Critical Thinking: CNAs Need It, Too!

Article Categories: CNA Skills & What is a CNA?

Critical thinking is what sets apart a good nursing assistant from an excellent one. If you are a CNA and believe critical thinking is only for nurses and doctors, think again.

To better illustrate our point, take a look at the following scenarios:

1. CNA Anna arrives early and participates in patient huddles. She reads the care plan before meeting her patients. She measures vital signs and records the patients' intake and output. One catheterized patient had little urine output in her urine bag. The same patient complained of feeling colder than usual. Anna promptly records the urine output measurement, covers the patient with a thick blanket, and tucks them in bed. She remembered that the care plan says to turn another patient every two hours, which she does as ordered.

2. CNA Mary, on the other hand, also comes to work early and refers to the care plan before she starts. She also takes the patient’s vital signs and measures intake and output. Before the shift’s end, Mary notices that a catheterized patient has very little urine output in her urine collection bag. She checks the tubes for kinks and finds none. She recalled that the patient had enough to drink the last two shifts, but also complained that she felt colder than usual. She took the patient’s vitals and recorded her findings. Mary suspects something is wrong and immediately informs the nurse of her findings.

Anna is a follower and a doer. She makes sure that she is following the care plan to a T. She is compassionate and loves her work. Anna is a good CNA.

Mary is a critical thinker and a doer. She does not dismiss small details nor considers them insignificant. Not only did she follow the care plan, but she recognized a problem and raised questions in her mind: “Why is a patient, who has had enough to drink since yesterday, passing very little urine? Why are they feeling unusually cold?”

Mary thought of possible reasons why the urine output was scant, and then she decided to act fast. The simplest thing she could do at the time was to double-check the tubes for kinks that could be preventing urine flow to the bag. She then proceeded to retake the patient’s vitals. When Mary found the tubes in good condition, she made a connection between the small urine output and her patient feeling cold. She informed the nurse immediately. Mary is an excellent CNA.

CNAs who are critical thinkers do not just do as they are told. They understand why they need to perform the procedures and how those actions can benefit a patient. They can also quickly recognize patient responses that indicate a potential problem. They do not jump to conclusions but, instead, take simple steps to gather more evidence. Above all, they communicate their observations promptly to the nurse.

The healthcare industry needs more CNAs like Mary. Workers who practice critical thinking are the most efficient because they produce the best patient outcomes.

So, the big question is, how can nursing assistants enhance their critical thinking skills? Here are some tips that will help you become an excellent CNA:

1. Practice asking yourself why a patient needs a specific type of care and how the procedure will benefit the patient.

2. Be open-minded and detail-oriented.

3. Be vigilant and know when signs and symptoms point to a complication or a new problem.

4. Don’t be afraid to ask questions of yourself and others.

5. Be proactive in gathering more information and updating yourself with the latest evidence-based patient care.

6. Continuously seek to improve your knowledge and skills and make sure to apply them to patient care.

7. Learn how to communicate your thoughts to the healthcare team.

8. Listen actively and participate in patient huddles.

9. Take continuing education courses.

CNAs who are critical thinkers become achievers and lifelong learners. To the healthcare industry, they are a diamond in the rough. Don’t hesitate to be one.


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