Everyday tasks as a link to critical thinking

Author(s): Christine V. Haynes, MSN, RN

One of the most frustrating hurdles for aspiring nurses is to leap and land on their feet while jumping over the directive of “think like a nurse.” Thinking like a nurse and speaking the language of nursing is like going into a foreign land and not speaking or understanding the native tongue. Helping both students and new nurses to realize they already have the intuition to use the nursing process and critically think is an essential key in both education and leadership.

In recent months I’ve worked to create assignments that covertly guide the student nurse through the primary roles of nursing. One focus has been on the nursing process: Assessment, Diagnosis, Planning, Implementation and Evaluation; ADPIE. One assignment requires the students to bake.* They can choose to bake any kind of cake: bundt, layered, cupcakes, etc. I provide only a few requirements such as they must use measuring tools for at least two ingredients. Then they must document various pieces of information. This assignment serves many objectives. First, it allows the instructor to have one common activity that all the students can relate to. For example when reviewing any area of the nursing process, I’m able to say to the students, “Just like when you…” and put in whatever fits.

In every class at least one student remarks with trepidation, “I’ve never baked before!” To which I respond, “Have you ever placed a catheter before? Then this will be good practice to learn something new.”

This assignment brings in topics of hand hygiene, personal protective equipment, the need to note allergies, and much more. The entire nursing process from assessment to evaluation is developed. The real excitement begins when students speak of having someone guide them in the kitchen, a need to alter the recipe due to allergies, or how they burned their cake. Some students go above and beyond the basic “order” and elaborately decorate the cake. Oh, to have that kind of nurse in the field!

Now when I ask, “When does the evaluation phase start?” I’m able to ask questions like, “When you broke the eggs into the bowl during the intervention stage, what did you do?” Students then connect that the evaluation phase begins as early as when implementation begins. They then discover evaluation spans far into the future—years from now they will still be thinking about the cake they made in crazy Professor Haynes’ class.

Are we dumbing down?

Making things relatable works in all areas of teaching. An English as a second language teacher was sharing the hurdle of teaching new writing skills to her adult foreign speaker. I suggested she draw a basic flower (a line with a big circle and little circles) and then in time add a diagonal lines (leaves) to demonstrate printing letters. Her first response was, “I’d never do that because it’s insulting to the adult student.” We had a great conversation about how this approach can be empowering rather than insulting. Allowing any student to feel they are on the same footing as us gives them a sense of confidence. The information is not only approachable, it’s applicable and relatable to all involved.

When one goes to a foreign country, they often use gestures and maybe a few key words to communicate what they are trying to get across. As elementary as it may seem to gesture with fingers to your mouth to indicate “food” or “eat” it’s not insulting; it’s an effort that is understood by both parties.

Like with the cake assignment, nurses may think this is a silly and unrelated approach to the very serious business of being a nurse. My students often also feel that way at first. However, once we review the bridge between the assignment and the nursing process itself, they appreciate all it has taught them. As an educator, I have watched our students testing scores rise almost 30%. That indicates not only a shift in learning, but also in retention and application.

Empowering through application

Use of real-life activities empower the learner. Often the fear of failing at a skill, which ultimately means the potential to harm a patient, leads the student to a deer-in-headlights moment. It’s like the student who was fearful to make a cake for the first time, just magnified. Allowing students to succeed, or even burn their cake, allows for great learning. I always tell my students, the same thing I tell my kids, “As long as you learned something, it was worth it!”

I would much rather teach the value of washing one’s hands and wearing an apron before the student is exposed to harmful pathogens in the clinical setting. Afterall, it only takes getting chocolate batter on your new blouse or jersey once to help you remember that personal protective equipment is an essential part of nursing when secretions are involved.

Those who desire to be a nurse have an underlying fear they won’t be able to think and perform as they should. Human lives are in our hands, and we want nothing more than to be safe and effective in our role. Eradicating fear and making learning approachable really can be a piece of cake.

*Other options are available for low-income students or those without necessary resources.

 

Christine V. Haynes is a nursing faculty member and creator of Brighter Nursing (#brighternursing).

8 COMMENTS

  1. This article is culturally bias. It represents the idea that people from a minority background – particularly people of color, do not have the basic ability to understand how to bake a cake. Many comments were offensive, like the hand movements towards the mouth as a sign language due to low intelligence. Consider the perspectives of students across the economic spectrum, not just the ones with limited access to baking appliances. Furthermore what does limited access to baking have to do with the nursing process. Perhaps there’s altruistic value in recognizing to make this assignment more inclusive for the students and to avoid marginalization who are unable to buy the baking supplies and did not have access to an oven. Where is the caring aspect of nursing that should be weaved into every assignment and when applying the nursing process? If I was a student in her class I would not find this learning experience creative, I would be confounded by this theory of chaos trying to comprehend how this would help me to pass the NCLEX. Which cake recipe books should I buy to pass the NCLEX?

  2. I absolutely loved this article. So quickly it is to forget the true importance of the basic skills such as proper hand washing and gowning up for isolations. It’s so easy these days to breeze through a head to toe assessment and just “skip” over some parts because they don’t seem important, but they are. Some learners like myself don’t learn by reading a textbook and then applying what I’ve learned from the textbook. I’m more of a hands on learner. I honestly think this concept of baking a cake and it’s application to the nursing process is outstanding and wish I would have had an experience like that when I was in nursing school to make me realize then the importance of a full assessment, hand hygiene, proper protection, etc. I don’t think in anyway that this article is racist or demeaning to anyone. I think it’s very realistic that regardless of which nursing school or even out of nursing school, people struggle financially on a daily basis and maybe don’t have access to an oven or the means to buy ingredients. I work at a hospital in an area that could be considered low income and there are people who work in this hospital who use learning methods like baking a cake to teach patients. Sometimes reading a pamphlet or a packet is not enough. I also work at another hospital who uses a sweet retreat to teach diabetic patients in which there are actually sweets to eat at this retreat. You could consider that insulting to this group of people, but it’s not. They use the sweets to show them that yes it’s okay to divulge every once in a while but make sure you know how to accurately dose your insulin. It’s a way to teach patients. We teach children not to be afraid of hospitals with teddy bears even at the age of 17 and 18 years old. Is that insulting to them to show them how an iv gets inserted on a bear in order to calm nerves? Or should we just go ahead and give them a handout that explains the iv process and then just stick them? I think the theory used in this article is fantastic. Kudos to the author for using this as a tool in the classroom.

  3. I agree that the use of real life activities may seem frivolous to some, but having been an educator for 25 years, I find these experiences really stick with students. The ability to relate so many things to the real life experience helps to keep knowledge and skills fresh in the mind. Way to think out of the box to get better results!

  4. “ I suggested she draw a basic flower (a line with a big circle and little circles) and then in time add a diagonal lines (leaves) to demonstrate printing letters. Her first response was, “I’d never do that because it’s insulting to the adult student.”

    You should have listened to your friend. Not only is it insulting to adult learners, when the majority of the worlds non-English speakers are Black and Brown it’s racist and insulting to the intelligence and abilities of folks who likely speak multiple languages and innumerable dialects need to complete exercises designed to improve the fine motor skills of a 3 year old.

    And the fact that you included a disclaimer” that low income students can complete an alternative exercise shoes that someone you showed this to knew it was potentially problematic but you ran with it anyway.

    This whole piece is insulting to adults especially those, all that have common sense and resent being treated like a child. Had a student come to me with this when I was a program director I would have joined them in a joint visit to the dean and diversity of inclusion to help you understand and pedantic, lacking in sound educational theory, and flat out ignorant your arrogance is.

    Embarrassing, shameful and part in parcel of the narrow minded whiteness of American nursing and nurse educators, that make it so hard for Black, Brown, immigrant, non-traditional, and LGBTQ students feel welcome, and able to be successful in nursing school.

  5. This is so problematic, in so many ways. Where to start? How about with the title “Let them eat cake”?!?!!!! Does the author know how racist/classist/clueless/harmful that concept is? As a nurse who works on a high volume/high acuity hospital unit, I have real-world view of the need to better prepare our new nurses to use critical thinking/intuition/multi-tasking/ongoing assessment etc- but I assure you that assigning a task solely to those privileged enough (time/money/oven/resources) to bake a cake is not a real-world solution (to any of our nursing crises.)

    • Thank you for your comment regarding the title of my blog. Your voice reinforces what we know about nursing: that it takes many of us, working together, to ensure the best outcomes.

      You are correct about the title of this article. It is insensitive, although it was not intended to be disrespectful in any way. I was able to change the title to better represent the topic.

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