Kiekkas and colleagues11 offer a thorough evaluation of tasks associated in patients with fever as an indicator of nursing workload in the intensive care unit (ICU). In this study, nursing workload was measured by the number of tasks or activities the nurse performed. However, the number of tasks is only partially indicative of the overall care the patient receives. Studies that exclude evaluation of the nursing process continue to ignore critical thinking as the true measure of the work of nursing.

Evaluating nursing based only on the number of tasks performed is like rating a pilot solely on the number of buttons he or she has pushed on a typical flight. Unless consideration is given to the thought processes behind these activities, it is impossible to accurately measure the pilot’s overall performance. Similarly, ICU nurses must be capable of assessing all...

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