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In the nursing profession, more now than ever, the ability to think critically is essential. The responsibilities of a Registered Nurse have increased over the years. In correlation with this increase in responsibility comes the additional increase in educational prerequisites and core requisites required to achieve a degree in Nursing. The ANA (American Nursing Association) Standards has set forth the framework necessary for critical thinking in the application of the nursing process". The nursing process is the tool by which all nurses can equally become proficient at critical thinking. The nursing process contains the following criteria:

1. Assessment

2. Diagnosis

3. Planning

4. Implementation

5. Evaluation

It is in the application of each of these processes that the nurse may become proficient at critical thinking. It is important to look at the components that describe critical thinking in nursing, The table below lists components that define the critical thinking process. There is much more that goes into critical thinking than what is listed in the table. The table is a rough draft of the process.

CRITICAL THINKING COMPONENTS

Entails purposeful, informed, outcome focused thinking, that requires careful identification of specific problems and other physiological and psychological factors that affect the clients position on the health and wellness continuum.

The process is driven by the client, the clients family and other health team members who are also collaborating in ensuring essential client care.

Specific educational knowledge base and level of experience in applying that knowledge in client care. (Nursing School to graduate nurse to experienced nurse) As the level of experience of the nurse increases so will the scientific knowledge base that the nurse applies.

Proficiency in the application of the institutions standards, policies and procedures.

Application of the humanistic standards of caring in conjunction with the nursing process, to holistically treat the clients response to an actual or perceived illness.

Constant evaluation and re-evaluation of the nursing process to determine the clients level of wellness

Nurses learn critical thinking via application with experience. Experience is the best teacher. But it is equally important to know that the process is being applied correctly. Many institutions will ensure that this pathway is followed by enlisting new nurses in a eight to ten week orientation program. During this time the new nurse will learn about the polices and procedures of that institution and what type of documentation is used for charting purposes. Also, the new nurse will have an experienced mentor who they will follow and who will evaluate their performance as well.

Documentation is an essential part of the critical thinking process for the nurse. Every institution places emphasis on documentation. It is said, that if it is not documented, then it was not done". Since the nursing process is a scientific process. In scientific research, all things are documented. In this documentation, researches can look back to see if the results were due to interventions and whether or not the interventions were successful or have to be altered. The documentation process helps the nurse accomplish the same goals. Many times procedures are used that have unproven efficacy.

In it is this framework of critical thinking and documentation that such procedures can be either continued or eliminated, depending on the efficacy of the research. In other words, does the procedure actually improve, help or otherwise jeopardize the clients health. An example of the critical thinking process and scientific reasoning is in the efficacy of taking a rectal temperature of new born infants. Currently, this procedure is still widely accepted. However the scientific approach is to ask the following, is the procedure safe, is it necessary, and can an axillary temp be used in place of the rectal temp? In answering these questions, the nurse can better evaluate whether the efficacy of taking a rectal temp on a infant should be continued.

This is just one example of how the critical thinking process is used within the nursing profession. The scientific approach using critical thinking helps the nurse develop evidence based practice. It is through evidence based practice" that the Joint Commission on Accreditation of Health Care Organizations (JCAHO) rates the performance of hospitals. Further research is still continuing in delineating the intricacies of the nursing process and the integration of critical thinking. All health care professionals are encouraged to pursue this type of research in their practice to ensure the quality of client care and enhance the validity of their profession.

Learn more about nursing education at The NET Study Guide.

The nursing entrance test study guide provides nurses the assistance they need with the nursing entrance test. The nursing study guide helps nurses. Visit http://www.thenetstudyguide.com for more information.

Robyn Knapp

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The Orlando schools will be promoting health and wellness to its students this year. As part of the Orange County Schools, the Orlando schools will implement a new wellness policy that was just approved this month.

The new policy is in response to a federal mandate, under the Child Nutrition and WIC Reauthorization Act of 2004. All schools that receive federal funding for school lunch programs must have a wellness policy in place.

The wellness program for the Orlando schools is designed to promote better health to their students. Healthy eating and physical activity will play a big part in the Orlando schools policy. The hope is to completely change the Orlando schools environments to healthier ones.

With the new wellness program effective on the first day of school, each of the Orlando schools is challenged to be creative and innovative in implementing wellness activities and promotions.

Each of the Orlando schools will create a Healthy School Team (HST). The organization of each team is based on the Centers for Disease Control and Preventions Coordinated School Health Model. There will be a member on each HST to represent each of the following areas of health:

Health education,
Counseling.
Psychological and social services,
School health services,
Nutrition services,
Physical education,
The healthy school environment,
Health promotion for Orlando schools staff, and
Family and community.

Under the belief that healthy children is a community-wide concern, each of the Orlando schools will enlist the involvement of parents, families, teachers, counselors, school administrators, healthcare professionals, businesses, and community groups and organizations.

The Orange County schools already have experimented with the wellness program, which will benefit the Orlando schools. For almost three years, the program has been used in 13 schools within the county. The HSTs have been found to be quite effective in promoting health and wellness, not only for the students but their families and school staff, as well. The Orlando schools will use much of the information and experiences from these schools, when implementing their own wellness program this year.

The experimental HSTs have sponsored walking and running clubs for students, school staff, and parents. Another example of creative thinking by the HSTs is wellness Wednesdays, whereby students are rewarded for being involved in healthy activities, such as eating nutritious lunches, drinking water versus soda, or participating in a physical activity. Each HST at the Orlando schools will be charged with developing activities that meet the specific needs of each school and its students. The HST members are limited only by their own imaginations to develop creative promotions, events and activities.

The new wellness program at the Orlando schools is all about health and wellness for children, and helping everyone concerned to understand the importance of good health and its effect upon a childs ability to learn. From the federal mandate to the Orlando schools implementation of the wellness program, the sole purpose is to improve the health of students in order for them to be better able to learn and achieve now and in the future.

Patricia Hawke is a staff writer for Schools K-12, Which provides free, in-depth reports on all U.S. public and private K-12 schools. Patricia has a nose for research and writes stimulating news and views on school issues.