Critical Thinking and Reflective Practice

Questions: 1.Describe the differences between critical thiking ,creative thinking and problem solving fromm a nursing perspective?2.Identify and apply the characteristics of problem solving to the steps of the nursing process and developlment of nursing caree plans? Answers: Critical Thinking and Reflective Practice 1. Critical thinking is both an intellectual ability and skill that enables one to identify a challenge and have reasonable reflective thinking based on evidence that answers the questions that may arise from a particular problem in the effort to find a solution (LeMone, et al. 2011). Critical thinking also involves identification of multiple alternative solutions, their applicability and effectiveness and communication with other parties about the solution implementation as well as how to optimize the outcomes. Critical thinking helps in understanding and implementing a well-judged solution for a given problem considerate of all determinant aspects (Potter et al. 2015). On the other hand, creative thinking is the approach to a problem from a new perspective that is not determined by the conventional approach to providing unorthodox solutions that may be equally effective or better than the broadly advocated for approaches. Creative thinking may be out of the integration of prior kno wledge from various fields in which a relationship is established to enhance the effectiveness of the resultant solution (Standing, 2017). Both critical thinking and creative thinking in nursing are aimed at problem-solving which is the mental process of discovering, analyzing and resolving a problem by strategically overcoming the obstacles presented by the issues of the particular challenge (Marriner, 2012). They are both essential in the development of new evidence with a balanced view of the implications of the implementation of the envisioned solutions. Creative thinking instigates research, evidence-based theory and evidence-based practice (LeMone, et al. 2011). 2. The problem-solving approach to nursing is a step-by-step scientifically informed the process of identifying a problem, planning and implementing solutions as well as evaluating the effectiveness of the implemented interventions (LeMone, et al. 2011). Effective problem solving requires that the problem causes are identified, solutions and their alternatives established as well as their possible implications to enable informed the choice of the most suitable In my nursing practice, I came across an isolated case of a 27-year-old diabetic patient with a genetic hematological condition, hemophilia. However, besides these chronic conditions, he was hospitalized due to a deep wound he accidentally sustained on his thigh while he was clearing a bush near his home using a machete. He presented in the hospital with a blood pressure of 89/62 mmHg, a body temperature of 37.80C, a respiratory rate of 28 breaths per minute and a pulse rate of 105 beats per minute. The patient had a capillary refill of more than 3 seconds, and his palms were pale. Upon further inquiry on his heritage and cultural background, the patient had a Cushitic descent in which no female should see a males nakedness (defined as from the thigh) if not married to the man. Furthermore, his cultural background advocated for intake of raw meat. Evidently, the problem-solving approach was required to come up with the solutions to the presented problems. Using prior clinical knowledge, it was notable from the presenting vital signs and the presenting signs and symptoms that the patient had a problem. Besides the chronic diseases, the presumptive diagnosis at the moment was hypotension, bacterial infection, and hypovolemia. According to Potter et al. (2015), the nursing process problem-solving process requires that subjective and objective data is collected to help formulate a nursing diagnosis after which the goals will be set. The presenting problem should be associated with a particular cause. This helps develop the best solutions that can adequately address the specific concerns. Also, the identification of the causes helps in the determination of the likely consequences that can be associated with the implementation of individual interventions as well as the ways to mitigate them. In the nursing profession, all patients a re treated as unique entities despite the similar presentation of their conditions (LeMone, et al. 2015). Using the assessment data, the nursing diagnoses developed were hyperthermia related to a presumptive bacterial infection as evidenced by a temperature of 37.80C. The second diagnosis established was impaired skin integrity related to a sustained injury as evidenced by bleeding and open wound. The third diagnosis was a risk for unstable blood glucose level associated with the diabetic condition. The fourth diagnosis was deficient fluid volume related to excessive bleeding as evidenced by relatively low blood pressure (hypotension). Some of the identified outcomes were that at the end of the implementation of the established interventions, the patient should be able to demonstrate normalcy such that the blood pressure should be within the normal ranges of 90-140mmHg systolic pressure and 60-90 mmHg diastolic pressure. The blood glucose level should be maintained within the normal ranges of 4.4-7.8 mmol, a temperature of between 34.5-37.50C as well as improved skin integrity free of in fection. To achieve these objectives, the most appropriate interventions included administration antibiotic empiric therapy to prevent progression of bacterial infection, analgesics and antipyretic, to reduce pain and fever respectively. Equally, administration of intravenous fluids was initiated, regular monitoring of blood glucose levels, as well as health education concerning diet, gave his chronic diseases and lifestyle changes (Howatson-Jones et al. 2015). Thus, the nursing care plan was formulated in such a way that it was considerate of the gender and the cultural background of the patient. The dressing of the wound was a reserve of the male nurses within the hospital since this was to demonstrate recognition of cultural diversity and thus to offer cultural sensitive care services. It is rare for patients to present with both diabetes and chronic hemophilia diseases. For this reason, the health education provided was based on the uniqueness of the patient. He is at risk of developing chronic wounds due to a diabetic condition and bleeding, and thus he is supposed to avoid risk for injury activities (LeMone, et al. 2015). References Howatson-Jones, L., Standing, M., Roberts, S. B. (2015).Patient Assessment and Care Planning in Nursing. London: SAGE Publications. LeMone, P., Burke, K. M., Bauldoff, G. (2011).Medical-surgical nursing: Critical thinking in patient care. Upper Saddle River, N.J.: Pearson. LeMone, P., Burke, K. M., Bauldoff, G., Gubrud-Howe, P. M. (2015).Medical-surgical nursing: Clinical reasoning in patient care. Boston: Pearson. Marriner T. A. (2012).Guide to nursing management and leadership. St. Louis, Mo: Mosby Elsevier. Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A. (2015).Essentials for nursing practice. St. Louis, Missouri: Elsevier Mosby. Standing, M. (2017).Clinical Judgement and Decision Making in Nursing. New York: Learning Matters.