The nursing process is one of, or may be the, most important of all concepts to understand when first entering the world of nursing. Not only must someone understand the nursing process to base their nursing education on, but they must also be able to incorporate it into their everyday life while interacting with their patients, fellow nurses, physicians, and any one they come into contact with in their life. This concept embodies knowledge and behavior that will only help and further a nurse in becoming the most nurturing, intellectual, and efficient nurse they can be in their career. In further discussion, the nursing process is explained in depth on its importance and the major points it presents. Also, the nursing process is evaluated on just how important its place in the field of nursing really is. Lastly, the nursing process is examined on why it has a profound impact and relation to nursing’s four paradigms: person, environment, health, and nurse. These paradigms reveal the ultimate meaning behind why it is crucial to comprehend this amazingly effective concept.
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Definition and Major Points of the Nursing Process
The nursing process is defined in several different ways. Chitty and Black (2007) describe it as “a method of critical thinking focused on solving patient problems in professional practice” (p. 192). Taylor, Lillis, LeMone, and Lynn (2008) defined the nursing process as a “five-step systematic method for giving patient care” (p.G-15). The American Nurses Association [ANA] (2010) sees the nursing process as “the essential core of practice for the registered nurse to deliver holistic, patient-focused care” (para. 1). Although these writers are correct, the author envisions the nursing process as a nurse’s way of working towards fulfilling the greatest state of being for each of their patients and maintaining this state of being at its highest peak to achieve optimal health. The nursing process is composed of five equally important steps: assessment, nursing diagnosis, outcome identification and planning, implementation, and evaluation. Each step helps in determining optimal care for each and every patient and works towards producing desirable patient results with their health, understanding, and education. Every step plays into each of nursing’s four paradigms which will be discovered during later discussion. Furthermore, the nursing process is considered to be systematic because of these steps and maintaining their accuracy to ensure the next step is achieved successfully (Taylor, 2008). Also, the nursing process is considered to be dynamic because of these steps being able to overlap and interact during its use (Taylor, 2008).
Critical thinking is a major point in properly executing the nursing process. In order for a nurse to thoroughly assess a patient, a nurse has to think of all components of the patient’s life that may have an effect on the patient’s reason for being at that health-care facility. Like Chitty and Black (2007) said in their definition of the nursing process, critical thinking is used to help solve whatever patient problems are presented. Taylor et. al. (2008) explain that critical thinking is crucial in developing cognitive skills to be able to excel in being a nurse. Not only is critical thinking used in assessing the patient, but it is used in every step of the nursing process to better the outcome of each nursing process step.
Paradigm of Person with the Nursing Process
Chitty and Black (2007) define a person as “each individual man, woman, or child” (p.294). In the nursing process, the person is the patient being cared for by the nurse. This person and their nurse work together to not only create a therapeutic relationship, but also to mutually work towards establishing the patient’s optimal place of well-being. The patient is what the nursing process revolves around (Taylor, 2008). They are what is being continually assessed to create nursing diagnoses, plan outcomes, implement care, and evaluate.
Each patient must first be assessed using Maslow’s Hierarchy of Needs, because “a human need is a requirement for a patient’s well being” (Chitty & Black, 2007, p.294). During the first step of the nursing process, the nurse will assess the patient’s every need to make sure an accurate and thorough collection of data is documented. Next, the nurse will create a set of nursing diagnoses that fit the needs of the patient or person. Third, the nurse will set the priorities of what problem should be attended to first to help provide what needs must first be met according to Maslow’s Hierarchy of Needs. Fourth, the patient will have care implemented to them to help achieve their needs and then they will be evaluated to see if they have achieved at least one step on the hierarchy of needs they lack. Overall, the nursing process aides in monitoring a person’s needs at every moment a nurse is at work to ensure that the patient is on the right path to ensuring homeostasis (Chitty & Black, 2007).
Paradigm of Environment with the Nursing Process
Environment “includes all the circumstances, influences, and conditions that surround and affect individuals, families, and groups” (Chitty & Black, 2007, p. 296). With the nursing process, the nurse is not only observing and incorporating just the problems within the patient, but also the patient’s environment within the health-care facility, work environment, and home environment. This is shown during assessment when the nurse assesses the patient’s duties at work, their recreational activities, and home life to gain a better understanding of the patient on all levels. With nursing diagnoses, the nurse makes sure to incorporate any problems that attributed to something in the patient’s environment to work towards fixing or aiding in helping this environmental hazard promote better health for the patient. An example of this can be understood with a patient that has a nursing diagnosis of Risk for Falls and the nurse and patient agreeing on a hopeful outcome of making sure that clutter is free out of the patient’s walkway or ensuring that a call light is within reach for assistance when wishing to ambulate.
Family is the most influential component of a patient’s environment (Chitty & Black, 2007). The nursing process includes the patient’s family not only during assessment, but mostly during outcome identification and planning and evaluation. The nurse should educate the patient’s family as much as they can on their family member’s health. This can be completed by the nurse educating during outcome identification and planning. Families may know better than the patient on what is realistic in determining a proper goal that can actually try and complete. They can also help in providing a safe and health-promoting home environment for the patient when discharge is near being completed. With evaluation, families should be educated on what to do in certain situations and what to look for when looking for improvement or lack of improvement. This is normally done at the final evaluation before discharge.
Paradigm of Health with the Nursing Process
Taylor et. al. (2008) defines health as “a state of optimal functioning or well-being (p. 14). The nursing process’s main purpose is to promote health within and around the patient. Each step takes into account the patient’s health to examine it in depth and find the best intervention to improve it. With the nursing process, a patient’s health can be taken care of holistically by the nurse first assessing each aspect of the patient’s life such as their religious preferences, cultural identity and practices, and of course their emotional and physical problems (Chitty & Black, 2007). If the nursing process is executed properly, an improvement in health is imminent. Whatever abnormality is first assessed in the patient, the nurse will go through each step of the nursing process to ensure that an improvement is made.
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A vital component to ensure that the nursing process will make a positive change is that the patient’s self-efficacy is measured to see if a patient is mentally able to participate in helping maintain their health. Self-efficacy is the patient’s own belief in their own self (Chitty & Black (2007). Self-efficacy is, of course, assessed during the first step of the nursing process, but most importantly during outcome identification and planning. This step involves not only the nurse establishing goals, but the patient and nurse establishing them together. If the patient has a high level of self-efficacy, they will be willing to work harder and promote realistic goals for their self to achieve. However, if they were to have a low level of self-efficacy, planning goals will be more difficult to set and especially achieve (Chitty & Black, 2007).
Paradigm of Nurse with the Nursing Process
Taylor et. al. (2008) says that nursing is “the care of others,” (p. 7) therefore, the nurse is the provider of care to others. The nursing process was conceptualized for nurses so they can carry out the foundation of the scopes and standards of nursing (Taylor, 2008). The framework of the nursing process illustrates the basic step-by-step process to adhere to when determining proper patient care. It is essential to incorporate this concept early on in the education of future nurses so it is set as a foundation to build more knowledge upon. Nurses are the only ones in the health-care environment to take advantage of this concept and they must be sufficiently capable in implementing all steps of the nursing process. If used correctly, not only will the nurse be able to provide “above-and-beyond” care, but also develop a trusting and therapeutic relationship with each of their patients.
The Nursing Process and Its Nursing Implications
The nursing process is a vital component to the career of nursing. It embodies the necessary steps to achieving holistic care to all patients and much more. Not only does the nursing process contribute to a patient’s health, but also in work relationships surrounding the nurse and patient. By following an organized approach to taking care of one’s patient during a certain shift, prepares for the nurse on the next shift to come in and continue providing optimal care.
With the nursing process, health-care relationships among the staff can greatly improve. Nurses can follow along a set standard of care implemented in the nursing process and still provide optimal conditions to help improve a patient’s health and provide continuity of care (Taylor, 2008). Not only will nurses benefit, but also physicians and assistive personnel, especially when interventions must be implemented. Furthermore, communication can greatly improve as well. With proper use of the nursing process, care will be up-to-date and if any changes, interventions can be put into place as soon as possible.
Conclusion of Conceptual Analysis on the Nursing Process
The nursing process is an extremely important component to providing optimal and holistic health-care. It comprises of five systematic, but dynamic, steps to adequately determine the best approach to implementing the best care available. By incorporating the person into the nursing process, they can be thoroughly examined and provided with proper care. The environment is involved in the nursing process, because it has a major influence on a patient’s health. Health is what the nursing process is working toward improving and therefore is a crucial part of the nursing process. Lastly, a nurse is the provider of the nursing process and they have a profound influence on how well that the nursing process is incorporated into patient care. By using the nursing process in the health-care environment, it can greatly make strides in improving professional and therapeutic relationships. Not only that, but the nursing process is the most essential step that will help nurses achieve their most important goal – providing care for others.
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