I.

Decision Making, Problem Solving, Critical Thinking and Clinical Reasoning in

Nursing

 Decision making – complex cognitive process often defined as choosing a

course of action.
 Problem solving – part of decision making. A systematic process that focuses
on analyzing a difficult situation. Attempts to identify the root of the
problems, much time and energy are spent on identifying the real problem.
Individual Variations in Decision Making:
 Gender
- Harvard researchers have found that parts of the frontal lobe, responsible for
problem solving & decision making, & limbic cortex, regulating emotions, are
larger in women.
 Values
- No matter how objective the criteria, value judgments will always play a part
in a person’s decision making, either consciously or unconsciously.
 Life Experience
- Each person brings past experiences that include education and decision-
making experience.
 Individual preference
- One alternative may be preferred over another.
- Physical, economic, emotional risks & time & energy expenditures are types
of personal risk & costs involved in decision making.
 Brain Hemisphere Dominance and thinking styles
- Recent research – abilities in subjects such as Math are strongest when both
halves of the brain work together.
- Both sides of the brain collaborate to perform a broad variety of tasks & two
hemispheres communicate through the corpus callosum.
- Critical thinking – reflective thinking, is related to evaluation and has a
broader scope than decision making and problem solving
- Involves higher order reasoning and evaluation, has both cognitive &
affective components.
Characteristics of a Critical Thinker
 Open to new ideas  Communicative
 Intuitive  Flexible
 Energetic  Empathetic
 Analytical  Caring
 Persistent  Observant
 Assertive  Risk taker
  Resourceful  Willing to act outcome
 Outside-the-box thinker directed
 Creative  Willing to change
 Insightful
Critical Elements in Problem Solving & Decision Making
1. Define objectives clearly
2. Gather data carefully
3. Take the time necessary
4. Generate many alternatives
5. Think logically
6. Choose and act decisively.
Why do we need to think critically?
 Need to make accurate and appropriate clinical decisions
 Need to solve problems and find solutions
 Need to plan care for ach unique client and client problem
Critical Thinking Competencies
 Specific critical thinking competency used in nursing practice
Nursing Process
 Assessment
 Diagnosis
 Planning
 Intervention
 Evaluation
Information Seeking
Some examples of information seeking:
 Looking up lab values
 Reviewing a policy or procedure
 Reading instructions about how to operate a piece of equipment
 Reviewing a patient’s chart
It’s no accident...
 It’s no accident that the nursing process mirrors a lot of the critical thinking process
 They are both processes developed to gather information, look ahead, pain and
evaluate processes
 Looking at the two, side-by-side really illustrates that example
A fishbone diagram, also called a cause and effect diagram or Ishikawa diagram, is a
visualization tool for categorizing the potential causes of a problem in order to identify its root
causes. Typically used for root cause analysis, a fishbone diagram combines the practice of
brainstorming with a type of mind map template.
6 M’s – Wrong medication
- Manpower
- Material
- Method
- Manager
- Moment
- Money
- Machine

II. Leadership Defined and Distinguished

Leadership combines:
 Intrinsic personality traits

LEADERSHIP
 Dynamic, interactive process that involves the leader, follower and situation
To achieve this conception the leader must utilize:
 Leader style
 Motivation
 Managerial skills
 Planned change
 Managerial Roles
 Conflict Management
Types of Leaders:
 Formal – persons who hold a position of power
 Informal – emerge when members of a group recognize a person has special knowledge,
expertise, communication skills, or other personality traits they respect and admire
s
 The art of getting things done through people
 To forecast and plan, to organize, command, coordinate, and control
 MAN – still an element of management
 AGE – old and young should be together
  MENTAL – do not stop learning
What is Leadership Management?
Leadership – the ability to influence