Ask the Nursing Expert about ... fostering critical thinking

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Kathy Owens, RN, MSN, DNS-CT, RAC-CT SVP, Clinical Services SAVA Senior Care
Kathy Owens, RN, MSN, DNS-CT, RAC-CT SVP, Clinical Services SAVA Senior Care

Some nurses struggle with critical clinical thinking, especially my newer nurses. The clinical orientation process mainly focuses on teaching how to document and reviews core competencies. What can I do to help increase their critical thinking skills? 

One approach that may help you mentor a nurse is creating “teaching moments.” To do this, it is helpful to think of yourself as the “Mentor” and the nurse as the “Mentee.”

Imagine there has been change in a resident's condition. The nurse approaches you, wondering how to handle the situation. Let's look at how to make this a teaching moment. 

1. The Nurse “Mentee” presents the information about the resident and the change in the resident's condition to you.  (You, the Mentor, remain quiet during this phase, allowing the Mentee to do the talking so you can assess her critical thinking skills). 

2. The Mentee tells you what she thinks is going on with the resident and why. She also discusses what the next steps should be in caring for this resident. (Again, the Mentor remains quiet, actively listening). 

3. You ask clarifying questions. You may choose to go with the Mentee to re-assess the resident, or review the resident record for more information with the Mentee.

4. You then provide feedback to the nurse, noting what she has performed well and making suggestions on opportunities for learning. 

This process requires the Mentee to commit to an assessment and plan, forces the Mentor to be quiet and listen, and provides an opportunity to give important feedback — and it turns a clinical situation into a teaching moment.