Critical Thinking and the Nursing
Process
Introduction
Nursing process: the foundation of the nursing profession
The nursing process requires the skill to clinically apply the knowledge and theory in
nursing practice
Nurses interact with patients in a scientific manner
Being scientific means to work systematically to address problems and to base decision
on scientific evidence (evidence-based practice)
To develop and employ critical thinking skills
It involves collaboration with the patient/client and the family
Definition of concepts
Nursing process: an orderly, systematic way of planning and implementing nursing care
Critical thinking: a purposeful process that is disciplined, active, multi-dimensional,
reasonable, rational and reflective to arrive at insight and to draw conclusions
Patient contact: an incident of contact between a patient needing nursing care and a
nurse(s). It may be a clinic visit, a hospital admission or a telephone conversation
Nursing history: essential background information about a patient at first contact,
including general and health information
Nursing diagnosis: a formulation of what the problem is, based on the information
gathered, which should now be the focus of the nursing actions
Observation: the act of noticing patient cues
Interviewing: the interaction and communication process for gathering data by
questioning and information exchange
Physical examination: the analysis of bodily functioning using techniques of inspection,
palpation, percussion and auscultation
Inspection: visual examination of the patient done in a methodical/deliberate manner
Palpation: the specialised use of touch for data collection that adds to and evidences the
inspection process
Percussion: a technique in which 1 or both hands are used to strike the body surface in a
precise manner to produce a sound called a percussion note
Auscultation: the technique of listening to body sounds with a stethoscope placed on
the body surface to amplify normal and abnormal sounds
Nursing goals: the expected outcomes the nurse wants to achieve with a patient before
his/her discharge. The outcomes may be short term (achieved within days/less than a
week) or long term (achieved in several weeks/months)
Nursing interventions: specific instructions to all the nurses who work with the patient
to solve a particular problem
Implementation: the action phase of the nursing process where nursing care is provided
Evaluation: defined as the judgement of the effectiveness of the nursing care so that the
patients goals can be met, based on the patients behavioural responses
, The nursing process
The nursing process is an orderly and systematic way to:
Make contact with the patient (MEET)
Determine the patient’s problems (ASSESS)
Make plans based on the information and knowledge to solve the problems
(PLAN & SET GOALS)
Execute the plans (IMPLEMENT)
Monitor to what degree the actions were effective in solving the identified problems
(EVALUATE)
Record and report all actions (RECORD KEEPING)
The nursing process is a problem-solving process that nurses use in every contact with a
patient and to plant nursing care for the whole duration of a patient’s care
The nursing process has the following characteristics:
It’s an orderly and systematic framework for providing specific nursing care to
individuals, families and communities
It is interdependent
It is patient orientated it uses the patient’s strengths to its advantage
It is appropriate for use throughout the lifespan
It can be used in all settings
Critical thinking underlies each step of the nursing process problem solving and
decision making
The MADGIE model can be used to better understand the nursing process
M – meet
A – assess
D – diagnose
G – goal setting and planning
I – implementation
E – evaluation
Meet
Greet the patient/client
Introduce yourself
State the purpose of the contact
Process
Introduction
Nursing process: the foundation of the nursing profession
The nursing process requires the skill to clinically apply the knowledge and theory in
nursing practice
Nurses interact with patients in a scientific manner
Being scientific means to work systematically to address problems and to base decision
on scientific evidence (evidence-based practice)
To develop and employ critical thinking skills
It involves collaboration with the patient/client and the family
Definition of concepts
Nursing process: an orderly, systematic way of planning and implementing nursing care
Critical thinking: a purposeful process that is disciplined, active, multi-dimensional,
reasonable, rational and reflective to arrive at insight and to draw conclusions
Patient contact: an incident of contact between a patient needing nursing care and a
nurse(s). It may be a clinic visit, a hospital admission or a telephone conversation
Nursing history: essential background information about a patient at first contact,
including general and health information
Nursing diagnosis: a formulation of what the problem is, based on the information
gathered, which should now be the focus of the nursing actions
Observation: the act of noticing patient cues
Interviewing: the interaction and communication process for gathering data by
questioning and information exchange
Physical examination: the analysis of bodily functioning using techniques of inspection,
palpation, percussion and auscultation
Inspection: visual examination of the patient done in a methodical/deliberate manner
Palpation: the specialised use of touch for data collection that adds to and evidences the
inspection process
Percussion: a technique in which 1 or both hands are used to strike the body surface in a
precise manner to produce a sound called a percussion note
Auscultation: the technique of listening to body sounds with a stethoscope placed on
the body surface to amplify normal and abnormal sounds
Nursing goals: the expected outcomes the nurse wants to achieve with a patient before
his/her discharge. The outcomes may be short term (achieved within days/less than a
week) or long term (achieved in several weeks/months)
Nursing interventions: specific instructions to all the nurses who work with the patient
to solve a particular problem
Implementation: the action phase of the nursing process where nursing care is provided
Evaluation: defined as the judgement of the effectiveness of the nursing care so that the
patients goals can be met, based on the patients behavioural responses
, The nursing process
The nursing process is an orderly and systematic way to:
Make contact with the patient (MEET)
Determine the patient’s problems (ASSESS)
Make plans based on the information and knowledge to solve the problems
(PLAN & SET GOALS)
Execute the plans (IMPLEMENT)
Monitor to what degree the actions were effective in solving the identified problems
(EVALUATE)
Record and report all actions (RECORD KEEPING)
The nursing process is a problem-solving process that nurses use in every contact with a
patient and to plant nursing care for the whole duration of a patient’s care
The nursing process has the following characteristics:
It’s an orderly and systematic framework for providing specific nursing care to
individuals, families and communities
It is interdependent
It is patient orientated it uses the patient’s strengths to its advantage
It is appropriate for use throughout the lifespan
It can be used in all settings
Critical thinking underlies each step of the nursing process problem solving and
decision making
The MADGIE model can be used to better understand the nursing process
M – meet
A – assess
D – diagnose
G – goal setting and planning
I – implementation
E – evaluation
Meet
Greet the patient/client
Introduce yourself
State the purpose of the contact
