Critical thinking is a complex cognitive process that allows individuals to analyze a situation, develop a set of appropriate actions and strive to achieve the proper solution. Even though this is an essential skill for nurses at the bedside, as primary caregivers, Patient Care Assistants (PCAs) must also be able to utilize critical thinking skills, effective listening and communication (Schub & Karakashian, 2018). As innovations are made in healthcare to accommodate the needs of complex care, staff members must remain versatile and adaptable.

The central education topic in the second quarter PCA education was "defining the PCA role in adequate patient observation and reporting." A few critical issues covered during the training session included delegation and escalation, recognizing abnormal vital sign trends and identifying the septic and hypoglycemic patient. The PCA plays a pivotal role at the bedside in recognizing and promptly communicating subtle changes to the registered nurse. During the training sessions, PCAs were referred to as the "eyes and ears" of the nurse. Before abnormal vital sign trends appear, fluctuations in a patient's baseline behavior or glucose levels may become evident. PCAs must be able to recognize and report those changes to the nurse immediately.

Some of the key highlights of the training were emphasizing critical components of patient care, including bedside shift report, performing intentional hourly rounding, and the rationale for developing a baseline observation for each patient. As knowledge of the individual patient increases, the PCA's overall judgment is enhanced. The quarterly education session ultimately allows PCAs to walk away feeling competent and confident as they continue to work in an ever-changing, dynamic clinical setting.