Meaningful living concept maps are all about focusing on nursing actions and their rationales. Although many texts and articles refer to nursing care planning and the enactment of critical thinking in that planning as nursing interventions, the term nursing action covers a much broader area and integrates critical thinking in all nursing care related decision making. Actions taken begin mentally as the nurse processes all patient related information. Nursing actions include:

• completing hands-on assessments
• monitoring and trending lab work and diagnostic tests
  
•  completing patient and family education
• changing dressings
• interpreting physician orders
• managing tubes and lines
• comparing and contrasting a patient's baseline status with current changes
• recognizing sequences and patterns related to care and treatment
• administering medications

​What are other things that you would consider to be nursing actions?

A concept mind is an expression of how your mind works. As your mind encounters information it categorizes what it sees. This incoming information is then compared, contrasted, clustered and placed into categories. But although this is automatic, the process can be controlled and directed in learning situations to align with learning style and used to apply what is learned. 
To test this, use an easy example. You are going to learn how to take a blood pressure. What things and processes does this make you think of. How do you see it in your mind's eye?  

Learning styles are often under emphasized in nursing education and take a back seat to educational strategies. But learning styles enhance the way in which a student learns and this certainly extends into the growth and development of critical thinking. A student who requires visual resources to move beyond remembering to analysis, for example, will have difficulty doing that if only verbal resources are utilized in class or provided as theory adjuncts. Since a particular learning style defines the thought processes used in taking nursing actions, isn't it fair to say that the same process is used in formulating nursing actions? I believe it does. 
Also, learning styles are part of us and the way we learn our whole lives. It's helpful to learn more and incorporate your learning style in each and every learning situation. In addition to making learning easier, it enables a better understanding of how we think and act.

Each and every day our brains take in huge amounts of information. What the brain does with that information is to pull it in, process it by making associations and connections, then file and categorize those connections. This could be called passive thought. Learning and critical thinking occur and expand by making this process a conscious one. Part of the process for successful, meaningful learning that becomes the foundation for critical thinking is the active, conscious participation we take in completing this process. This is what using concept maps is all about. It is a natural progression using learning the way the brain likes to and is used to seeing things. Does that make sense?
Thinking about nursing knowledge and nursing actions follows this same pathway. 
Look at the concept map below. Every nursing action is made based on an association. Associations and connections can be made from symptoms, subjective and objective information, labs, vital signs and many other pieces of information. Active thought processes help us to RECOGNIZE that associations and connections have been made. 

Florence Nightingale's birthday and the celebration of nurse's week has me thinking about nursing leaders. Although I recognize and respect acknowledged leaders I also believe that there are many nurses who are unrecognized leaders; nurses who practice in all areas of nursing and through their dedication and commitment qualify for this honor. These heroes and heroines practice and dispense nursing wisdom in many ways and make an impact in all they do. This is the essence of our profession.
Take a moment to reflect on these thoughts and thank a leader you know personally. Even better, recognize the leader in yourself.

Classroom critical thinking could be thought of as static in some ways. I say that because it is structured. Having an outline to serve as a template in many ways aids in guiding thought processes along critical thinking pathways. It is important to reflect on concepts such as this because the situation changes in the clinical setting. Required information used in the reasoning process may not be readily available. I have seen this happen so often. The cause can be something as simple as not having the chart near the patient's room but can also result when hand off communication is inadequate or when access to information is delayed by the need to electronically access vital information.
In this case thinking needs to be active, rapid and accurate. The patient problems must be identified, prioritized and acted upon rapidly and often simultaneously. This is why nursing education stresses the importance of wisdom. Nursing actions reflective of safety and all other practice standards orginiate from wisdom. A strong base of knowledge along with reasoning and judgment contribute to successful practice and positive patient outcomes.
Feedback on how you have developed wisdom would be welcomed.

Wisdom, like critical thinking has many definitions. These definitions can be summed up in the following- wisdom is to be wise, and to use our knowledge in performing actions. From a nursing care perspective, this means our base of knowledge helps to define nursing actions. Since nursing actions are used as part of the nursing proces, we can then say that wisdom is part of that same process.
Wisdom then is part of critical thinking. Our ability to use what we know in  a way that considers patient problems and concerns, as well as outcomes

Study the shock action plan concept map under the images tab. What critical thinking questions would you ask to accomplish or act on this plan?

I have been updating the site and would love not only some feedback, but some dicsussion as well. I've added both a short commentary on critical thinking as well as a concept map based on that commentary. Critical thinking is a woven thread into the practice of all nursing in all settings. How would you help a nursing student understand it? What does it mean to you? Has anyone ever really defined it for you?

How do you define critical thinking? Beyond definitions, how do you think nursing actions demonstrate it?
In some ways critical thinking is blending both past and current knowledge for application. Another facet of it is to ask appropriate questions about how to apply knowledge.

A major part of critical thinking is asking questions. As our critical thinking abilities expand, more and more questions are posed. This is a good thing because it means our minds are open and reasoning and judgment are actively working. Questioning begins in the classroom and then extends into clincal situations. Some examples of critical thinking questions you may ask yourself are:

• What abnormal assessments in this patient match the disease or pathophysiology I am seeing?
• Why am I not seeing evidence of all the symptoms my text outlined?
• How do my patient's symptoms define my nursing actions?

 

What is your take on this?



Nursing students- feel free to weigh in on this. In what types of situations is use of critical thinking easy?

Concept mapping does not just take form on paper. It takes place verbally and mentally as you reason through a situation, skill or assessment! Pretty cool, huh?