In the world of nursing and non-nursing education, metacognition is a common pedagogical concept for nurse educators to consider when working with students on the path to becoming licensed healthcare professionals. Metacognition is at its most basic the act of thinking about your thinking. Aside from its commonplace setting of education, metacognition can be also considered in terms of how we approach our nursing careers and professional lives. So let’s stop and think about our thinking here on episode 195 of The Nurse Keith Show. (Note: this episode and these show notes are based on a previously published blog post.)

Metacognition and the Earnest Nurse

When you think about your nursing career, what do you think about? Is it how unhappy you are or how you’re mistreated by a particular colleague or supervisor? Are you confused about what might be the next best career move for you? Does the next chapter of your life feel completely unfathomable? Do you actively examine your thoughts or do you get stuck in moments you just can’t get out of (like the old U2 song)?

In terms of metacognition for examining the state of your nursing career, I’m encouraging almost the opposite of what a meditation instructor might teach: I want you to watch your thoughts carefully and then watch how you think about your thoughts, and then how you react to them emotionally. This is a big difference and quite a powerful exercise, especially when you then use cognitive strategies to deescalate any negative emotions, fear, or stress that surfaces.

Start With Your Thinking

The first step is to simply realize that your thoughts are running rampant, even if you’re often not paying that much attention to them. You may soon realize that your thoughts about your nursing career (and perhaps your current job) can be pretty negative and have a great deal of power to bring you down. Talk about a buzzkill.

Once you’re aware of your thinking — especially habitual negative thinking — the next step is to convince yourself that there’s another way, and that may be in the form of purposefully engaging in metacognition.

Metacognition for nurses: thinking about your thinking.

Engage Your Metacognitive Brain

Do you have a colleague who always seems unhappy about her work life and/or personal life? Does she almost always verbalize the same old complaints time after time, almost like a broken (nurse) record? She’s mired in negative thinking, and changing her own mind and short-circuiting those thoughts can be a heavy lift if such thoughts are deeply ingrained and she’s habituated to thinking them.

Enter metacognition. If the above-mentioned nurse can engage in metacognition and identify the thoughts that are keeping her in a highly negative state with regards to her work or career, she can then choose to manage her thoughts in order to change the tone of her thinking vis-a-vis her career.

Critical Thinking About Your Thinking

The purpose of metacognition for your nursing career is to be aware of your habitual thought patterns, make choices about which thoughts are most helpful, reject the thoughts that trap you, and then work to create a new reality for yourself. Most of us spend time thinking all sorts of things without critically examining our thoughts, and that’s where the rubber can hit the road when we begin to do so.

Here’s some homework:

  • During the course of a few days — or an entire week — closely watch your thoughts about nursing, being a nurse, your workplace, your career, your colleagues, etc.
  • Write down the negative or critical thoughts that you notice (the list may be quite long!) 
  • Examine each thought you’ve recorded and consider if it’s truly helpful to you in any way
  • Next write down a thought that could counterbalance the original negative thought. 

For example:

You notice that a recurring thought is, “My nursing career sucks, and I’m totally unhappy. I’m trapped and there’s nowhere else for me to go.”

So, what could the counterbalancing thought be? Maybe something like this: “My career may feel tough right now, but I have the capacity to change my situation. I’m free to act, move, change, grow, or find a new job or career path. Now I need to snap into action and take some positive steps in the right direction.”

Think, Think, and Think Again

Nursing practice is powered by the engine of critical thought. Likewise, the trajectory and direction of your nursing career are also powered by thought, not to mention how you think about your thinking about your career’s discontents and joys.

When you notice yourself sinking into “stinking thinking” and negative pathways, consider using the techniques outlined above to counterbalance the negativity. This takes practice, determination, and an actual willingness to change. If your thinking feels completely entrenched and beyond your ability to alter, consider psychotherapy or counseling, specifically Cognitive Behavioral Therapy or a similar cognitively-based modality.

Think critically about your thinking, make the best possible choices, and continue to examine your own habituated behavior and thoughts. In controlling and harnessing your thinking, you will move inexorably closer to a happier, healthier life and a more satisfying nursing career.


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Nurse KeithIn case you didn’t already know, Nurse Keith is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, keynote and motivational speaker, and popular career columnist. With two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast. Keith’s message of savvy career management and professional satisfaction reaches tens of thousands of nurses worldwide. Keith can be found on Facebook, Twitter, LinkedIn, and Instagram—as well as at NurseKeith.com.