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VOlume l Number 5 August 201 1 4g

s, oning as a ide to belieF or action soning of intelligent. m inds com mit- denly develops, lhird degree heart(Paul, Ennis & Norris). ted to sL afe, effective client care. block. Tl1e ph vsician orders, external

cardiac pacing.In nursing, cjtical thinking for clin 'ro accom pli,sh this goal, studentsical decision m g ìs the ability vill be required tu reason about, Ho should you prepare the client

to think in a s ystematic and lo cal nursing by reading, writing, lìsten- for procedure'9.m anne. r with openness to nuestion ine and speaking critically. By doingand renect on the reasuning process so nurses vill be thinking critically How slluuld the exteE nal pacer adRLused to ensw e s, afe nursing practic e abuut nursin6y and it ensures that be applied?.and quality care (Heas lip). to gain in-depth knowledge about

nursing as .a prac c tice proL'ession. External pace niakeE fails, and tlleCritical thinking include adhe r- ph sician tells you to pE epare ror in-ence to intellectual standayds, pru- Exam ples uf cjtical thinking skills sertion of a tem porar.h pacem aker.ricicncy in usine reasoning, a com - that can be taught in nursine in-m itm ent tn develop and m ntain cludes at is, the dimerence bethveen aintellec tual tr ts of the m ind and te Enporar pacem aker and externalhabits oFthought an,d the com petent Developing pjoritizatiun skill5 cardiac pacingy7.use of khinking skills and abililies nowing vhen to call the ph5 si-

fi}r ,sound clinical judgments and cian at teaching do yuu prepare Li rs afe deci on-m aking. Producing effective docum enta- this treatm ent modalities7.

tion

Critical thinking , M lls and Anticipating worst case scenar Nurse educ aturhs nlust make stu-abílities ios dents wjte a,ssignment,s ith active

t Responding to abnorm al rind- learning aktit,ude. Studenls shouldCritical thinkers in nursine are skil- ines apprec ìate eveE h

. hing related tu

ful in appl ng intellect.ual skills for Handling unexpected patient it from CCU during theil clinicalsound reasoning. These skill,s have outcom es learning period. This m ethod willbeen defined as, inform ation gatheE - help students to learn ho to prc-in6, focusine, rem embering, urga- Cjtical tllinking includes m ore pare clicnt for procedure. positionnizin6, analyzing, generating, inte than .ju,st nursine knowledg e. It in- uf pad placcmcnts, vith suitablc atine and evaluating. The f'ucus of cludes the ability to think throueh pictures of pacem al er dcsigns avail-classroom and clinical activities is to complex, m ultifaceted problem s to able in huspital ,di èrences bet 1eend' evelop the nurse's understaridine anticipate needs, reco 'ze potential external and interna l pacem akeE ,m nof sc holarl , acadeEnic work throueh and actual com plications , and to ex- m udes and m ettin,?s in pace m akeE .s,the effective use of intellectual abili pertl ? conlmunicate with the team . testing Func tinn oí'pacem akers, tem-ties and skills. As nurses encounter A nui se who is able to think criti- porary and peE m anent pacem aker,s ,increasin6ly m ore com plex prac- call.v, will ve better patient care. advancemcnts in technolr g T relatedtice situation,s, ii will be required Vajous strate es can be used to de- to new pacemakers, identih need ofto think through and rea,s on about velop cjtic al thinking in ICU nurs- pacin6, plannin6 information to cli-nursin6 in eater depth and dra es. Nw se leaders are encouraged to ent and ram ily. Enem bers, etc.on deeper, more sop sticated com support the developmen¬ of critical-prehension of what il means tc be a thin ng s lls in less expejenced H olistic ap roachnurse in clinical practice. stan' with the goal of im pro n¬ the

nu se,s abilit T to work in the CU Treating the person as a whole, theNursing is never a s upemEcial, m ean and im prom ng patient outcc}m es. body, m ind, spirit.ingless activity. l acts in nurs, ingare deeply si ifcant and require Critîcal thinking challenee: Holistic nursing is defined as ''al3o2' the nw se a mind fully engaged in l $ am ple nw sing practice that has healing

the practice of nursing. This is the the vhole person as its goal''.challenge of nw sing; critical, renec- Client ad tted in ED with chesttive practice based on the sound rea- pain, com plains of nausea and sud- I-Iolistic nursing is a nupecialty prae

5 Nighting le Nursing Times

,

,

t:ce tnat di , L i1 nIJrs:i36T kilohh l- R ecom m endations answe?3 que , t:ons, i ?l , te?d tcdge, the orie,s, expel ti se ancl i ntLl- c,acll dis ease condi t,iun of' critiition tu 6?uicte nlIi .sc . ,s in he,comine ln critical c a) e unit.s, i3u3 ses cal thinki ng chal lenecs, so that

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thei capeutic partne,) s hh,ith people in m u,st, deliver hieh quality care i, t wi tl hc,,lp ttlem cli ni cally lo

thei3 cca) c,. 'his p LaL t.ic e recc gn izes l .s, usingT cri tical thinkin,? con- app) ecicate. N ui ,si ng stuclen ts

the to tali t..y r f t.he h Llman bei ng - the cepts mith holistic attitude t'oi m ust learn critical thin kingi n tercunncctedness t)F horl , m ind, t ettei client uutcomc,. Mui ,ses ,s W I l.s (. prr)ble)Ti iden tiric,atirli e)notiun, spirit, srtciaUcultui ,al, relca h ho think ci itically

, ap }ly siin- olv i ng, deci,sion n3, 3ki ng,, evition,s. hi E , conteKt, anrl e?nh i3 on)nent. ple to Lich , u se eoucl com in unica- dence .d practice, co6m i tive .s, ki lls

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t,ion , wiI l , ,ive t}etter clicnt ca3 e,; of :in alyzing , a pE)l.y s . tandard,s

E Iol is? tic nu3 ,se . inau inte¬ atc com - i t is an es.s . en ti,al cumpetenc L lo cal i ea,soninh , prcdicting'

p l e me nt�\i yv)a l tern a t i ve 3nod al i t ie s th a t ca l l n u rs es n eed to g i ve h igh a nd t ) ans, fnrmin,c, knoml ed,n (,,)

l CAmI ) i n to cli n i cal p ) ac t,ice tL) t ) ea t ( u al i t h. .. out coine di rectcd ., in,ak i n ide nt i f i g pri L)7 it,y n ecds to

pent7le s E hys. iul ogical , ps chulo?,ical, ing, clinical j udgments un ,scien attcnd, p ) edict unu 4ual ch;i nges_

L3nd ,spi it,Lial needs . Doinx so due 4 tific e den(:es cost cmcctive c ,li or paticnt, and f revcn L. cumpl ic :inot nexat,e the h ,al idi t.v of cunh en ent cai e. tion,st,ion at medical thc,,r c E7ie,s , hut sci Les C,linical easoilingr anclj udc,} men tto r ,om plc i3 (,,nt, broa(gen, and ei33 :c ,l3 n Li,st be? us c,,d :n cl:n:c,al pi <act:c( ,

'

C onclusionthe .scopc ? of' n ursinc,, }}l act,icc L\nd to rui pi ovidinc,, qlial it hcalthcarc?,hclp ii d ivid Lials c icces , . thei) g) (?,at- to palient. 4 t,h at oids adver,s c A nu) se vho is ahlc to think critic,.s¬, he, ili n g tot,c ,nti cal. events and pa tient harm . Murs.. cal l

.y wil l ,c?ive hetter patie,.nk carc. It

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es m ust develop the charcnctei i ncl udc,.s ,sim ple touch, tender loving_

Thie pi actice uf holi,slic nur,sinh re- and rela t,innal ski l ls, t.h,at en ca) e, cc)ns, tcant cibsei ation, n3ultifac4Liii e : nu ) se,4 . to inteKn ate sel t'-c:3re, ablc the)n ko pei ce?ive ,and un eted probl c,ins tu can ticipate needss: e3 f' rcspc}ns ibilit , sE}ii it,Li,alit . L, cnnd dei stand their p,aLient's ne?eds ) eL oeni ,e potcntial and actu al coinreflecti un in their lives,. This )nL 3 h ,\nd concc,.rns. This reqliii es ac pl ic a ti ons, and co)nm un icate wi kh

_lc? ad the? n ui se to 6T) ecatei L i t ai c,- cur:3tc interpretatir n ut' p:3tien t clien t and tvith t,eam . Nurse leadnes.. s, of t he i ntci c .on )1ectednes ; h i th dc 3t,a which i s, rele L:int tu patient ci s and nur,se cducators are encour.selt othi .,i , na tui e, an d s pii it. 'rhi s s, ituation. agcd lo suppurt thc dcve?,lopm e?,nk uf

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a aren e,s ,s m a y t'u rth e ) en h a n ce t he xpert is e i s, req u i i e d t h i o u6h crit ical th i nki ne. s ki l l s i n s, t uden ts

n Lirse,s' u nder4 tanding ut' call ii\dih id- I7i ofe s,4 ional expei ience an d ex- as h ell Las nui se practi tioners wi thuca l s, a nd theii relat,ionships to the pei-ience pi ecccle.s (,,x. pc,) tis . e. Sc) eo:il u t' im pi ovin,cT the n ur,s , e,s' abi l i ky

,hu3nan :ii\d glubal c(t)n m Lini t , and c.xpe?rt nurse,s provi(Ic? c a3 e nLith tL ork i n the IC 7 and iinprovingpei m it, n u ) .sehn tu ust , th is Lah L \) ene,ss ne xibilit - :inrl s, peed t.h ruu,c?h thc 7atient ciulcom e,sto f'aci l i t:itc? the he Lali ne E3i ocr?,s,s. com bi nation c}f l no vlc,,dgc anrl

.s kill gai ned f'ro m i :ing c or theu The h iK?h, pci fc)i m ance, expectatiunsretical and cxpe3 i ential s( Li ) ce.s c)1' nur,se.s is de,penden l up()n the

H oIistic approaches incIud- ,exI)ei t n urse? s cL \)i p3 (}vicle ilo- nlL) se's, cor)li n ual tcarn ine, 7ro Fcsed in critical care units are , l is tic cai e. (' ritic a l cc )i e u nits s? io Ilat acc( untcabilitv

u , ii3dependcnt_

'

.shou ld hy e c,xpei t. anc1 experi- : nd in t.crdependent dc,,ci,siun m aka. rel�\x�iliu)l thcrn pies e?nced nu r,s. c,s kn p3 cactice. N L) rse, i n6, ci-c,,ativr?, problr,,)n sul n6 abi l ib. mc ss a6} e leade l s in L)st a ssess ti mc lu ti me tit?

,.s cand guc)d c(i)ninunic;ition skil lsc. . i iinf le to Lich , ind identi f'

.s the learni ng nc,eds..ri. idc,cl iinag. inai . , r}F n L)i se.4, i)\ CCU and plan ,staft'

L . pi a.vcrs etc develnpi 3ent p3 og i :\inmes ec) ob R ere encest,ain learn ingy experien( ,e ,s

' uch ,i )lt,e?r Tentir)ns atrect whr le Nu ) sc eclucatoi s must e'm pha l. Pott,er and Per4 - r, tic .al

L, i s. on ,a n cl !n e l p i n a ugm en ti n g s i e 1i om ba se Ic,. Lel ne i :icticr?, th i n kingy i n nu rsi ng pr,acti c ,e, tand Li rcl treat,nlents., l rctm c)te c 3nd relc 3 lc,,d to ci itical thín iii?

. ap 'P L)nda)nc? nt:3ts r l' nu r,singT. .6tth'

m Li i nia i n h e,alth anLt i ep lace certaiii ,n lica ' on s n ith n ui ,sinc,, pi r)cess n di t,ion ,ino,sbv .etycvie,r.page O

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i n t(,..i Lc? n ti on s. ut cach cii ent. S t uden ts )n u sl to 7 3

lolume l Number 5 ugust O1 1 1

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uT sic Lll nur . . .i ng -c i icyl t tlinl{- Thìnkin,c,J. S lls i n Nur,s. ins St,ll B? Ann h : n iner r(}n e?

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in6 fi.}E collabur , rt,ih,e car c.. t't,h den t b 1 Gl oup U v. nam ics ' Raile Allig?iTod. cr itic:l,l car e : cti ,ie d i t i (l E , E l .s e v i {<, t p u b l i c a t i o n . tìes pyge n n 1 83 to l Y()l}aec. to 5 , l 56, X 9. . .

rj. he he . c r i t, i c . a l th i n k i ng. o rg?/resour ce : (HE/ctand n elr,sing.ct'm

3 . Jav a l L ru v i l l y .

E ,s t n t ial s o r c rit- " 9 . ww . c a t c , ( , rto o l l j l,s . c.o m/rl (I ( s..

ical c Larc nuT sin e?.j a?. Tpee 7m bl i c a- G. nurx4e-r e , l'ere nce..b1 og ,sput,.comJca r- i n cl iti c .:T l c ar e-n eE r,4ins.h tm3

tion. nr h de lh i in¬ -nlrr , ,e 4-cl i( ,ical thinl ing-i n. h10. w th w . n h n a. o E sT ( J l o e t, lJ .4, (

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