Nursing is a lot like a game of chess.  It’s complex and you have to think several moves ahead.  You need to be able to assess a patient critically to determine his medical needs, while taking multiple factors and potential outcomes into account. Critical thinking is a process by which you review the situation, analyze what’s going on, and question what you don’t know.  You can break the process down into 5 steps: Step 1: Identify the goal, the problem, or the issue. Step 2: Review and diagnose the goal, problem, or issue.  What information do you have available about the goal, problem, or issue?  Based on the information you have, what’s the best resolution? Step 3: Explore your options.  Think about what the resolutions may be, and how and who would actually achieve them. Step 4: Actually carry out the resolution.  Get it done. Step 5: Reflect on your success or failure.  What went well and what didn’t go so well?  What can you do better or differently next time?  How do we learn from this experience? Nurses need to be able to communicate with their patients in order to understand how their patients are feeling and what they are concerned about.  Communicating effectively means you can listen well when someone else is speaking to you, and that you can speak clearly and concisely to someone else (e.g. patient, doctor, other nurses, family members, etc.).  As a nurse you’re also likely to make a lot of notes whether in a physical chart or on the computer, therefore you must also be able to communicate effectively in writing as you may not be there in person to explain what you meant.  Keep in mind that you will be dealing with many different nationalities, including people who may not speak the same language as you or the doctor. Find out what services are available to the patient to help them communicate effectively — are there interpreters on staff? Are you aware of any cultural beliefs or practices that might interfere with their health? As a good nurse you need to be able to listen to a doctor’s instructions and carry out those instructions quickly without needing to clarify every detail.  In order to do this you need to be able to listen to the doctor in what is likely a fast-paced and hectic environment while you’re doing something else. At the same time, don't hesitate to ask questions to clarify what is needed. Doctors, just as nurses, need to communicate effectively. If it is not clear what the physician/provider is trying to relay, keep asking questions. An exceptional nurse not only listens and carries out instruction, they advocate for their patients.  Because of your excellent listening skills, you’ve developed an understanding of your patients, how they feel, and what they want.  You should also understand that your patients may be a little intimidated speaking up and asking their doctor specific questions, or making requests.  As their nurse, you may need to do the speaking up for your patients. Encourage your patient to write down questions that they want answered and that you know them as well to help facilitate questions. If the patient can not ask them, then ask the questions for your patient. To learn more about being an effective communicator, you can read the following wikiHow article, How to Communicate Effectively. Being detail-oriented means you pay attention to both the big stuff and the small stuff.  When dealing with a patient, even the smallest anomaly or symptom can be a big deal, so you need to always be paying attention.  Being detail-oriented means you ensure all your patients get the exact treatment they need, when they need it.  While not exactly the same, being detail-oriented has a lot to do with being organized.  It’s easier to pay attention to the details when you are organized. Detail-oriented also means being accurate.  In the medical field you can’t estimate or guess at the amount of medication you give a patient, you need to be accurate.  Your patient’s life may depend on it.  Being detail-oriented also means paying attention.  Getting distracted or allowing your mind to wander will likely result in you missing something important.  Because all details regarding your patient’s care are critical, you need to remain focused and on task at all times. Nurses, especially those working in a hospital, need to deal with multiple patients at the same time.  Each patient has their own personal requirements that are critical to their well-being.  Each patient also has his or her own personality and emotional needs.  As a nurse you need to be able to organize yourself to keep track of who each of your patients are, what their treatments are, when they need their treatments, and the small details about the patient that will help them feel better (both physically and emotionally). Being able to organize yourself efficiently means being able to do the following things when needed:  Learning to say no.  While you may not be able to say no very often at work, you can certainly say no in your personal life.  Sometimes being able to clear out all the stuff you don’t really want to be doing will lower your stress level overall and help you become more focused when you’re at work. Finding balance in your life. There is such a thing called caregiver burn out. Always ask yourself before accepting an extra shift: what the benefit it and what is the cost? If the cost is personal loss of perceived health, sleep, enjoyment, then the extra money is not worth it. Asking for help.  If you are new to the nursing field, you are going to need to ask for help.  Don’t be afraid to ask, just ask.  Once you’ve asked chances are you’re going to be able to move forward with what you need to do, and understand how to efficiently carry out that task the next time. Prioritizing.  Being organized means being able to prioritize all the tasks you have on your to do list.  Knowing which ones are more important or which ones have the earliest due dates. Spending your time wisely.  Think about all the things you need to do in the next little while, and carry those tasks out efficiently.  If you need to go to the storeroom for one thing, think about all the things you need in there over the next little while so you only have to make one trip.  Don’t waste your time doing repetitive and unnecessary tasks. Most nurses will be on their feet for their entire shift, which can last 12 hours or more.  Nurses may also need to restrain patients, help patients walk from one place to another, hold patients up, move patients to and from a bed or gurney, and other physically demanding tasks.  If you aren’t up to the physical requirements of the job, you will likely be in a lot of pain at the end of a shift.  Personal health must be observed first — how can you advise health-related behavior if you do not observe it yourself? Physical stamina isn’t just about being able to do physical activities, it’s about being able to do them over a long period of time, over and over again. As a nurse you’re allowed to wear scrubs and comfortable shoes — take advantage of this.  There is nothing worse than being on your feet for 12 hours in shoes that are really painful. The medical profession in general isn’t the type of profession where you can always just sit back and "wait and see." In many cases, as a nurse, you’ll notice something and need to react to it quickly.  You won’t always get the chance to pause and evaluate all the options and debate back and forth with another nurse as to the best course of action — sometimes you just need to act.  Being able to think and react quickly comes with experience and confidence.  The more experience and confidence you gain, the faster your ability to react will become. Thinking and reacting quickly can also include knowing when it’s time to get help from someone else ASAP.  Don’t worry if you may be overreacting or if someone will have a bad opinion of you because you bothered them, those things aren’t important.  Keep in mind that your patient’s well-being is always the most important thing and react quickly when that well-being is in jeopardy. Reacting quickly doesn’t mean forgoing critical thinking; it means going through the critical thinking process quickly and carrying out your decision immediately.
Think critically. Communicate effectively. Be detail-oriented. Organize efficiently. Maintain physical stamina. React and think quickly.