Tuesday, October 8, 2019

Critical Thinking in Correctional Nursing

The biggest attribute a nurse needs to be successful in Correctional Nursing is Critical Thinking skills.

"Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness."

It is a skill that needs to be honed.

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To put it simply, in order to think critically about an issue, a nurse needs to take in everything into consideration concerning an issue - including the inmates medical history, past and current complaints, past and current actions, past and current mind-set, medical inventory AND the nurses experiences and observations pertaining to the issue at hand.

Sometimes things are not what they seem to be on initial glance.

For example:

An inmate sends in a complaint that they have a headache. Without critical thinking, a nurse would follow their protocol concerning headaches and move on with their day.  ie: give a medication to alleviate the headache.
This inmate then dies of a massive heart attack a half hour later.

If the nurse would have used critical thinking, this inmate would have been found to be having a heart attack, been sent to the hospital and lived.  How you ask, simple really - all the nurse had to do is take a moment to review the inmates file (medications, diagnoses, prior complaints, vital sign trends, how long has the inmate been incarcerated for, if they came in due to drug charges, age etc.), see the inmate (looking for skin color, how is the inmate behaving, are they visibly showing signs of pain etc.) and speak with the inmate (are they able to answer questions logically, is their speech pattern normal or hyper, etc.).  From here the nurse would take all of these 'observations' and formulate an educated critical thinking view on the inmates condition and react accordingly.

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Nurses should be consistently working on honing their critical thinking skills by always questioning, researching, observing and keeping an open mind!

With every issue that pops up with an inmate, as a nurse you should:

  • Review the complaint in an unbiased manner
  • Research the inmates history (medical file, medications, previous complaints, diagnoses etc.)
  • SEE THE INMATE - I cannot stress this enough!!!
  • Formulate a plan of action (need for additional information: vital signs? urinalysis? mental health evaluation etc.)
  • Use all the information gathered including impressions from the visual ques given when you seen the inmate
  • Formulate a plan of action to treat the complaint
  • Follow up after treating

Biases and Routines are two of the most dangerous things a nurse can develop in my opinion.  Every person (patient/inmate) is UNIQUE and should be treated as so.  It is one of the things I love about nursing!

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  1. Good morning! Nursing is a stressful profession. The patients in a correctional setting are often victim of trauma. Therefore, as a person observing everything, you are likely to absorb the stress around you.

  2. Interesting topic, never knew about this.