Essay on The Five Phases of the Nursing Process

A number of emotions were felt during this experience, in regards to transitioning from a student nurse to the registered nurse role. Primarily, the transition in role from student nurse to registered nurse was similar to any clinical experience I have had at Midlands Technical College. I was placed in a medical-surgical rotation. I felt slighted that not only were we required to complete a data tool but we also participated in the teamwork model demonstrated in prior semesters. Personally, I did not feel a transition during this particular clinical experience.

The second step that I used in the nursing process was diagnosing. Based on my results from my assessment, I was able to use that information to come up with a couple nursing diagnoses. This step is used to offer effective nursing care because it helps me set an intervention and plan of care to help my patient’s health outcomes for the better.

The ASPIRE framework, also referred to as the nursing process (Barratt, Wilson and Wollands, 2012) was used to structure and develop Susan’s care plan. Introduced by Barrett, Wilson and Wollands (2012), following on from APIE developed by Yura and Walsh (1967), ASPIRE stands for assessment, systematic nursing diagnosis, planning, implementation, recheck and evaluation. Hogston and Marjoram (2006) believe that systematic nursing diagnosis was added to offer direction and time for the nurse to reflect on gathered information and systematically develop a diagnosis. Also the aspect of rechecking is to enable the nurse to monitor and plot a patient’s progress contributing to the final stage of evaluation of care and if its successfulness (Barratt, Wilson and Wollands, 2012).

Burkhardt, M. & Nathaniel, A. (2008). Ethics & issues: In contemporary nursing, (3rd ed.) Clifton Park, NJ: Delmar

Assessment of a patient is a big process of decision making, it is about the collection of information which will contribute to an overall judgement of a person and the illness they may have. Lloyd (2010) states that assessment is one of the first steps which is needed to be done in the nursing process, it is a building block for a relationship and an ongoing process which lets health professionals gather the correct information to help them understand the problems and needs that the patient is going through. Most of the nursing assessment which are in use today will all have very similar aims. The difference is that how the assessment’s are carried out is where the differences come from.

I realized I wanted to be a nurse after I had my 2nd ACL surgery, my senior year of high school. I had to stay in the hospital 3 days in order to recover, and I was very lucky to have such a wonderful and caring nurse. She made me feel as if I was her only patient. I will never forget how well I was taken care of and how comfortable she made me feel. I was young and scared, but she was reassuring, because she made me feel as if I had my own mother taking care of me. She was the reason I wanted to become a nurse, because I wanted to make others feel the way she made me feel. My personal definition of nursing is encompassed within that one nurse. A nurse should be loving, compassionate, dependable, competent, empathic, responsible,

Nursing care is focused on the assessment, nursing diagnoses, planning, implementation, and evaluation of patients. This nursing process can also be implemented in aspects outside of nursing and on the nursing field as a collective group. The nursing role is evolving, following the process the outcomes have to be evaluated and put into perspective. Research is being completed the conclusions are all the same, the higher education of nursing care the better the patient outcomes.

The first stage of the process is assessment. Roper et al (2001) refer to this process as ‘assessing’ indicating an ongoing activity; this encourages nurses to recognise the on-going nature of this initial phase. The assessing stage includes gathering information about a patient, reviewing this information, identifying actual and potential problems and prioritising (Roper et al 2001). Roper et al (2001) explain the importance for assessing, as early as possible in the patient’s stay. Extensive, in-depth information may not be gathered on an initial assessment, however any information obtained contributes towards individualised care (Roper et al 2001). Ambrose and Wittig (1998) explain that the initial assessment becomes a foundation for ongoing assessing and holistic care. Barrett, Wilson and Woollands (2009) concord with Roper et al and Wittig in that assessing is an ongoing process and elaborate on this explaining that assessment should not be confused with admission. They state “an admission tends to be a one-off process when you first meet the patient, whereas assessment carries on throughout your relationship with the patient” (pg22). Assessment enables the nurse and patient to identify actual and potential problems. Although, some problems can be directly related to biological needs, holistic needs must be considered, i.e. psychological state and cultural/social standing

Closely linked to this decision-making model is the ubiquitous nursing process. The nursing process includes data collection and documentation, analysis of the data to determine current condition and real or potential health related issues, development of an individualized plan of care to deal with these issues, implementation of that plan of care, and evaluation of the plan of care to determine its effectiveness and adjust the plan as needed. (Blais, Hayes, Kozier, & Erb, 2006)

As a nurse I will use my knowledge of critical thinking skills with in the nursing process: assessment, analysis, planning, implementation, and evaluation. Furthermore as a member of the nursing profession, I will assume accountability and responsibility for the quality of nursing care that I provide to clients, act as an advocate to promote quality health care for all clients, and take part in activities that promote the development and practice of professional nursing.

Assessment is described as”The first stage of the nursing process, in which data about the patient’s health status is collected” (Oxford dictionary of nursing, 2003, p23), following this phase a care plan can be devised.

It is during the second phase that the nurse must establish a nursing diagnosis. Only diagnosis approved and listed through The North American Nursing Diagnosis Association (NANDA) may be used. Ineffective airway clearance, risk for impaired skin integrity, risk for infection and ineffective coping are just a few examples of NANDA approved diagnosis. A nursing diagnosis is a clinical judgment about actual or potential individual, family, or community experiences/responses to health problems/life processes. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability (Defining the Knowledge,” 2012).

Any nurse would admit that preparation to becoming a nurse is a difficult task. Mostly because the practice of nursing consists of many things to follow in order be a great nurse for the patient. To make the preparation less difficult for nurses or nurse to be, Ida Jean Orlando contributed to the Discipline of the Nursing Process to further prepare those in nursing. The Discipline of Nursing Process is a theoretical approach to nursing that follows a nurse-to-patient relationship that would improve the patient’s behavior to seek beneficence and autonomy of the patient (Orlando, 1972). This provides nurses or upcoming nurse the strategies to deal with real life circumstances in nursing and improves the skills of the nurse to improve a patient care. This piece will focus on the theorist, Ida Jean Orlando, the meaning of the nursing process and the reason for the nursing process, any discrepancies that may be associated with nursing such as medical procedures and professional nurses, studies associated with the use of the nursing process and how the nursing process influence personally.

As a knowledge worker, a nurse moves from the role of a “data gatherer, information user, knowledge user, and knowledge builder, respectively” (McGonigle & Mastrians, 2015, p. 114). It is in the role of a knowledge user that the nurse starts to take “notice of the trends in a patient’s clinical data and determines whether the clinical data fall within or outside the normal data range” (p. 114). In measuring the final outcome of the patient as suggested by O’Grady and Malloch (2003)

"Brenner (1984) described the 5 stages of development for the professional nurse. The stages are (1) Novice (2) Advance Beginner (3) Competent practitioner (4) Proficient practitioner (5) Expert Practitioner. The stages progress from a nursing student to the professional practitioner through growth and knowledge." (Lopez-Boyd, 1997, p. 41) Nursing is a profession. Look around you, you see competent, caring individuals