Critical Thinking Skills in Nursing Management

In recent years, critical thinking skills have been recognized as a necessary component of nursing education. There’s an obvious reason for this: health care today is a complex, high-tech environment, and bedside nurses have to make complex decisions in order to deliver safe, effective patient care.

But by far, the most effective way to expand critical thinking skills is through education.

But there’s been a lot less discussion about the critical thinking skills needed by nurse managers, who also must function in a highly complex environment. Many nurse managers have risen to their current positions based on their competence in a clinical role, without any formal training or experience in leadership and management skills. They somehow have to learn to think critically about unfamiliar areas like finance, budgeting, staffing, strategic planning, and quality assurance. Without critical thinking skills, nurse managers can’t make day-to-day decisions strategically, with an eye toward advancing the goals of the organization.

Through critical thinking skills, a nurse manager can become a transformational leader. She or he can challenge assumptions, develop a more robust understanding of a problem’s underlying causes, and generate more creative solutions when using critical thinking. Without these skills, a manager may fall back on reactive, automatic responses to problems – and miss the opportunity to make changes that are visionary and goal-driven.

In 2010, a group of nurse researchers designed a study that would allow them to measure the effects of a manager’s critical thinking skills on the attitude of the floor nurses that person was managing. They concluded that nurse managers with stronger critical thinking skills were better able to create positive practice environments that correlated with higher job satisfaction and better retention of staff nurses. Nurses who work in a positive environment are thought to be less susceptible to the effects of burnout, putting them in a better position to deliver high-quality care and keep patients safe.

A Medscape article about critical thinking skills for nurse managers illustrated, with a hypothetical example, the difference a strong leader can make. It presented a case study about a manager facing a scheduling conflict over the holidays. In the past, staff nurses with seniority were given first choice of days off, leaving more junior nurses dissatisfied. The reactive way of thinking would be continue on with this same policy – without challenging current assumptions about seniority, fairness, and staff satisfaction. Yet a manager with critical thinking skills might look at alternatives that improve staff satisfaction and enhance the goal of self-governance – and then form a unit committee to produce a holiday schedule with sufficient staffing.

To further develop critical thinking skills outside of clinical areas, nurse managers can adopt the following habits:

  • Suspend judgment, and demonstrate open-mindedness for other departments and other views. This allows you to work as a team with other leaders, and to balance the goals and interests of various departments – which benefits the organization as a whole.
  • When confronted with a problem or situation, seek out the truth by actively investigating a problem or situation.
  • Ask questions about anything you may not fully understand and never be afraid to admit to a lack of knowledge. Gathering data in this way is crucial to making informed decisions, and to building a full understanding of both your organization and the current industry environment.
  • Reflect on your own thinking process and the ways in which you reach a conclusion. Identifying a personal bias is the first step toward eliminating it, allowing you to move toward more objective or multi-dimensional ways of thinking.
  • Look for a mentor with more experience than you have and join professional organizations, in order to gain experiential knowledge and build a network of colleagues whom you could turn to for advice when needed?

The Medscape article mentioned above also describes this innovative way to further develop critical thinking skills:

One way nurse managers can develop critical thinking is to start writing in a reflective journal. Establishing a consistent routine of writing at least weekly in a journal can improve critical thinking (Profetta-McGrath, 2005). Writing about critical incidents, complex situations that require decision making, as well as emotions and feelings about interactions and events stimulate analysis, synthesis, judgment, and creativity that are components of critical thinking. Through the process of writing, connections are made between theory and practice. Patterns of behaviors are recognized and a hypothesis may be formed that can lead to a change in practice (Profetta-McGrath, 2005).

But by far, the most effective way to expand critical thinking skills is through education. When you acquire a broader view of health care, from a systems and policy perspective, you equip yourself to make strategic decisions at the managerial or executive level. Highly effective nurse leaders know this, and have made education their ally.

American Sentinel’s online MSN, nursing management and organizational leadership specialization degree is designed for experienced nurse professional who seek to develop both management and leadership skills. Through case studies and hands-on course work, nurses examine the various human resource challenges facing an organization as well as the dynamic nature of the strategic planning and management processes.

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