Nursing Strategies for Success Chapter 5 Critical, creative & Practical thinking

Successful intelligent thinking is BALANCED

What is thinking? Asking questions  Move towards answers

There is no such thing as a bad question.

“Only students who have questions are really thinking and learning” Ask students – do you believe it? Ask questions that stimulate thought.

“The difference between good science and great science is the quality of the questions posed.” ~ William Hunter

Can you get smarter?

How can You improve your analytical thinking skills? AKA: Critical Thinking Gathering information Analyzing & Clarify Evaluating for the purpose of Gaining understanding Solving a problem Making a decision Writing a paper on nursing ethics: Review assignment – what are the requirements - research out relevant information Choose two topics, find 4-5 comprehensive pieces on each Sick patient: Diagnosis of diabetes Review in mind pathophysiology of diabetes? What might be wrong? Obtain data: -read their chart lab values, medications FSBS Vital signs Assess urine output Assess skin for dryness, color,

6 stages of Cognitive learning Knowledge Comprehension Application Analysis Synthesis Evaluation

6 stages of Cognitive learning Knowledge Comprehension Application Analysis Synthesis Evaluation Memorize

6 stages of Cognitive learning Understand Knowledge Comprehension Application Analysis Synthesis Evaluation

6 stages of Cognitive learning Knowledge Comprehension Application Analysis Synthesis Evaluation Use the information

6 stages of Cognitive learning Knowledge Comprehension Application Analysis Synthesis Evaluation How does this relate Break information into parts Separate the ideas Compare and Contrast Examine cause and effect* Look for themes, patterns and categories the ideas Paper: ER nurse: different types of ER nurses. Triage. Cardic monitor. Major trauma ICU: CCU, Neonatal ICU(NICU) Telemetry Diabetic patient: Vital signs FSBS Medications

6 stages of Cognitive learning Knowledge Comprehension Application Analysis Synthesis Evaluation Develop new ideas

6 stages of Cognitive learning Knowledge Comprehension Application Analysis Synthesis Evaluation Judge

Assumptions A thing that is accepted as true or as certain to happen, without proof

A conclusion reached on the basis of evidence and reasoning Inference A conclusion reached on the basis of evidence and reasoning

How to Improve your creative thinking skills Everyone knows what Post-it®  notes are: They are those great little self-stick notepapers.  Most people have Post-it®  Notes.   Most people use them.  Most people love them.  But Post-it®  Notes were not a planned product.  No one got the idea and then stayed up nights to invent it.  A man named Spencer Silver was working in the 3M research laboratories in 1970 trying to find a strong adhesive.  Silver developed a new adhesive, but it was even weaker than what 3M already manufactured.  It stuck to objects, but could easily be lifted off.   It was super weak instead of super strong.  No one knew what to do with the stuff, but Silver didn't discard it.  Then one Sunday four years later, another 3M scientist named Arthur Fry was singing in the church's choir.  He used markers to keep his place in the hymnal, but they kept falling out of the book.  Remembering Silver's adhesive, Fry used some to coat his markers.  Success!  With the weak adhesive, the markers stayed in place, yet lifted off without damaging the pages.  3M began distributing Post-it ® Notes nationwide in 1980 -- ten years after Silver developed the super weak adhesive.  Today they are one of the most popular office products available.

Improving creativity Brainstorming Divergent thinking Group think

Shift your perspective Improving creativity Shift your perspective Challenge assumptions Take a new and different look Ask “what if” questions

Improving creativity Set the stage for creativity Choose – or create environments that free your mind Be curious Give yourself time to “sit” with a question Believe in yourself as a creative thinker

Improving Creativity Take risks Fly in the face of convention Let mistakes be Okay

Improving practical thinking skills offered, "Experience keeps a dear school, yet fools learn in no other.“

Practical thinking means action! Stay motivated Make the most of your personal strengths When things go wrong, accept responsibility and reject self pity Focus on the goal and avoid distractions Manage time and tasks effectively Believe in yourself

Practical Thiking

Introduction: Nursing Process Communication tool Organization tool A systematic method of providing care to clients Allows nurses to communicate plans and activities Encourages orderly thought, analysis, planning Clients Health care providers Families

Overview of the Nursing Process Purpose: Individualized Holistic Effective Efficient Nursing CARE Process: “A series of steps or acts that lead to accomplishment of some goal or purpose” Purpose is to provide client care that is: Individualized Holistic Effective Efficient

Holistic Health Treat the Whole person Mental Spiritual Social Physical Holistic health is a concept in medical practice upholding that all aspects of people's needs, psychological, physical spiritual and social should be taken into account and seen as a whole.

Overview of the Nursing Process Consists of 5 steps AD-PIE Build on each other Not linear

Nursing Process Used throughout the life span

Used in every care setting

Assessment Step #1 Involves Collecting data Validating the data Organizing the data Interpreting the data Documenting the data

Assessment Types of Data Subjective / Symptom Data from the pt’s viewpoint Interview Types of data Subjective Data from the client’s point of view Feelings, Perceptions, Concerns Main way to collect subjective data: Interview Objective Observable & measurable data Main way to collect objective data: Physical assessment Lab and diagnostic testing

Assessment Types of Data Objective / Signs Observable & measurable PE assessment Lab Dx testing Types of data Subjective Data from the client’s point of view Feelings, Perceptions, Concerns Main way to collect subjective data: Interview Objective Observable & measurable data Main way to collect objective data: Physical assessment Lab and diagnostic testing

Diagnosis Step 2 in the nursing process Formulating a nursing diagnosis Analysis and synthesis of data

Nursing diagnosis: “A clinical judgment… about an individual, family or community… responses to actual or potential health problems” Forms the basis for nursing interventions “A clinical judgment about individual, family or community responses to actual or potential heal problems / life processes. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable.”

Medical vs. Nursing diagnosis Medical diagnosis Nursing diagnosis Identifies conditions the MD is licensed & qualified to treat Identifies situations the nurse is licensed & qualified to treat Focuses on illness, injury or disease Focuses on the clients responses to actual or potential problems

Medical vs. Nursing diagnosis Medical diagnosis Nursing diagnosis Remains constant Changes as the clients response changes i.e. Breast cancer i.e. Knowledge deficit Powerlessness Grieving, anticipatory Body image disturbance Individual coping, ineffective

Planning Step 3

Planning Goals

Interventions! What are we going to do? Planning Interventions! What are we going to do? Independent nursing interventions No order needed Elevate edematous legs Listening Interdependent nursing interventions In conjunction with an interdisciplinary team member Assist client with physical therapy exercises Dependent nursing interventions Require an order Administering of medications

Prioritizing Nrs Dx Maslow’s hierarchy of needs

Maslow’s Hierarchy of Needs Physiological: Breathing, food, water, sleep, homeostasis, excretion ABC’s Physiological: Breathing, food, water, sex (gender) sleep, homeostasis, excretion ABC’s Airway Breathing Circulation Safety Security of body, or employment, or resources, or morality, of the family, of health, of property Love/Belonging Friendship, family, sexual intimacy Esteem Self esteem, confidence, achievement, respect of others, respect by others Self-Actualization Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts

Maslow’s Hierarchy of Needs Safety Security of body, employment, resources, morality, family, health or property Physiological Physiological: Breathing, food, water, sex (gender) sleep, homeostasis, excretion ABC’s Airway Breathing Circulation Safety Security of body, or employment, or resources, or morality, of the family, of health, of property Love/Belonging Friendship, family, sexual intimacy Esteem Self esteem, confidence, achievement, respect of others, respect by others Self-Actualization Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts

Maslow’s Hierarchy of Needs Love/Belonging Friendship, family, sexual intimacy Safety Physiological: Physiological: Breathing, food, water, sex (gender) sleep, homeostasis, excretion ABC’s Airway Breathing Circulation Safety Security of body, or employment, or resources, or morality, of the family, of health, of property Love/Belonging Friendship, family, sexual intimacy Esteem Self esteem, confidence, achievement, respect of others, respect by others Self-Actualization Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts

Maslow’s Hierarchy of Needs Esteem Self esteem, confidence, achievement, respect of others, respect by others Love/Belonging Safety Physiological Physiological: Breathing, food, water, sex (gender) sleep, homeostasis, excretion ABC’s Airway Breathing Circulation Safety Security of body, or employment, or resources, or morality, of the family, of health, of property Love/Belonging Friendship, family, sexual intimacy Esteem Self esteem, confidence, achievement, respect of others, respect by others Self-Actualization Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts

Maslow’s Hierarchy of Needs Self-Actualization Creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts Esteem Love/Belonging Safety Physiological: Physiological: Breathing, food, water, sex (gender) sleep, homeostasis, excretion ABC’s Airway Breathing Circulation Safety Security of body, or employment, or resources, or morality, of the family, of health, of property Love/Belonging Friendship, family, sexual intimacy Esteem Self esteem, confidence, achievement, respect of others, respect by others Self-Actualization Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts

Implementation 4th step: Execution of the care plan

Implementation 5 Rights of Implementation Right patient Right medication Right route Right dose / amount Right time

Evaluation 5th step Have the clients goals have been met, partially met or not met. Determining whether the clients goals have been met, partially met or not met.