CARING IMPLEMENTATION IN DAILY LIFE AND NURSING PROCESS

The nursing process is the framework for providing professional quality nursing care. It
directs nursing activities for health promotion, health protection, and disease prevention and is
used by nurses in every practice setting and specialty. In their 1967 book The Nursing Process,
Yura and Walsh identified four steps in the nursing process: assessing, planning, implementing,
and evaluating.1 But, currently, the steps in the nursing process which used daily are: assessment,
diagnosis, outcome identification and planning, implementation and evaluation.
Implementation is the 4th step in nursing process. Implementation is performing nursing
activities that have been planned to meet client outcomes. Caring implementation is needed when
we do nursing process. It involves many nurse skills. For example the nurse must continue to
assess the client’s condition before, during, and after the interventions.
Implementation is always appertaining with caring. Caring, itself has some phases, they
are : caring about, taking care of, caregiving and care receiving. 2 In the first phases, the nurse
recognized the need for increased pain medication in the assessment of the patient’s pain. In
phase two (taking care of), the nurse saw a responsibility to respond to the level of pain the
patient was experiencing. Therefore, in phase three (caregiving), the nurse took action to call the
physician. Finally, in phase four (care receiving), the nurse assesses the success of the
intervention with the patient (receiver of care).3
Tronto’s (1993), said too, that there were four elements of caring, include: attentiveness,
responsibility, competence, responsiveness of the care receiver (p. 127). First, attentiveness
entails the detection of the patient and/or family need. If the nurse fails to recognize the need, the
patient or family will not experience caring. Attentive nurses take up a receptive position with
respect to the patient; they are challenged to step out of their own personal preference system in
order to take up that of the patient, so they can better understand the patient’s real-life situation. 4
Second, according to the Code of Ethics for Nurses (ANA, 2001), all professional nurses
have a responsibility to care for patients under their care. Therefore, there is no uncertainty
surrounding responsibility as the second element of caring. In the context of nursing ethics, there
is no ambiguity that nurses have a responsibility for their assigned patients (Edwards, 2009).
The third element is competence (Tronto, 1993). If the nurse executes pain management
strategies that are ineffective, either due to lack of knowledge or organizational protocols, then
this nurse would not be seen as caring from the patient’s perspective. The administrator has an
obligation to provide the nurse with pain management education and effective, evidence-based
pain management protocols. The nurse has a responsibility to update competence continuously.
The final element is patient/family responsiveness to care (Tronto, 1993). The nurse needs to
verify that the caring needs of the patient are met.
There are so many activities that shows nursing implementation such :
1. Ongoing Assessment
2. Establishment of priorities
3. Alocation of Resources
4. Initiation of nursing intervention
1
Lachman, Vicky D. Applying the Ethics of Care to Your Nursing Practice
2
Achterberg, Teo Van. Nursing Implementation Science: How Evidence-Based Nursing Requires
Evidence-Based Implementation
3
De Laune, Sue. Fundamental of Nursing. Unites States of America
4
Gastmans, 2006, p. 136
 5. Documentation of intervention and client response
The nursing plan of care is based on the initial assessment data collected by the nurse
and the nursing diagnoses derived from those data. Ongoing assessment demands attention
to verbal and nonverbal cues from the client and requires knowledge of expected responses
to specific interventions. Following ongoing assessment and review of the problem list,
priorities are determined for implementation of care. Before implementing the nursing plan
of care, the nurse reviews proposed interventions to determine the level of knowledge and
the types of skills required for safe and effective implementation.
After reviewing the client’s current condition, verifying priorities, and examining
resources, the nurse should be ready to initiate nursing interventions. A nursing intervention
is an action performed by the nurse that help the client to achieve the results specified by the
goals and expected outcomes. All interventions must conform to standards of care. Finally,
communication concerning implementation of interventions must be provided through
written documentation and should also be verbally conveyed when responsibility of the
client’s care is transferred to another nurse.
Nurses have many regulates when they are caring people. They have to doing care
as what regulated in nursing process. When doing implementations which become the fourth
step in nursing process, nurses have to do some activities too which show their caring to the
patient. This is what makes different that nurses have their own program to care people
which not be owned by other professions.
 SOURCE

Lachman, Vicky D. Applying the Ethics of Care to Your Nursing

Practice
Achterberg, Teo Van. Nursing Implementation Science: How
Evidence-Based Nursing Requires Evidence-Based Implementation
De Laune, Sue. Fundamental of Nursing. Unites States of America
Gastmans, 2006, p. 136