How To Develop Critical Thinking Skills | Nursing Hacks # 3

Experienced nurses often complain about new nurses lacking critical thinking skills. But as an observer, I've noticed many flaws in how some graduate nurses are being trained. When it comes to critical thinking, it's a trait built over time and needs to be nurtured. As a preceptor, you must cultivate and assist the trainee in finding their critical thinking abilities. It doesn't come naturally and will require development and reinforcement. Some nursing trainees need structure and lack a game plan for building critical thinking skills. This is where the preceptor must step in. As a new nurse, the expectation shouldn't be that he or she will disclose their weaknesses. Until told otherwise, assume all nursing trainees need help in this department. I'm in the process of obtaining my business degree, and I read an article in the Harvard Business Review titled, Mangement Time: Who's Got The Monkey? It is an excellent article that breaks down five levels of initiation. This same concept can be applied to critical thinking.

 5 Levels of Initiation
1. Wait until told what to do. 
2. Ask what to do, implement quickly.
3. Recommend an action, then with approval, implement. 
4. Take independent action, and advise preceptor at once.
5. Take independent action, and update preceptor as needed. 

As the weeks go by, the graduate nurse should use number one and number two less and less. After a few months, the preceptor shouldn't allow numbers one and two for problem-solving. With proper education and training, a four-month graduate nurse shouldn't be waiting for instruction. The goal is to nourish independent thinking and assist your trainee is building their critical thinking skills. Yes, it can be a nerve-racking process, but the goal as a preceptor is to develop individuals. Being afraid to allow a person to independently think is a problem and usually involves a preceptor who doesn't want to give up power. The preceptor-trainee relationship isn't based on power, it should be based education and trust. With using the five levels of initiation, you are developing and not merely telling a trainee what to do. Because once they are off training, they won't have a crutch (you) and will spiral-down and become indecisive. The key to training is to develop, not demand. This critical thinking strategy will assist you in this process.