and may apply their repertoire of skills and knowledge to assist clients. This facilitates theindividualization of the nurse's plan of care.
The nursing process is interpersonal and collaborative. It requires the nurse to communicate directlyand consistently with clients and families to meet their needs. It also requires that nurses collaborate,as members of the health care team, in a joint effort to provide quality client care.
The universally applicable characteristic of the nursing process means that it is used as a framework for nursing care in all types of health care settings, with clients of all age groups.
Nurses must use a variety of critical-thinking skills to carry out the nursing process.Table 11-2 provides examples of critical thinking in the nursing process.
The Nursing Process in Action
The nursing process is a systematic, rational method of planning and providing nursing care. Its purpose is to identify a client's health care status, and actual or potential health problems, to establish plans to meet the identified needs, and to deliver specific nursing interventions to address those needs.The nursing process is cyclical; that is, its components follow a logical sequence, but more than onecomponent may be involved at one time. At the end of the first cycle, care may be terminated if goalsare achieved, or the cycle may continue with reassessment, or the plan of care may be modified.Amanda Aquilini, a 28-year-old married attorney, was admitted to the hospital with an elevatedtemperature, a productive cough, and rapid, labored respirations. In taking a nursing history, NurseMary Medina, RN, finds that Amanda has had a "chest cold" for two weeks, and has beenexperiencing shortness of breath upon exertion. Yesterday she developed an elevated temperature and began to experience "pain" in her "lungs."
The nursing process in action.
The five overlapping phases of the nursing process. Each phase depends on theaccuracy of the other phases. Each phase involves critical thinking.
is the systematic and continuous collection, organization, validation, and documentation of
(information). In effect, assessing is a continuous process carried out during all phases of thenursing process. For example, in the evaluation phase, assessment is done to determine the outcomesof the nursing strategies and to evaluate goal achievement. All phases of the nursing process dependon the accurate and complete collection of data. There are four different types of assessments: initialassessment, problem-focused assessment, emergency assessment, and time-lapsed reassessment (seeTable 11-3). Assessments vary according to their purpose, timing, time available, and client status. Nursing assessments focus on a client's responses to a health problem. A nursing assessment shouldinclude the client's perceived needs, health problems, related experience, health practices, values, andlifestyles. To be most useful, the data collected should be relevant to a particular health problem.Therefore, nurses should think critically about what to assess. The Joint Commission on Accreditationof Healthcare Organizations (2005) requires that each client have an initial assessment consisting of ahistory and physical performed and documented within 24 hours of admission as an inpatient.The assessment process involves four closely related activities: collecting data, organizing data,validating data, and documenting data (seeFigure 11-3).
Assessing. The assessment process involves four closely related activities.