Patient Crisis and Critical Thinking

Patient Crisis and Critical Thinking

by Carol Whiteside


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The primary goal of nursing care is that the patient be oxygenating and perfusing at the same time. In addition for baseline functioning the patient needs a normal pH, balanced electrolytes, glucose and oxygen in the cell making ATP. If the patient cannot repolarize the last action potential in their heart, there is no next heartbeat. Understanding these concepts allows the nurse to focus attention on what is truly important.

As stress hits the body, its regulatory systems adjust and attempt to maintain homeostasis . When this compensation fails, the body becomes ill and the vital signs become abnormal. If the nurse can see and act upon the signs of compensation then potential problems can be averted. Patient Crisis and Critical Thinking emphasizes proactive critical thinking using a framework which contains various solutions to any problem.

The resulting actions for care are dependent on the following concepts:

• You only see what you know
• You can't think critically about what you don't know
• Knowledge + experience before critical thinking
• Critical thinking can be taught using a model, or framework, for organizing the nurse's thought processes.

Combining her vast clinical background and information with critical thinking strategies, Carol Whiteside, MSN, PhD, has created an easy to follow book for nurses in the clinical setting. Her strategies are the result of over 40 years in the healthcare field in the areas of trauma, burn, pediatric, neonatal, medical/ surgical, and cardiac Intensive Care Units. Carol's conversational writing style presents easy to understand examples and scenarios. This book is a must for the novice and seasoned nurse or nurse educator.

Product Details

ISBN-13: 9781937661007
Publisher: PESI HealthCare
Publication date: 11/30/2011
Edition description: PESI HEALTHCARE
Pages: 251
Product dimensions: 5.50(w) x 8.50(h) x 0.50(d)

About the Author

Carol Whiteside has been a nurse since 1972. She is a Clinical Nurse Specialist, a Cardiovascular Nurse Specialist and recieved her PhD in Educational Leadership with her dissertation titled The Leadership of Florence Nightingale as Depected in Her Letters from the Crimean War. Carol has been a staff nurse, cath lab manager, nursing supervisor and director of education. She previously worked in trauma, burn, pediatriac, neonatal, medical/surgical, and cardiac ICUs. Carol has also been a preceptor and a clinical nursing instructor. Additionally, she is a nurse entrepreneur presenting courses in critical thinking and a variety of nursing topics. Carol has the unique ability to combine her vast clinical background and information with critical thinking strategies and has been a sought-after international speaker for many years.

Read an Excerpt


Human physiology is like a choreographed ballet. It is gentle and it is fierce. It is logical and it is obedient. If everything performs as it should, there is health. If an event does not obey the rules, there is dysfunction and illness. All we have to do is figure out what the rules are. But the problem with the rules is that our understanding of them keeps changing as our knowledge of how the body works increases. Change is occurring faster today that at any other time in history and it shows no sign of slowing down. Nurses care for patients with higher acuity rates than ever before. What you are expected to know and do is through the roof! Your job is not one of crisis management, it is one of crisis prevention. To prevent a crisis, you must be able to see it coming before it arrives. Clinical signs are the ones they taught us in nursing school: vital signs, lung sounds, neuro-vascular checks, etc. These signs are great for recognizing a problem because they occur after the body's compensatory mechanisms have failed to correct the problem. What if we could see signs that compensation was taking place before the process failed? We can. It is these subclinical signs of impending doom that this book will depict - how to tell your patients are going bad before they keel over and die. Everything - every thought, every movement, and every action in the body - has a physiologic, and therefore chemical, basis. The smallest living units in the body are its cells. It is the action and events occurring on a cellular level that spell wellness or illness in the human body. It is imperative that we know something about cellular metabolism in order to understand the compensatory mechanisms we want to observe. Florence Nightingale said it is the physician's job to take the bullet out of the patient. It is the nurse's job to place that patient into the very best environment for healing to take place. She knew that you cannot heal your patients; patients heal themselves. Medical professionals bring bones together with all kinds of fancy screws and plates, but the patient must heal the break by himself.

What we nurses are equates to environmental engineers. We manipulate the environment and hope our patients have the wherewithal to heal themselves. The environment we manipulate contains things like inspired oxygen, giving drugs on time, making sure our patients have adequate nutrition, and keeping our patients in a safe place where they can heal.

Table of Contents

Chapter 1 The Cell1
Chapter 2 Energy and Purpose27
Chapter 3 Oxygen Delivery to the Cells41
Chapter 4 The Cardiac Cycle69
Chapter 5 Acute Respiratory Distress99
Chapter 6 Heachaches111
Chapter 7The Look Test121
Chapter 8 Renal135
Chapter 9 The Effects of Surgical Trauma141
Chapter 10 Compartment Syndrome151
Chapter 11 GI Emergencies159
Chapter 12 Conveying Your Concerns167
Chapter 13 How We Learn175
Chapter 14 Critical Thinking Skills at Differing Levels of Nursing Proficiency191
Chapter 15 The Stages of Proficiency205
Chapter 16 A Critical Thinking Model215
Chapter 17 Effectiveness of the Model223
Chapter 18 Teaching Critical Thinking231
Chapter 19 Examples Using the Critical Thinking Model235
About the Author253

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