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Running Head: Using the Nursing Process 1

The Nursing Process and Developing Critical Thinking

Channing Derrick
Dixie State University

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The Nursing Process and Developing Critical Thinking
The Nursing Process is a systematic way to assess and collect information about a
patient you are caring for. It involves a series of steps and utilizes guidelines to organize
information and data that is received. Nurses must also use critical thinking while providing
care. Critical thinking involves looking at the whole picture and not overlooking or discarding
any information that could be relevant. Critical thinking and using the nursing process go hand
in hand, and both should be used during planning and implementing patient care on a regular
What is the Nursing Process?
The nursing process contains six steps and is remembered by using the acronym
ADOPIE. Assessment, Diagnosis, Outcome, Prevention, Intervention, and Evaluation are used
to collect patient data and evaluate their care. Assessment is the first step in developing and
delivering patient care. The American Association of Nursing states that, An assessment
includes not only physiological data, but also psychological, sociocultural, spiritual, economic,
and life-style factors as well (American Nurses Association, 2014). It is important that we assess
the whole patient. It is more than just doing a basic physical assessment. Psychological, cultural,
spiritual needs can also play into ones plan of care. Pain must also be assessed during this
stage. Questions about pain onset, location, duration, exacerbation, radiation, relief, and
severity should all be included.
Diagnosing relates to the nurse assessing and finding problems or those that the patient
might be at risk for. When a nurse makes a diagnosis, they use all the information gathered in
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the first step of the nursing process, and piece together a plan of care. The nurse uses critical
thinking and clinical judgment to identify the problem.
Outcome and Prevention are the third and fourth step, and are often grouped together.
The nurse and patient should set goals together. These goals are specific and relate to each
problem identified. These goals are individualized, and can be short or long term. Assessment
data, diagnosis, and goals are written in the patients care plan so that nurses, as well as other
health professionals caring for the patient, have access to it (American Nurses Association,
2014). Doing this ensures that other members of the health care team can look at and have
access to the patients goals.
The intervention step is next. Interventions are implemented to assure continuity of
care is done while patient is in the hospital. This care is done up until the time of discharge.
Interventions are used to help decrease the severity or fix those problems that were identified
during the assessment. The nurse must critically think and come up with interventions that will
help with each diagnosis.
Evaluation is the final step of the nursing process. A good nurse will evaluate throughout
the entire nursing process. One must reflect and evaluate the plan of care that is set for each
patient. If an intervention isnt meeting the need of the patient, why continue doing it? If the
interventions arent working and the patient isnt improving, something needs to be changed.
Nurses should always be reviewing and updating their plan of care. Something that works one
day might not always work the next.

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How to Utilize Critical Thinking While Using the Nursing Process.
The purpose of the nursing process is to help nurses manage each patients care
scientifically, holistically, and creatively (Taylor, Lillis, LeMone & Lynn, 2011). In order to do this,
the nurse needs to acquire specific cognitive and technical skills, along with having the
motivation and willingness to promote and restore health. Cognitively skilled nurses are critical
thinkers. Critical thinking is defined as, thought that is disciplined, comprehensive, based on
intellectual standards, and, as a result, well-reasoned; a systematic way to form and shape
ones thinking that functions purposefully and exactingly (Taylor, Lillis, LeMone & Lynn, 2011).
When thinking critically, there are 5 suggestions the Fundamentals of Nursing textbook
outlines. The first is to identify a purpose of your thinking. Nurses must focus on a goal and
filter out any unnecessary thoughts or ideas. A nurses goal should be to make a decision and
decide on how to best intervene. The second is to look at the knowledge one has. Is this
knowledge accurate and complete? Or iss important information left out? Each nurse should
also evaluate as to whether or not they understand all of the details within the problem. The
third suggestion is learning how to flag potential problems. Think about ways to deal with these
problems and continue working towards the goal. Nurses do not want their thinking to be
biased. Emotion can also get in the way of critical thinking in this area. The fourth is to identify
helpful resources and use them when needed. Not everyone knows all the answers. Identify
resources that are experienced or can help you in your deficiencies. Some key resources could
be clinicians, textbooks, policies and procedure manuals, and professional groups. Last is
identifying opposing views or opinions and incorporating those into the decision. All factors
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should be weighed and evaluated before drawing a conclusion. Using these suggestions will aid
in developing critical thinking.

Nurses are trusted and depended on, in their profession, to complete the total care of
those they treat. Using the nursing process is key to grasping the entire picture and making
an accurate and complete plan of care. Starting with assessment and working through each
step will help organize the care for the people we care for. Each plan of care will not be perfect
and will most likely have to be modified. That is why it is important that nurses be able to
critically think and reason through this process. Critical thinking is weighing all possible factors
and looking outside the box for answers. It is a complete process of thinking and requires

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American Nurses Association (2014). The Nursing Process. Retrieved February 28, 2014, from

Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of Nursing. (7th ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.