Critical thinking is a term we hear quite often in nursing. Most often we associate critical thinking with the bedside or clinic nurse as they care for patients. According to Tim Porter-O’Grady and associates, however, critical thinking is a fundamental element of nursing leadership. In this blog article we will explore critical thinking and its impact on the Charge Nurse role.
Porter-O’Grady and associates define critical thinking as a discipline. The discipline of critical thinking is a process that “frames…thoughts, decisions, and actions in a way that is both systematic and explicit”. Critical thinking creates a factual foundation for accurate and effective decision-making.
Critical Thinking is Fundamental to Making Good Day-to-Day Decisions
The critical thinking process includes accurate interpretation of data, analysis, inference, evaluation, and self-regulation. Accurate interpretation of data, analysis and inference help to draw reasonable conclusions and set the stage for effective decision-making. Evaluation determines the reliability and viability of the conclusions and leads to a logical and well-thought-out decision.
Self-regulation, or reflection, facilitates the examination of the decisions to identify any bias, inaccurate information, lack of data, and/or flawed conclusions that impacted the decision. Self-regulation enhances the critical thinking process by refining interpretation, analysis, inference and evaluation skills.
Charge nurses manage the day-to-day operations of the nursing unit and/or clinic. Effective decision-making is critical to their role. Decision-making in the clinical environment must be timely and each situation is unique. Critical thinking skills are essential for charge nurses to support safe patient care, as well as employee satisfaction and retention.
Essential for Evidence-based Practice to Thrive
For evidence-based practice to thrive, critical thinking must be the norm and not the exception. Critical thinking challenges the status-quo and encourages different perspectives to handling complex situations. The reflection inherent in critical thinking facilitates change.
As frontline leaders, charge nurses need to understand how critical thinking fosters evidence-based practice. Charge nurses need to learn and continuously reflect on their critical thinking skills, particularly how those skills are impacting evidence-based practice on their units.
The Importance of Creating a “Spirit of Critical Thinking”
Porter-O’Grady and associates share that the nurse leaders’ role in the clinical environment is to create a “spirit of critical thinking”. This supports a safe-space for asking questions, challenging the norm, and fostering change through the facilitation of curiosity, creativity, inquiry, and evaluation.
The discipline of critical thinking raises the standard of practice which promotes excellence with a commitment to “find, define, and expand best clinical practices”. Charge nurses are ideally situated in the nursing leadership structure to nurture a “spirit of critical thinking” on their units.
Transferability of Critical Thinking from Clinical to Leader Role… Not a Given
Critical thinking is not inherent, it must be learned and practiced. Clinical nurses are often moved into charge nurse roles without formal preparation for this unit-based leadership position. The literature shows that structured professional development for clinical nurses transitioning to the role of charge nurse improves confidence as well as quality outcomes.
Critical thinking skills is one aspect identified as essential in charge nurse development as a unit-based leader. It is easy to assume that the critical thinking skills that clinical nurses use will automatically translate into their role as a charge nurse. The research literature does not support this assumption.
Clinical nurses transitioning into the charge nurse role need to learn and practice critical thinking skills as a nurse leader. Charge nurses need to incorporate curiosity, compassion, honesty, mindfulness, decisiveness, willingness, and creativity into their leadership skill set. Charge nurses also need to be able to foster these traits in their teams to create that “spirit of critical thinking”.
Role Model Critical Thinking and Help Others Meet the Challenges
Porter-O’Grady identifies that nurse leaders must role-model critical thinking as well as continue to develop their own discipline of critical thinking. Role-modeling must include the value of critical thinking in their specific leadership role as well as demonstrate the value of critical thinking in clinical practice. The complexity of the healthcare environment demands the ability to adapt, and change based on constantly shifting information. The discipline of critical thinking helps nurse leaders meet those challenges.
Charge nurses, with formal professional development from a program like NCharge®: Nurses Learning to Lead, can develop the discipline of critical thinking and thereby role model that discipline for the clinical teams on their units. Contact us today to learn about our recently updated NCharge course, Critical Thinking for Frontline Nurse Leaders.
Author: Joyce K. Borgfeld, DNP, RN, NE-BC
References:
Breedlove, D. W., Amiri, A., & Arris, L. (2021). Evaluating the efficacy of an evidence-based charge nurse professional development activity at a highly complex Veterans Affairs medical center. Journal for Nurses in Professional Development, 38(2), E19-E24.
Kramer, M. & Davies, C. C. (2021). A charge nurse orientation and development program. Journal for Nurses in Professional Development, 37(5), 268-277.
Porter-O’Grady, T., Igein, G., Alexander, D., Blaylock, J., McComb, D., & Williams, S. (2005). Critical thinking for nursing leadership. Nurse Leader, 3(4), 28-31.
Catalyst Learning (2024). NCharge Nurses Learning to Lead Series: Critical Thinking Skills for Charge Nurses. Louisville, KY: Catalyst Learning Company.