The nursing process is a comprehensive, holistic five-step process that helps registered nurses to become united by a common thread in their patient care practices (ANA, 2014). The tool was developed to maintain consistency and efficacy in the nursing sector of healthcare. The process is the nurse’s core tool for providing patient-focused attention. The first of the tool’s five-pronged nature is assessment. Nurses are required to carry out an in-depth analysis of the patient’s symptoms, not only those manifested biologically, but those tied to sociocultural, economic, and spiritual factors as well.
For example, a nurse investigating a patient suffering from acute migraine need not only focus on the headache itself, but also on the patient’s response to the condition. Diagnosis is the second step that involves the nurse giving their professional opinion on the nature and cause of the patient’s condition. The diagnosis is a clinical judgment that identifies the patient’s condition, the nature of their suffering, causative agents, and any potential special needs. A patient suffering from migraines can be diagnosed with high stress levels.
Outcomes/planning provide the nurse with a provision for laying out the expected outcomes from treating the patient and how to achieve those outcomes. Planning is the result of the findings from the assessment and diagnosis stage. Based on these findings, the nurse sets measurable goals, short and long-term, medicinal and therapeutic aimed at alleviating the patient’s condition. Such actions might include drinking plenty of water and minimizing exposure to stress raisers for the migraine patient. The implementation phase is the fourth one, where nurses carry out the remedial actions proposed or outlined in the planning phase. Medication is given to the patient for the stipulated timeline, in the prescribed dosages.
For the migraine patient, treatment might include THE NURSING PROCESS 3 administering painkillers and engaging them in relaxing exercises to relieve stress. Finally, the last step is the evaluation phase. This phase closely interleaves with the implementation phase. The nurse takes data on the patient recovery status and compares it to the benchmarked outcomes. The rate of recovery is determined and corrective action on the treatment plan done to bring patient recovery on track (ANA, 2014).
Increasing the dosage or varying the strength of the pain relieving agent might be alternatives implemented on the treatment plan to expedite the patient’s recovery. Direct and Indirect care as described by the Nursing Intervention Classification (NIC) project Direct care is care administered through interaction with the patient, such as giving them medication, talking to them or changing their bedspread. Indirect care involves things done to aid the patient’s recovery but are not directly performed on the patient. These include checking the patient’s emergency chart or talking to their family to solicit increased support for the patient.
In both these instances of indirect care, the nurse is proactively trying to improve the patient’s health status without directly interacting with him/her. The three (3) types of Nursing Interventions Interventions carried out by nurses on patients are categorized into three; those that are entirely proposed by the nurse (nurse-initiated), those proposed by a clinical officer or doctor (dependent) and finally those arrived at as a result of discussion between the nurses and the doctors (interdependent). Nurse initiated interventions, for the case of a patient suffering from
migraines and refusing to take medication, might involve taking measures to educate the patient on the dangers of refusing medication. A dependent intervention will require an order or directive from another health worker, such as a physician (Doenges & Moorhouse, 2013).
THE NURSING PROCESS 4 For example, the physician might advise the nurse to try a different way of administering medication to the patient. Interdependent interventions require joint input between the nurses and associated medical personnel to deine the best course of action. For the migraine patient, interdependent intervention may be a physiotherapist educating the patient on the need of leading a cheerful life, while the nurse advises them on punctilious drug taking. Role of Nursing Process as a tool for aiding Nurses provide safe and reliable patient care As an organizational framework, the nursing process is a lighthouse that guides registered nurses to make the best possible healthcare plans for their patients (Basford & Slevin, 2012).
Based on a five-step process, the framework interrogates the comprehensive nature of the patient’s condition, then formulates a clinical judgment, followed by outcomes or objectives and plans to achieve patient wellbeing. Implementation is carried out where the carefully thought out action plan is followed to the letter. The overall effects of the treatment regimen or therapeutic intervention are assessed in the evaluation step to determine the level of efficacy of the treatment program. If the treatment is effective in curing the patient, no changes are necessary, and the plan is carried on. Lack of discernible progress towards wellbeing on the patient indicates a deficiency in the assessment, diagnosis or planning step.
Therefore, the nurse has to revisit their diagnosis and critical evaluation of the patient’s condition to see if they missed important information. The plan is consequently adjusted according to new information and the effect of the modified treatment regimen evaluated. The nursing process builds on the client or patient participation in the process of building an all-encompassing health profile of the client. As a result, involving the patient in formulating the healthcare plan makes the process an efficient tool that covers all relevant nursing bases. Being outcome based and client-centric, evaluation of patient response to
THE NURSING PROCESS 5 formulated healthcare plans provides an effective way of troubleshooting malfunctioning treatment or therapies. How Registered Nurses evaluate overall use of the Nursing Process and variables that affect Outcomes Registered nurses evaluate the overall use of the nursing process through identifying the treatment cases that have been successful after implementation of the process. Achievement of patient outcomes is the ultimate goal of the process.
The result is a comprehensive and holistic patient care plan that meets or exceeds the expected outcomes, thus paving the way for the evaluation of the overall program as successful. One of the variables that can influence the ability to achieve desired outcomes is inadequate or insufficient assessment of the patient. For instances where the patient is debilitated to a degree where they cannot effectively communicate, the nurse might end up with an incomplete or inaccurate conditional profile. Underlying and subjective symptoms are difficult to gather in such a scenario.
Such insufficient information makes it difficult to give a fitting clinical judgment on the patient’s condition. Diagnosis is another variable that banks on the nurse’s proper knowledge of medical conditions and their symptomatic nature to give accurate diagnostics. Wrong diagnostics lead to improper healthcare outcomes and planning schedules that inadvertently offer the wrong medication. Planning is the third variable in the nursing process that involves a thorough analysis of the available treatment alternatives present for the patient. The most effective treatment plan is chosen that provides the best emotional, spiritual, and psychological comfort for the patient.
Plan Modifications when Outcomes are not met The plan is modified by revisiting and adjusting one of the first four steps of the nursing procedure based on the evaluation of the outcome. The patient can be reassessed to see if THE NURSING PROCESS 6 condition details were missed or omitted, the diagnosis can be reviewed and changed if erroneous information was presented, or the proposed planning/outcomes were not properly formulated.
The implementation of the corrective action can also be adjusted to give more appropriate medication if the prescribed medication was not the best choice. Registered Nurse’s use of the Nursing Process to prioritize care Care prioritization is a possible outcome of the nursing process through the capability it gives the registered nurse to select the most pertinent care plan to alleviate the client’s condition. In the case of the patient suffering from migraines, the nursing process can help the nurse prioritize stress relief practices over medical prescriptions if the patient is exposed to extremely stressful circumstances.
Prioritizing care ensures that patients receive the best treatment first in line with their conditional dictations. THE NURSING PROCESS 7 References Doenges, M. E. , & Moorhouse, M. F. (2012). Application of nursing process and nursing diagnosis: An interactive text for diagnostic reasoning. Philadelphia, PA: F. A. Davis. ANA. (2014). The Nursing Process. Retrieved from http://www. nursingworld. org/EspeciallyForYou/What-is-Nursing/Tools-You- Need/Thenursingprocess. html Basford, L. , & Slevin, O. (2012). Theory and practice of nursing: An integrated approach to patient care. Edinburgh: Campion Press.