Nursing

Investing in critical thinking skills pays retention dividends

Nurse Leader Insider, June 22, 2007

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Investing in critical thinking skills pays retention dividends

New graduates entering the nursing world may breathe a sigh of relief that classes are done. But according to Shelley Cohen, RN, BS, CEN, and Kelly A. Goudreau, DSN, RN, CNS-BC, when it comes to critical thinking skills, school is just getting started.

"When we really begin this critical thinking process, we get these new grads into a position where they can make some good decisions based on actions that are validated through evidence," said Cohen during the recent HCPro audioconference titled "Critical Thinking in Nursing: Evidence-Based Methods for New Graduates." Cohen is an educator and consultant for Health Resources Unlimited, a company in Hohenwald, TN, that she founded in 1997.

One of the main questions to ask when assessing a new graduate's critical thinking capacities, said Cohen, is to look at Dorothy Del Bueno's principles of critical thinking. When analyzing a new graduate's ability to critically think, Del Bueno identified the following four questions that one should ask:

* Can the nurse recognize the patient has a problem?

* Can the nurse manage the problem safely and effectively, recognizing his or her scope of practice?

* Does the nurse have a relative sense of urgency?

* Does the nurse take the right action for the right reason?

The dollars don't say it all

One of the biggest reasons that facilities hesitate to invest in teaching critical thinking skills, said Goudreau, is due to finances. However, she urges managers to look at other numbers besides the start-up dollar figures.

"This is not just a money issue," said Goudreau. "This is a retention issue." She said that 15-50% of new nurses who go through a program that provides a high level of support and intensity in addressing their critical thinking abilities will be retained.

"Think about the dollars involved in that, and the time that is involved," she said. "It really is a very strong argument."

When time and money are invested in critical thinking programs, the new nurse will truly reap the benefits, said Cohen. There is no better feeling for new nurses, she said, than to:

* Be accepted by their peer group

* Feel confident in their delivery of nursing care

* Know there is a process to support staff when errors occur

These items, said Cohen, are "absolute essentials in helping to hang onto these folks."

And, she adds, it goes beyond the new nurses. "Our job is to nurture and encourage not just critical thinking in a new grad, but in everybody who's delivering nursing care to your patient."

Source: The Staff Educator, July 2007, HCPro, Inc.



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