The Importance Of Critical Thinking As A Hospice Nurse

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Masters defines the following term as:
Critical thinking is the ability to think in a systematic and logical manner, solve problems, make decisions, and establish priorities in the clinical settings. Critical thinking is the competent use of thinking skill and abilities to make sound clinical judgement and safe decision. (p. 217). During this thinking process the nurse must make good clinical judgement and promote positive patient outcomes. Therefore, for the nurse to be a good critical thinker they must poses competent skills, knowledge, creativity and expertise. As a hospice nurse, our goal is to make the patient as comfortable as possible and free from pain during the last days of their lives. I recently had a newly diagnosed lung cancer patient. He had already been on services for a couple …show more content…
As the weeks past the patient had begun to call in to the on-call services complaining of uncontrollable pain. The dosage frequency was increased and would only manage the pain for a day or two and then we were back to square one, changing order from PO to IV to finally a PCA pump. However, at this point the patient pain was still not managed and complain of pain an 8/10 no matter. I then begin to think that maybe this cancer had metastasized to the bone and if so no opioid ever made would manage this pain. At this moment, it had come to my recognition an article I read some months ago of how patient with cancer pain used steroids, no steroidal ant inflammatory drugs and bisphosphonates with opioids to manage bone cancer pain. In the following IDG meeting, I begin to go over the patient plan of care and informed the MD of my pt constant complaint of deep aching pains. The MD made the changes from morphine to dilaudid added Dexamethasone 4 mg and a
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