Tuesday, April 21, 2020

Nursing Process Essay Example

Nursing Process Paper 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. We will write a custom essay sample on Nursing Process specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Nursing Process specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Nursing Process specifically for you FOR ONLY $16.38 $13.9/page Hire Writer 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. Nursing Process Essay Example Nursing Process Essay The nursing process is described as being an individualised problem solving approach in which patients receive nursing care. The nursing process consists of four distinct phases, each having a discreet role in the process, theses phases of the process are: assessment, planning, intervention and evaluation. (Oxford Dictionary of Nursing 2003) It is important that the four stages of the process from assessment to evaluation are carried out sequentially because each phase follows logically from one to the other. As a result the maximum well-being of the patient is always the key issue and the nurse is aware and confident of action to be taken during intervention. This essay will describe the nursing process and the importance each of the phases in turn. It will highlight the significance of each element not only in ensuring the physical and general well-being of the patient but also treating the patient as an individual. Finally the importance of evaluating the complete process will be discussed in order that nursing staff may reflect on the success of their actions. Assessment is the initial and a very important stage of the nursing process. It involves the gathering of information on the patient’s overall state of health from which a care plan may be created (Oxford Dictionary of Nursing 2003). It is suggested that the ability to assess a patient is to find out their health needs, and to highlight fears and expectations that the patient may have. Questions will focus on the medical, social, psychological, spiritual and cultural needs of the patient, rather than just focusing upon medical and physical needs as each patient is different (Nursing Midwifery Council (NMC 2010)). We will write a custom essay sample on Nursing Process specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Nursing Process specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Nursing Process specifically for you FOR ONLY $16.38 $13.9/page Hire Writer That may be resolved through additional questioning of family or friends if required, examining medical records and taking into account the doctor’s diagnosis. This is vital to the nursing process to allow a high standard of care to be reached for each patient. Assessment is important as it helps the nurse gain knowledge and understanding and the ability to identify the patient’s needs (Linda Nazarko 2008). However it has been proposed that in certain care setting in depth assessments are not carried out resulting in the patient not receiving holistic care. Sometimes elderly patients in a care home may need continual assessment which may not always be possible due to lack of staff. (Dingwall L 2008). The NMC (2010) recommend that nurses refer and adhere to the code of conduct at all times when carrying out assessments in order to offer support to the patient and to recognise that treating each patient as an individual is essential and respecting their dignity is vital in maintaining a high standard of care. A high standard of assessment will ensure the efficiency of the next element, planning. Planning consists of the nurse working with the patient and other members of the multi-disciplinary team, in developing a care plan to assist the patient and staff in reaching short-term and long-term goals that were identified in the earlier assessment process. Its focus is holistic and is based on the clinical judgement of the nurse and other medical staff, using assessment information such as the patients individual needs and wishes in relation to their health (Royal College of Nursing (RCN)). According to the International Journal of Palliative Nursing (March 2007) as nurses are in a unique position to assist in the planning process, they require knowledge, skills and resources to provide the highest level of care. This could become a major issue if the nurse does not have the appropriate information about the patient. According to John McKinnon (2004) the involvement of patients in decision-making to improve patient compliance with medical advice between a practitioner and patient, can be regarded as having a positive sequential link with patient-centred care planning. It is suggested to be a process of co-operative care that underpins the principles of patient centeredness and partnership working. This shows the importance of working along with a patient when creating a care plan in the planning stage of the nursing process. However this may lead to conflict as the nurse and the patient may have different priorities from each other, for example, if the patient requires a blood transfusion but they are a Jehovah witness. It has been accepted that planning is a process which offers patients active involvement in deciding, agreeing and knowing how their health will be managed, thus allowing the patients ethical belief to stay intact. (Department of Health 2006 (DH)). Once the planning stage of the nursing process is completed the next stage is intervention. The intervention phase of the nursing process is the beginning of the practical nursing care to the patient. Details of treatment are clearly given to and are acknowledged by the patient. Thus goals laid out in planning will be achieved by the patient and nursing staff. Throughout this phase the nurse will continually review the patient to ensure that the interventions are successful (Jyoti Beck 2011). It has been suggested that the early phase of intervention is time consuming. However as soon as the procedures are integrated into daily standard care they become more manageable even when they are in addition to the current workloads as long as the goals are in suitable practice (Maria Dunckley et al 2005). This suggests that the nurse must ensure that they never undermine the care of a patients everyday needs as these are as important as the action plan is in part of the nursing process. Furthermore, another important part of the intervention phase is documentation. As the intervention stage is an accurate, up-to-date account of the patients progress, it must be signed by each nurse engaged in delivering the care as detailed in the care plan. (NMC Code 2010). Nursing interventions are designed to promote and maintain holistic wellbeing of the patient. In order to prevent further ill health, the nurse carries out these interventions by using a range of knowledge and skills acquired using evidence based practice (British Journal of Nursing 2010). Evaluation is the final stage of the nursing process, it is the final phase in the previous stages of care. It reviews how assessment, planning and intervention have identified the specific needs of the patient, how successful the delivery of nursing care has been. (www. rcn. org. uk). It will also examine patient satisfaction. Evaluation is on-going and is an active process which may involve the change in the patient’s health, resulting in further planning of care or indeed discontinuation of the treatment at the intervention stage. When nurses carry out evaluation they should analyse the previous phases of the nursing process in order to determine whether expected outcomes for the patient have been met. This will define the level of recovery the patient has reached and their ability to cope with their own health care needs independently. Evaluation is a feed -back mechanism for judging the quality of care given on the patient’s progress. It specifies if the patients problems have been resolved and if there is a need to re-assess, re- implement and re-evaluate the care plan. In conclusion this essay has demonstrated the four different stages of the nursing process and its value to practice. It is of utmost importance that a professional working relationship exists between the patient and other members of the multi-disciplinary team in order for the patient to receive the best outcomes for their health and well-being. The nursing process enables nurses to continually question the care they give to patient and acquire better knowledge and understanding of working for benefit and safety of the patient. It can be seen that each phase of the process of nursing is essential, as each part contributes to the patient having maximum holistic health outcomes and patient satisfaction from the treatment that they receive from nurses. The nursing process encourages nursing practice to improve the effectiveness and quality of healthcare to be beneficial to the patient. This assignment also discussed the issues where the nursing and patient may have their differences of opinion when receive treatment in clinical practice, and the nurse must adhere to respecting the patient’s dignity in every case. Without the nursing process the efficiency and quality of care that the patient would receive may not be patient centered as nursing care would rarely involve the patient but focus on the illness. The process of nursing helps to keep nursing practice current as nurses apply Evidence Based Practice in the care they provide. It is the nurses duty to stay currently informed and educated on any treatments as nurses must provide a high standard of practice and care at all times by using the best available evidence. Each section of the process helps the nurse to contributes to improved patient outcomes because nurses must make decisions on a regular basis on what is the appropriate care to provide for the patient. The four elements comprising assessment, planning, intervention and evaluation will help reduce the negative outcomes since the care is based on a plan incorporating the use of evidence-based practice and ensures patient satisfaction.