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Nursing Process

The nursing process: A help or a hindrance to contemporary nursing practice. Introduction. The nursing process is the core for the nursing care plan and enables one to think like a nurse. It was based on the theory developed by Ida Jean Orlanda in 1950’s where she observed good and bad nursing practices (Faust, 2002). The nursing process is important as it is a systematic problem solving approach which involves the partnership with both the patient and their family.

It serves as an important tool to improve practice, quality care and promote good health (Potter and Anne, 1992). In this essay, the four stages of the nursing process will be described and if this is a help or a hindrance to the contemporary nursing process will be discussed. Main Section The model of nursing developed by Roger, logan and Tierney in 1976 and then updated in 1983 is the one which the nurses are most familiar with. The model of nursing recognises 12 activities of daily living which is most related to basic human requirements.

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The model o f nursing can be used as a guide when an assessment of need is being carried out between the nurse and the patient where each of the activity is discussed and previous routine is identified (Aggleton and Chalmers, 2000). The nursing process is an organised, dynamic and cyclical process and has four interrelated steps. The nurses use the four steps with every patient they interact with. The starting point of the nursing process is the assessment stage (Seaback,2001) .

For the assessment to take place successfully, it is very important that the nurse is able to communicate effectively with the patient, and the patient’s family (Yura and Walsh, 1988). The planning stage of the nursing is therefore directly linked to quality and comprehensiveness of the assessment stage. During this stage, the patient’s needs are identified and how their needs/desires in relation to their health can be achieved. The plan is then implemented and this part of the nursing process details fully the care given and received by the atient. The final stage of the nursing process then evaluates the effect of the implementation. Evaluation is carried out at least twice in 24 hours and ever incident is noted. A general statement of the patient’s condition is written and with every care plan the nurses evaluate the patient’s progress towards the attainment of outcomes (Yura and Walsh, 1988). Studies have been conducted to show the attitudes of nurses towards the nursing process.

From the result from one particular study conducted by Martin 1994, it was found that patients who took part in the study showed positive outlook towards the nursing process and the diagnosis. Nurses, with higher degrees showed more positive attitude towards the nursing process. One of the hindrance that was found in the contemporary nursing practice was insufficient study and it was found that only around 30% of the patients were satisfied with the way care planning was done (Martin, 1994).

From the result, it can be concluded that by improving the care planning would overall improve the nursing process. Another study conducted, in 2005 explored factors that affected standardized care plans. It was found that one of the challenges to the contemporary nursing practices is to identity patient problems and the use of appropriate care plans. The result from the study conducted showed that, nurses used the same evaluation plans to meet the hospital requirements and were found to match patient’s condition to the designated nursing diagnosis (J Clin Nurse, 2005).

Thus, in order to improve the quality of care plan the nurses should be educated and enhance their ability to use nursing diagnosis. Chart audit are used by health care to show the quality of care, thus the results gained from this study should be applied to the in service training programmes by institutions that are replacing the traditional manually written care plans with standardized care planning systems (J Clin Nurse, 2005). Nursing process and care plan is regarded as an effective means of communication between the patient and the nurse ( Yura and Walsh, 1988).

Dingwal et al (1988) , has pointed out the significance of the care plan and the importance of the nursing plan to be utilised as the management tool to provide high quality care. A well written care plan, shows the identifies the problems that needs to be worked upon and a patient will feel more at ease if they know exactly what needs to be done and how it will be achieved , thus meeting their individual needs( Kemp and Richardson, 1994). However there has been conflicting views, regarding writing the care plans.

Questions have also been raised regarding the nursing process and if it’s increasing the workload of nurses (Walton, 1986). Some nurses believe that the care plan has been the major barrier to the implementation of the nursing process. The care plans were regarded as an unnecessary task to be filled at the end when time permitted them to do so, and were thought done for administrative and not practical purposes (De la Cuesta, 1988). Various studies conducted has proved the implementation of the nursing process to be difficult ( de la cuesta, 1983; Buckenham and McGrath, 1983; Bowman et al, 1983; Melia, 1987 and Dingwall et al. 988). On the other hand though, some authors have stated that the disappointment of the nursing process might be attributed to take into account of the fundamental nature of nursing work in complex organisations such as contemporary hospitals (De la Cuesta, 1983; Milne, 1985; Melia, 1987 and Keyzer, 1988). There are many challenges the nurses in the 21st century have to face, such as issues of access, quality, cost and they are also challenged by ageing population.

There are also many shortages of nurses and a survey was carried out from October 2002 till December 2002, which involved 1322 registered nurses (RN) to focus on the subject of clinical errors and ethics . Around 78% of the nurses revealed that they did not give medicines on time to the patients and 68% of the nurses believed this was the case because of shortage of nurses and 73% of nurses were strongly distress as a result of the action (Silva and Ludwick, 2003).

These errors have an impact on the nursing process and in order to improve contemporary nursing practice, the nation needs to educate and train more people in becoming successful nurses. Conclusion In conclusion, from various studies conducted, the nursing process can be seen as a help in contemporary care. There have been conflicting views regarding writing a care plan, however it can be argued that if a nurse takes the time out to write it carefully, it ensures that the care patients receive is carefully planned, thus meeting their specific needs.

Other professionals can also utilise the specific plan, and work together in order implement the care plan and evaluate if the desired outcome of the care has been achieved. If the goal plan, has not been achieved the nurses need to establish why and the care plan may be revised and assessed again. Referencing – guidelines, author, book’s name, Edition, publication, page number. References Faust C. Orlando’s deliberative nursing process theory: a practice application in an extended care facility. J Gerontol Nurs. 2002 Jul; 28(7):14-8

Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book. http://www. ncbi. nlm. nih. gov/pubmed/8138601 _ Nursing attitudes, towards nursing process, martin, 1994. http://www. ncbi. nlm. nih. gov/pubmed/15840079 – Factors that affect standardized care plans Aggleton p, Chalmers H 2000 nursing models and the nursing process, 2nd edn. MacMillian, Basingstoke, UK. http://www. thenursingsite. com/Articles/the%20nursing%20process. htm Wanda Seaback (2001) Nursing process, concepts and application.

Delmar Cengage Learning; 2nd Revised edition http://www. freeonlineresearchpapers. com/nursing-risk-injury Ludwick, R. , & Silva, M. C. (August 15, 2003). Ethics Column: “Errors, the Nursing Shortage and Ethics: Survey Results” Online Journal of Issues in Nursing. Available: http://www. nursingworld. org/ojin/ethicol/ethics_12. htm http://pages. cpsc. ucalgary. ca/~tangsh/documents/PhD/References/record-keeping%20and%20routine%20nursing%20practice%20–%20the%20view%20from%20the%20wards. pdf – Criticise nursing process. De la Cuesta C. 1983), the ‘Nursing process’ from development to implementation. Journal of advanced nursing 8, p 365-371 Buckenham J. & McGrath G (1983). The society reality of nursing. Adis health science press, Baglowalah, Australia. Bowman G. S. , Thompson D. R. & Sutton T. W (1983). Nurses attributes to the nursing process. Journal of advanced nursing 8, 125-129 Dingwall R. , Rafferty A. M & Webster C. (1988) An introduction to a social history of nursing. Routledge. London Melia K (1987) Learning and working: The occupational socialistaion of nurses. Tavistock. London

Keyzer D. M. (1988) Challenging role boundaries: conceptual frameworks for understanding the conflicts arising from the implementation of the nursing process in practice. In polictical issues in nursing. Past, present and future (volume 3) (White R. ed). , John Wiley, London, pp. 95-119 Walton l. (1986). The nursing process in perspective. A literature review. University of York, department of social policy and social work, York. Yura Helen and Walsh Mary B (1988). The nursing process: assessment, planning, implementing and evaluating. Appleton and lange, 5th edition


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