Critical thinking skills help nurses shape their actions. In other words, critical thinking is necessary to make good decisions. Good decision-making requires a good foundation of scientific knowledge. The nurse must also be aware of standards that should be followed. Internal and external variables such as the nurse’s personal experience, knowledge, creative thinking ability, education, self concept, as meshed with the nurses’ working environment, and situational stressors all can work to enhance or inhibit effective clinical decision making for a nurse. Types of Decisions
Decisions can be grouped into two main types, programmed and non-programmed. programmed – meaning they are anticipated and routine. There are likely guidelines, policies, or procedures that can be followed. Non programmed – are unexpected, unique, and more complex.
Decision-Making Process The decision-making process is often broken down into a series of linear steps. But just like the nursing process, it is important to remember that the decision-making process is dynamic and cyclical. • Define the decision – Decision-making can only occur when there is a choice between actual alternatives. • Gather information and deliberate – Data should be gathered about the alternative choices that are available. • Choose from among alternatives – Judgment about the merits of each alternative should lead to a preferred path. • Act – After a decision is made it must be implemented. • Evaluate – After taking a course of action, the results must be evaluated to determine if it was the best choice. This step is similar to the critical thinking skill of reflection.
Factors Affecting the Decision-Making Process There are numerous factors that can influence the decision-making process. These can be grouped into internal and external factors. • Internal factors include characteristics of the person making the decision. Critical thinking ability is paramount to making good decisions. • External factors relate to issues outside of the nurse that affect the decision.