I attended an intriguing session about critical thinking at the recent Updates in Correctional Healthcare program. Is critical thinking more challenging in corrections? I’m not sure, but let’s consider it. Albert Einstein described insanity as ‘doing the same thing over and over again while expecting a different outcome’. Are we working to make change in correctional healthcare without consideration for improving the thinking abilities of the frontline nursing staff who bear a majority of the decision-making about intervention?

It appears that lack of critical thinking is a major issue in all clinical areas. A study by Del Bueno in 2008 found that across the board, new nurse from diploma, associate degree and BSN education backgrounds  do not meet critical thinking competency from 65-72% of the time. Experienced nurses fare better but still are concerning. From 32-44% of experienced nurses in all education categories did not meet critical thinking competency levels.

Nurses working in corrections must often practice at a higher autonomy and frequently work without the usual technology of an acute care hospital. Anecdotally, a small study done by the speakers found that nurses working in corrections with backgrounds in critical care and emergency scored lower in critical thinking in the corrections level than nurses from less high-tech clinical areas. It has been said that correctional nurses must be able to do everything with nothing. Clinical units in jails and prisons do not have high tech monitoring equipment. Nurses must rely on their assessment skills and basic metrics like vital signs, breath sounds and 12 lead EKG readings.

Hear more about critical thinking in corrections by listening to my Correctional Nursing Today interview with one of the session speakers, Tre’ O’Brien, BSN, RN, CCHP-RN.

Tell me what you think. Do correctional nurses need to apply critical thinking skills more than nurses in other specialty areas? Why do you think so?

photo credit: © Jeffrey Collingwood – Fotolia.com