Students first entering nursing are often most concerned about learning those hands-on skills we most associate with nursing: starting IV’s, inserting catheters, giving meds and so forth. The reality is, though, that these hands on skills represent only a small fraction of the skills that truly make you a successful nurse.

If these were the only skills needed, nursing school would be over in a few weeks. But it is not. Depending on what level of education you choose, nursing school could last anywhere from one to five years. Why the difference? Because the one skill that most important for a nurse to develop – and the one least often associated with nursing in the minds of most people – takes quite some time to develop and requires a significant amount of knowledge in order to do well. What I’m talking about is the ability to think critically.

Critical thinking has many definitions. The one I like best defines it as a process of evaluating facts in their arrangement and proportions to understand certainty of our beliefs and interpretations. My own definition is that critical thinking allows us to take imperfect information, mix it with our knowledge and understanding of the underlying processes to select the most appropriate action to take in providing care for our patients. Critical thinking does not apply the same standard to all situations but adapts to the situation based on the information available.

Convincing students that this skill, more than any other, is what defines the best nurses is one of my hardest tasks as a nursing instructor. Why? Because it is neither sexy nor obvious and because it is hard. We don’t like to think. Thinking requires a level of effort that many of us are simply not accustomed to doing. But do it we must, if we are to become quality nurses.

The simple fact is, we may be admired for our ability to find a vein in even the most challenging arm, or for the imperceptible way we administer an injection. But, the nurse that gains the greatest respect from the doctors and nurses with whom he or she works is the one who can see patterns emerging that suggests the patient’s condition is deteriorating and takes or suggests the appropriate course of action to prevent the continued slide.

To successfully think critically about a situation requires knowledge. I can hardly anticipate a patient’s needs if I’m unfamiliar with how their illness affects their overall functioning. Anticipating, for example, that the renal patient may experience cardiac dysrhythmias when hisr potassium level rises requires that I know what normal potassium levels are, how the kidneys regulate the potassium level as well as how potassium affects the body. This is a simple example, but one that demonstrates that critical thinking requires the evaluation of multiple pieces of information to arrive at a decision. That decision requires study.

To gain that knowledge requires personal responsibility. It is incumbent upon the nurse to identify his or her learning needs and to take definitive action to fill those needs. That means not relying on others to answer questions, but seeking out reputable sources to support your knowledge. That means taking the time to find answers to questions you have. Taking on the responsibility for self improvement regardless of your employer’s requirements. These are the habits of the successful nurse.

Whether you are a new nurse, or have been around the block a few times, recognizing the impact of knowledge on critical thinking and the impact of personal responsibility on your level of knowledge positions you to be the very best nurse you can be and gives you the power to control your own destiny.