critical thinking (CT) is associated with maintaining standards of
care, improvement of practice and achieving optimal patient
outcomes. By encouraging critical thinking skills, the nurse learns
to challenge existing therapies, recognise subtle signs of
deterioration or improvement in the patient’s condition and act
accordingly. To facilitate a psychomotor skill, one explains the
procedure, demonstrates the activity and the learner practises
under supervision. Alternatively, teaching skills from the cognitive
domain remains a challenge to the clinical facilitator.
Definition of Critical Thinking
The literature states that critical thinking is an essential skill to
integrate into the nursing curriculum (Daly 1998, Profetto-McGrath
2003, Brunt 2005a). Critical thinking theory is incorporated into
academic programmes and the terminology is used through
summative assessments.
Critical thinking is not a new concept although it remains poorly
defined and difficult to determine in clinical practice. Brunt (2005b)
defines CT as:
“the process of purposeful thinking and reflective reasoning
where practitioners examine ideas, assumptions, principles,
conclusions, beliefs, and actions in the context of nursing
practice” (p.66).
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