[Sharon]

Nurses use critical thinking skills every day. Think of a time you used critical thinking in your nursing role; now share your example online explaining why you feel it was critical thinking and not just decision making or problem-solving.

[Jaswinder]

At my workplace as a nurse I applied critical thinking when caring to a patient who suddenly complaints of dyspnea. I checked the vital signs, patient oxygen saturation had dropped as compared to previous readings. I assessed the patient again and listen the lung sounds , checked the patient history and current medications. After getting more information reported to the healthcare team and the patient was assessed by the RN and doctors. After evaluation the healthcare team informed that the patient was experiencing respiratory complications that require urgent medical care.
I believe I used critical thinking instead of simple decision making because I didn’t depend on only one symptom. Before reaching any decision, gathered more information and did comparison with normal condition and considered potential causes.

[Shea]

Hello,
I agree with your example, it really shows how important critical thinking is with one symptom present. You completed your assessment in a timely manner , compared it to the patient’s baseline and considered possible causes before involving the healthcare team. Critical thinking allowed you to care for your patient in a timely manner so they could receive the care they required.

[Cheryl]

I had a client who was becoming quite aggressive in his home during a respite home visit where my staff was on their own. She tried de-escalating and reorientating client along with offering distractions etc. Every single thing tried (in calm demeanor) was only escalating things. This client had dementia and was looking for his wife as she had left during the respite visit. The staff called me in a panic. She was advised to leave the visit and I called wife to return home. The staff remained on the phone with me until wife came home and monitored the client for elopement etc. Had the client tried to elope, then 911 would have been called for police. Staff’s safety is of the utmost importance and her being removed from the risk of harm was important, however having her stay onsight and monitor his behavior from afar ensured his safety as well. In the end, no one was harmed and wife came home with no incident.

[Shea]

One time I used critical thinking in my nursing role was when a resident in long-term care suddenly became more confused and weak than usual during my shift. At first it could have been easy to assume it was from increased behavior due to their diagnosis. Instead, I assessed the resident more closely, checked their vital signs, reviewed their documentation, and spoke with the personal support workers about any changes they noticed. I also considered possible causes such as infection or dehydration and reported my findings to the NP, a urine was obtained and the resident was assessed by the NP and treated for a urinary tract infection. I believe this was critical thinking because I did not just assume the resident was having behaviors and continue to monitor. I used critical thinking to investigate further, looked at the whole situation, considered different possibilities, and used my clinical judgment to decide the next steps to keep the resident safe which was to send a referral to the NP for follow up based off my assessment.

[Thea]

Hi Shea,
Your example clearly shows how important critical thinking is in nursing. Instead of just assuming the resident’s confusion and weakness were due to their existing diagnosis, you took extra steps to look into the situation. You checked vital signs, reviewed documentation, and spoke with PSWs, which helped you understand what was really going on. By considering other possible causes, such as infection or dehydration, you demonstrated strong clinical reasoning. Getting the NP involved based on your findings led to the discovery and treatment of the urinary tract infection. This is a great example of how critical thinking keeps residents safe and leads to better outcomes in long-term care.

[Jaswinder]

It is a good example of critical thinking in nursing practice. You didn’t assume anything, you took time to carefully assess the resident and getting information from others. By considering all the possible causes and share the findings with other staff, ensured that patient receive the right care without any potential error. Your actions indicate that how important it is to collect the information and thinks critical before taking any further action to keep residents safe and encourage their well being.

[Thea]

Nurses use critical thinking every day to assess situations, analyze information, and make decisions that affect patient care. When I worked in long-term care, I noticed one evening that a resident seemed more confused and agitated than usual. It could have been easy to assume this was just sundowning, which is common with dementia. Instead, I chose to take a closer look at what was happening.

I checked the resident’s vital signs, observed their behaviour, and reviewed their recent charting and medications. When I talked with the resident, I noticed they looked uncomfortable. After investigating further, I suspected the resident might have a urinary tract infection, which can cause confusion in older adults. I told the charge nurse what I found and contacted the physician. Tests later confirmed the infection.

This situation shows that critical thinking is more than just making decisions or solving problems. I gathered information, questioned my initial thoughts, and considered other possible causes for the change. Critical thinking means looking at the evidence, thinking about different reasons, and using your judgment to decide what to do. By doing this, I identified the real problem and ensured the resident received the right care.

This experience reminded me of the importance of critical thinking in nursing. It helps prevent missed diagnoses and ensures residents receive safe, effective care.

[Marion Catherine]

Common to all health care facilities, the overburdened PSW population is being further stretched to the point where the work environment is unsafe. Increasing behaviours resulting from the progression of the residents’ diagnoses create an unstable environment on the unit. The residents become suspicious and paranoid about their neighbours and often this creates episodes of verbal and or physical aggression. I work on a locked unit caring for residents with increasing behaviours due to the progression of their diseases.
During the last hour of the shift, at the nurses’ station, the two units’ PSWs and one of the 2 RPNs were gathered and engaged in a discussion of how to address the unmanageable workload the PSWs were expected to complete during the shift. The other RPN mentioned to the PSWs that when she addressed the issue to their supervisor earlier in the week, a very unsavory response was provided. I was not an active participant in this conversation as I was documenting and charting an intervention for a resident who was experiencing a symptom of sundowning, but I was listening. A deafening silence broke out when the question, ‘’what we can do now if the supervisor is unwilling to discuss the matter’’ was asked.
In the split seconds of that silence, I considered who was at the nurses station, that my unit was unsupervised, and sundowning behaviours were emerging. I simply and clearly stated to go to the Union. It was a quick remedy, and the Union has the time to invest in resolving this concern. This suggestion was not accepted and the discussion carried on about their next steps. As the conversation resumed, I left the station to get back on the unit to ensure the residents were safe and supervised.
I consider this to be a decision showing critical thinking because the other RPN who is a full-time nurse on the unit was managing the situation with the PSWs and had been leading this conversation all week.
I offered my opinion to go to the Union as this matter was ongoing and increasingly worrisome, and that timeliness was of the essence. In assessing the situations at hand, I responded to the area that also needed immediate support – the residents safety and wellbeing – while the rest of the staff took the time needed to devise a plan of action to ensure safer work expectations. Standing by the PSWs and supporting a group decision on how to resolve their concerns is an important task in leadership. However, given the immediate concerns for the well-being of the residents under my care, and that the other RPN was already very engaged with the PSW situation, I chose to get back on the unit to ensure the safety and wellbeing of the residents and address an issue that was brought to my attention regarding an escalating aggressive behaviour.

[Tammy]

hi all
one time at my work, there was a resident whom became almost unresponsive at the breakfast table after recieving medication. she was a diabetic and it could have been assumed that her BG was low or even that she was more tired from a poor night sleep r/t new pain. her intial bg check was within range, it then checked again after some sugar was administered and found to be lower. she was sent to the ER and admitted to hospital where they evaluated her medication and also explored the new pain and was sent home with more supports. if she was not sent and more attempts to raise her BGs were only explored, she wouldnt have had more diagnostics done or had more supports in place.

[Angusami]

Hello,
Thank you for sharing you experience. You took initiative, followed the nursing process and took appropriate action, based on your critical thinking that benefitted the resident.

[Sharon]

Critical thinking contributes immensely to patient safety. In this case recognizing that treating the initial low is not enough; and re-evaluating the client to ensure resolution was very critical. Also been able to recognizing the need for further medical investigation was crucial in this case. Well done.

[Angusami]

Hello,
Critical thinking in nursing is vital and we tend to use every shift. It also based on your nursing process – diagnosis, assessment and appropriate intervention. I used critical thinking on a specific shift, when our staff member reported that resident has an acute confusion- imagining things. I completed the initial assessment on the resident, vitals, pain assessment, x no days with confusion, previous episodes of same complaints and any other associated symptoms ( i.e cloudy urine). Based on the assessment findings, I informed the RN supervisor for further direction. NP was contacted/ordered collection urine sample and resident was started on antibiotic treatment appropriately.

[Vanessa]

Great example of critical thinking. You utilized your nursing skills and your example is evident that you are a good listener as took the staff members report seriously. You further identified that that the RN needed to be informed, escalating further treatment for the resident.

[Vanessa]

When I worked as a restorative care nurse, I relied on my critical thinking skills to develop individualized care plans that truly reflected each residents goals, abilities, and potential for for improvement, Creating these plans meant looking beyond standardized interventions and carefully assessing what each resident needed to succeed. I regularly analyzed progress and success rates adjusting interventions when outcomes weren’t meeting expectations or when a residents condition changed. This constant cycle of assessment, planning and evaluation helped ensure that every care plan remained meaningful, achievable nd centered on the resident’s personal goals.

[Sharon]

Critical thinking contributes immensely to patient safety. I rely on my critical thinking skills to administer medication by utilizing the rights of medication administration. Administering medication is a routine for some nurses but it is a critical task. Medication errors can lead to severe consequences sometimes even death. Critical thinking allows nurses to double-check , some times triple- check medication orders and ensure the correct dosage is administered. I remember overseeing a new nurse as she prep her meds for medication administration for a client ; while she was gathering the meds I asked that we double check the meds together. It was at this time that we caught that she had mistakenly poured 2 tabs of Clobazam as opposed to pouring 1 tab as per MAR. Critical thinking in nursing enhances the overall quality of care.

[Brittany]

In my daily practice, I consistently apply critical thinking, not only in routine care but also in high-pressure situations. A recent example occurred while working in a clinic when a patient experienced an anaphylactic reaction following an allergy shot. This was one of his final maintenance doses after years of treatment. Our clinic policy states that patients must remain for a 30-minute observation period post-injection. However, this patient left the waiting area after only five minutes and went to his car, where he began experiencing symptoms of anaphylaxis. Fortunately, he was able to return to the clinic, alerting staff. Recognizing the urgency of the situation, I immediately went to retrieve an epinephrine auto-injector. Upon arrival at the emergency kit, I discovered that the EpiPen had expired by over one year. Quickly reassessing, I identified that there was a pharmacy within the building and ran there to obtain a new, unexpired EpiPen while our registered staff waited with the patient. After administering the medication, I remained with the patient, closely monitoring vital signs until EMS arrived.
This experience reinforced the importance of rapid decision-making, adaptability, and situational awareness. Since this incident, I have become more vigilant in ensuring patients adhere strictly to the 30-minute observation period and take extra steps to monitor them closely, including checking on them every 10 minutes when clinic time allows. It also highlighted the importance of regularly checking emergency equipment to ensure readiness. Had a pharmacy not been immediately accessible, the outcome could have been significantly different.

[Marilyn]

As we enter week 4, the conversation has been very rich; filled with critical thinking and implementation. So far, this discussion really highlights how essential critical thinking is in nursing practice.

Reading the responses about your experiences reinforced that critical thinking is used in many situations, whether identifying infections behind confusion, managing challenging behaviors, preventing medication errors, or responding to emergencies.

The biggest takeaway from the conversation so far is the importance of gathering complete information, considering different possible causes, and acting promptly.

Great conversation so far and I’m looking forward to further contributions.

[Author]

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