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Nursing Process: Purpose and Steps

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  • 0:05 Purpose of Nursing Process
  • 1:01 Assessing
  • 2:08 Diagnosing
  • 2:48 Planning
  • 3:42 Implementing
  • 4:32 Evaluating
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Lesson Transcript
Instructor: Leslie Jennings

Leslie has taught college level nursing courses, both in the classroom and online and has a master's degree in nursing with specialization in education.

The nursing process is a series of organized steps designed for nurses to provide excellent care. Learn the five phases, including assessing, diagnosing, planning, implementing, and evaluating.

Purpose of the Nursing Process

What is the nursing process? In nursing, this process is one of the foundations of practice. It offers a framework for thinking through problems and provides some organization to a nurse's critical thinking skills. It's important to point out that this process is flexible and not rigid. It is a tool to use in nursing care, but one that should allow for creativity and thinking outside of the box.

Let's look a little more closely at the five steps. Here is an acronym to help you: ADPIE, which stands for assessing, diagnosing, planning, implementing and evaluating. For this lesson, we will be thinking of each part of the process as a slice of pie. All of the pieces added together give you the whole pie, or ADPIE.

Assessing

The first step in the nursing process is assessing. In this phase, data is gathered about the patient, family or community that the nurse is working with. Objective data, or data that can be collected through examination, is measurable. This includes things like vital signs or observable patient behaviors.

Subjective data is gathered from patients as they talk about their needs, feelings and perspectives about the problems they're having. In this step, information about the patient's response to their current situation is established.

Let me introduce you to Mrs. Apple, and we will start with assessing. The nurse takes her blood pressure, pulse and oxygenation level, which are abnormal. She also notes that Mrs. Apple is sweating and pale. These are examples of objective data. Mrs. Apple states, 'I feel like an elephant is sitting on my chest' and 'I am scared.' These are examples of subjective data.

Diagnosing

The second phase of the nursing process is diagnosing. The nurse takes the information from the assessment, analyzes the information and identifies problems where patient outcomes can be improved through the use of nursing interventions.

Nursing diagnoses are different from medical diagnoses because they address patient problems that result from the disease process, while medical diagnoses focus on the disease process alone. The nurse takes the information he gathered during the assessment of Mrs. Apple and makes a list of her current problems. These include pain and fear, among others.

Planning

This moves us to the third phase of the nursing process, planning. The nurse prioritizes which diagnoses need to be focused on. The patient can, and should, be involved in this process. Planning starts with identifying patient goals. Goals are statements of what needs to be accomplished and stem from the diagnoses - both short and long term goals should be established. Next, the nurse plans the steps needed to reach those goals, and an individualized plan with related nursing interventions is created.

Let's go back to Mrs. Apple. The nurse, along with Mrs. Apple, sets goals for her pain management and plans steps to take. Although the nurse recognizes that Mrs. Apple is afraid, she prioritizes the pain first, knowing that addressing her pain may make her anxiety lessen.

Implementing

Professional nurses use the first three steps of the nursing process in order to provide excellent, thoughtful and purposeful nursing care. If we skipped straight to step four, the things that are best for the patient may not occur. The fourth phase of the nursing process, implementing, occurs when the nursing interventions, or plan, are actually carried out.

Common nursing interventions include pain management, preventing complications following surgery, teaching and educating patients, and procedures that are part of nursing care. In our scenario with Mrs. Apple, the nurse offers pain medication, teaches deep breathing and relaxation techniques, darkens the room and plays soft music for her.

Evaluating

The final phase of the nursing process is called evaluating. Here, the nurse measures the patient's progress toward the goals that were established in the planning phase. Keep in mind that as the nurse carries out the planned interventions, he or she is constantly re-assessing the patient, modifying diagnoses and adding to the care plan along the way as needed.

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