In this article “Use of critical thinking in the diagnostic process”, the principle of critical thinking (CT) is illustrated as an important component during diagnoses since it helps in realizing accurate diagnoses. With the realization that the responses provided by patients are foundational in diagnoses, it is emphasized that nurses need to encompass CT during nursing diagnoses as this helps in unraveling the complexity and uniqueness of human beings. Lunney (2010) mentions that metacognition as competency in nursing should be improved among nurses since there are variations in CT competency among individuals. Moreover, the author highlights that repetitive application of CT concepts is helpful in improving CT. Before demonstrating that critical thinking can enhance accuracy in nursing diagnoses, the author of this article describes 7 cognitive skills as well as 10 habits of mind that nurses should apply in the diagnosis process. It is advised that a total of 17 critical thinking items should be used, if possible since there are no specific skills for specific diagnoses that have been identified this far.
A case study of a 61-year old woman suffering from heart failure has been provided as an illustration of how the use of CT can reach an accurate diagnosis. Data about the patient was collected in three phases, beginning with phase one which has a shallow description of the patient’s condition. The first phase describes the age, sex, and ethnicity of the patient in addition to several aspects of the patient’s history such as prior hospitalizations for the same condition, BP, and HR measures among others. In this phase, Lunney (2010) warns that it is inappropriate to make a diagnosis since the information is insufficient. As such, the author advises the application of information-seeking CT skills to gather more information and also use open-mindedness to assess the patient’s views on hospitalization.
In the second phase, more information is provided and this includes the family and career background of the patient. Data from the second phase of the assessment is utilized together with CT skills of analyzing (according to context) and seeking more information to make an accurate diagnosis. Furthermore, it is emphasized that the nurse ought to apply flexibility as a way of exploring more possible diagnoses. Intellectual integrity as a habit of mind provides the best solution to use with the patient. In the third phase, more information is sought and the medication, intervention, feelings, and thoughts of the patient regarding the whole experience with the condition are assessed. More CT skills are used with an emphasis on analyzing skills, flexibility and logical thinking which result in an accurate diagnosis that the patient needed assistance in self-health management. Other skills that were applied include discrimination as an aid to decision making, logical reasoning as a rationale to the selected intervention and the skill of predicting to visualize the likely benefits after the intervention.
The author of this article describes that even if nurses do not apply all the 17 CT items, repeating the use of CT skills is helpful in getting appropriate interventions. It is suggested that students, as well as clinicians, can enhance their metacognition abilities by illustrating their thinking process in writing (clinical journals) when dealing with patients and this leads to professional growth. Indeed, this article provides evidence that critical thinking should be emphasized as a component of nursing diagnoses if nurses are to remain helpful in achieving healthy living among individuals and communities as well.
References
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal of Nursing Terminologies and Classifications, 21(2):82-88.