09Jones Leadership(F)-ch 09 148 1/14/07 3:39 PM Page 148 Understanding Organizations Thede, L.Q (2003) Informatics and nursing: Opportunities & challenges (2nd ed.) Philadelphia: Lippincott Williams & Wilkins Turley, J.P (1996) Toward a model for nursing informatics Image: Journal of Nursing Scholarship, 28(4), 309–313 Washington Publishing Company (1998) Overview of healthcare EDI transactions: A business primer Whitten, J.L., Bentley, L.D., & Dittman, K.C (2000) Systems analysis and design methods (5th ed.) Boston: McGraw-Hill Irwin 10Jones Leadership(F)-ch 10 1/14/07 3:40 PM Page 149 SKILLS FOR BEING AN EFFECTIVE LEADER 10Jones Leadership(F)-ch 10 1/14/07 3:40 PM Page 150 This page has been left intentionally blank 10Jones Leadership(F)-ch 10 1/14/07 3:40 PM Page 151 chapter 10 Enhancing Your Critical Thinking, Decision Making, and Problem Solving DEBORAH A JASOVSKY, MSN, PHD, RN, CNAA, BC MARY KAMIENSKI, PHD, RN, APRN-C, FAEN CHAPTER MOTIVATION “Successful problem-solving requires finding the right solution to the right problem The problems we select for solution and the way we formulate them depends more on our philosophy and our world view than on science and technology.” Russell Ackoff, a social systems scientist CHAPTER MOTIVES ■ ■ ■ ■ Identify the relationships between critical thinking, decision making, and problem solving Discuss various decision-making and problem-solving models Utilize various tools to make good decisions and solve complex problems Utilize group techniques to enhance problem solving 151 10Jones Leadership(F)-ch 10 152 1/14/07 3:40 PM Page 152 Skills for Being an Effective Leader D ecision making is one of the most frequent activities performed by a professional nurse At the bedside or in the boardroom, nurses must make decisions and solve problems to produce outcomes that enhance patient care Some decisions, like when to brush your teeth, become habits, so one does not think about them Other decisions become life-altering events that should be made with structured thought or after utilizing problem-solving techniques All decisions are not made in response to problems, but all problems were resolved because of decisions made along the way Driven by critical thinking and using a multidisciplinary knowledge base, nurses need to make decisions that are appropriate to the context of the situation and considerate of the culture where the services are being provided These decisions need to be based on knowledge of the individuals, relationships, ethics, politics, and financial considerations of the situation Decision making can be simple or complex The situation may require a quick response or allow for reflection, collaboration with others, and a carefully considered response Nurses need to develop and enhance ways to see all sides of an issue, find various approaches to solve problems, and make careful, intelligent decisions Critical thinking is the foundation for examining all possibilities and arriving at reasonable and justified conclusions This chapter will explore various ways to make good decisions and solve problems effectively by using creative critical thinking skills Critical Thinking Critical thinking is a complex process that has many definitions Some authors state that it is a reflective and reasonable way of thinking; others see it as an attitude of inquiry Still others describe it as a disciplined, self-directed thinking process Most agree that critical thinking does entail an orderly investigation of ideas, assumptions, principles, and conclusions Critical thinking is the process that guides scientific reasoning, the nursing process, problem solving, and decision making The cognitive skills attributed to the critical thinking process include divergent thinking, reasoning, reflection, creativity, clarification, and basic support (Green, 2000) ■ ■ ■ ■ ■ Divergent thinking is the ability of an individual to analyze a variety of opinions and judgments Reasoning involves the use of logic and the ability to discriminate between observation and inference, fact and guessing Reflection allows one to deliberate about something, whereas creativity enables one to produce ideas and alternatives and consider multiple solutions Clarification includes identifying similarities, differences, and assumptions and defining terms Basic support involves the use of known facts and background knowledge CRITICAL THINKING PROCESS Critical thinking is a process that entails identifying assumptions, considering context and meaning of issues, and gathering data to consider alternatives and outcomes (Box 10-1) Identifying Assumptions The critical thinking process begins by exploring the assumptions underlying a situation These assumptions may be beliefs that influence how an individual will reason or understand a situation and may reflect a person’s point of view or perspective These assumptions may not necessarily be grounded in reality For example, administering medications is a common activity of nurses, and finding strategies to avoid medication errors has become an important concern and problem-solving initiative in many organizations If a patient assumes the nurse will always administer the correct medication, it is unlikely that the patient will Box 10-1 Critical Thinking Process Identify assumptions underlying the issue Consider the context and meanings of the issue to all of the individuals Gather enough data to allow for consideration of alternatives and prediction of multiple possible outcomes ... between observation and inference, fact and guessing Reflection allows one to deliberate about something, whereas creativity enables one to produce ideas and alternatives and consider multiple... right problem The problems we select for solution and the way we formulate them depends more on our philosophy and our world view than on science and technology.” Russell Ackoff, a social systems... critical thinking, decision making, and problem solving Discuss various decision-making and problem-solving models Utilize various tools to make good decisions and solve complex problems Utilize