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FUNDAMENTALS OF NURSING

I. Nursing as a Profession
Profession
- It is defines as an occupation tat re!uires e"tensi#e education or a ca$$ing tat re!uires specia$
%no&$edge' s%i$$ and preparation.
Professiona$is(
- It refers to professiona$ caracter' spirit or (etods.
Professiona$i)ation
- It is te process of *eco(ing professiona$ tat is of ac!uiring caracteristics considered to *e
professiona$.
+riteria of a Profession
,. Specia$i)ed Education
- It is i(parted *- te co$$eges and uni#ersities
.. /od- of %no&$edge
- It is a %no&$edge *ase of nursing tat gi#e direction to nursing practice' education and ongoing
researc.
0. Ser#ice orientation
- Differentiate nursing fro( an occupation pursued pri(ari$- for profit
- Nursing as a tradition of ser#ice to oters tat is guided *- certain ru$es' po$icies' or codes of
etics
1. Ongoing researc
- Researc in nursing is continuous$- increasing to contri*ute to te de#e$op(ent of nursing
practice
2. +ode of Etics
- Integrit- 3 a nurse is e"pected to do &at is considered rigt regard$ess of te persona$ cost.
- Preser#ed te ig #a$ue on te &ort and dignit- of oters
4. Autono(-
- It regu$ates itse$f and sets standards for its (e(*ers
- Nursing is to a#e professiona$ status terefore te- (ust function autono(ous$- in te for(ation
of po$ic- and in te contro$ of its acti#it- pro#ided tat it sou$d *e &itin te scope of practice.
Scope of practice 3 particu$ar functions and ro$es and deter(ine its goa$s and responsi*i$ities in
de$i#er- of its ser#ices.
5. Professiona$ Organi)ation
- Go#ernance is te esta*$is(ent and (aintenance of socia$' po$itica$' and econo(ic arrange(ents
*- &ic practitioners contro$ teir practice' teir se$f6discip$ine' teir &or%ing conditions' and
teir professiona$ affairs.
Different definitions in accordance to different teorist7
Focus of Teor-
Teor- E(pasis of Nursing
Teor-
+$inica$ Approac
F$orence Nigtinga$e
8En#iron(ent Teor-9
Te proper en#iron(ent for te
patient 8uses fres air' $igt'
&ar(t' c$ean$iness' !uiet' and te
proper e$ection and ad(inistration
of diet6a$$ at te $east e"pense of
#ita$ po&er to te patient9.
Nursing focuses on creating a
positi#e en#iron(ent troug te
(anipu$ation of te patient:s
surroundings in order to enance te
reparati#e process.
Te nurse re#ie&s te e(ergenc-
roo( en#iron(ent and finds tat it is
c$ean' &ar(' and &e$$ $igted. Se
p$aces te &o(an in te !uietest area
to discuss er o(e en#iron(ent &it
er.
Te nurse' at te re!uest of te
&o(an' ca$$s neig*or &o is a c$ose
friend to &atc te dog for er.
Tus' te &o(an can no& uti$i)e
er energies to assist in er o&n care.
;i$degard Pep$au
8Nurse6Patient Re$ationsip9
8Nursing is as significant'
terapeutic interpersona$ process.
Nursing is an educati#e
instru(ent' a (aturing force tat
ai(s to pro(ote for&ard (o#e(ent
of persona$it- in te direction of
creati#e' constructi#e' producti#e
persona$ and co((unit- $i#ing. Te
re$ationsip ad
Four pases7 orientation'
identification' e"p$oration' and
reso$ution' and it initiated te
recognition of a fe$t need &ic is
re$ated to a ea$t pro*$e(.
Te nurse identifies te &o(an:s
need to care for er pet at o(e and
er need to *eco(e (o*i$e. Te nurse'
acting as a counse$or' identifies &o
can (eet er need' contacts te
neig*or' and reso$#es tat concern.
/ot te nurse and te &o(an &a-
eiter unti$ te &o(an is (o*i$e' or
unti$ se as (atured in suc a &a- as
to accept er $i(itation.
Te four pases are7
,. Orientation is si(i$ar to te assess(ent pase of te nursing process. It a$so (eans *eing inte$$ectua$$-
and e(otiona$$- set and directed to&ard a nurse6patient re$ationsip.
.. Identification re$ates to fee$ing a c$ose e(otiona$ association &it oters for gratification' e(otiona$
support' or re$ief fro( stress. Tis is si(i$ar to esta*$ising rapport and in te conte"t of te nursing
process' tis pase fi$$ fa$$ under te assess(ent and p$anning stages.
0. E"p$oitation is si(i$ar to te i(p$e(entation stage of te nursing process. In ;a$$ description'
e"p$oitation' (eans ta%ing ad#antage of resources <nursing s%i$$s' e(pat-=. Te reso$ution pase
corresponds to te e#a$uation pase of te nursing process.
1. Reso$ution in#o$#es findings an ans&er to' or reacing a fir( decision a*out so(eting. Te reso$ution
pase corresponds to te e#a$uation pase of te nursing process.
>irginia ;enderson
8Uni!ue function of nursing9
8Nursing is pri(ari$- assisting
te indi#idua$ <sic% or &e$$= in te
perfor(ance of tose acti#ities
contri*uting to ea$t or its reco#er-
<or a peacefu$ deat= tat e &ou$d
perfor( unaided if e ad te
necessar- strengt' &i$$ or
%no&$edge9.
Tis can *e done *- identif-ing
te needs of te patient in ter(s of
Te nurse a$$o&s te &o(an to
e"press er fears and opinions' and
assists er in caring for te dog *-
contacting te neig*or.
Te focus of te care &i$$ *e to aid
te &o(an to *eco(e independent'
Especia$$- in te area of *odi$-
(o#e(ent.
fourteen co(ponents.
Fourteen u(an needs
,. /reat nor(a$$-
.. Eat and drin% ade!uate$-.
0. E$i(inate *od- &astes.
1. Mo#e and (aintain desira*$e posture.
2. S$eep and rest.
4. Se$ect suita*$e c$oting.
5. Maintain *od- te(perature.
?. @eep *od- c$ean and &e$$6groo(ed and protect te integu(ent.
A. A#oid en#iron(enta$ dangers and a#oid inBuring oters.
,C. +o((unicate &it oters in e"pressing e(otions' needs' fears' or opinions.
,,. Dorsip according to fait.
,.. P$a- or participate in #arious for(s of recreation.
,0. Dor% at so(eting pro#iding a sense of acco(p$is(ent.
,1. Learn' disco#er' or satisf- curiosit- tat $eads to nor(a$ de#e$op(ent and ea$t and use of te a#ai$a*$e
ea$t faci$ities.
Fa-e A*de$$a
8T&ent-6one nursing pro*$e(9
Patient needs can *e c$assified
into four categories7
,. sustena$ care re$ated to
sur#i#a$ needs
.. re(edia$ care directed
to&ard restoring te patient:s
se$f6e$p a*i$it- *- reducing
or correcting te i(paired
state
0. restorati#e care e$ping te
patient to $i#e &it
i(pair(ent
1. pre#enti#e care (a%ing te
patients *etter a*$e to e$p
te(se$#es
After te nurse ca$$s te neig*or'
se &i$$ identif-' under sustena$ care'
&eter er needs for p-sica$
co(fort' rest and acti#it-' safet-'
o"-gen' nutrition' f$uids' and e"cretion
are *eing (et. Se &i$$ focus on
pre#enting co(p$ications fro( te
patient:s i((o*i$it- and e$ping er
$i#e &it er i(pair(ent. Tis &i$$ *e
done *- focusing on te identification
of fee$ings and encouraging
co((unication and te use of
co((unit- resources.
T&ent-6one nursing pro*$e(
,. To (aintain good -giene and p-sica$ co(fort.
.. To pro(ote opti(a$ acti#it-7 e"ercise' rest' and s$eep.
0. To pro(ote safet- troug pre#ention of accident' inBur-' or oter trau(a and troug te pre#ention of
te spread of infection.
1. To (aintain good *od- (ecanics and pre#ent and correct defor(it-.
2. To faci$itate te (aintenance of a supp$- of o"-gen to a$$ *od- ce$$s.
4. To faci$itate te (aintenance of nutrition of a$$ *od- ce$$s.
5. To faci$itate te (aintenance of e$i(ination.
?. To faci$itate te (aintenance of f$uid and e$ectro$-te *a$ance.
A. To recogni)e te p-sio$ogica$ responses of te *od- to disease conditions6pato$ogica$' p-sio$ogica$'
and co(pensator-.
,C. To faci$itate te (aintenance of regu$ator- (ecanis(s and functions.
,,. To faci$itate te (aintenance of sensor- function.
,.. To identif- and accept positi#e and negati#e e"pressions' fee$ings' and reactions.
,0. To identif- and accept interre$atedness of e(otions and organic i$$ness.
,1. To faci$itate te (aintenance of effecti#e #er*a$ and non#er*a$ co((unication.
,2. To pro(ote te de#e$op(ent of producti#e interpersona$ re$ationsips.
,4. To faci$itate a&areness of se$f as an indi#idua$ &it #ar-ing p-sica$' e(otiona$' and de#e$op(enta$
needs.
,5. To create and E or (aintain a terapeutic en#iron(ent.
,?. To faci$itate a&areness of se$f as indi#idua$ &it #ar-ing p-sica$' e(otiona$' and de#e$op(enta$ needs.
,A. To accept te opti(u( possi*$e goa$s in te $igt of $i(itations' p-sica$' and e(otiona$.
.C. To use co((unit- resources as an aid in reso$#ing pro*$e(s arising fro( i$$ness.
.,. To understand te ro$e of socia$ pro*$e(s as inf$uencing factors in te cause of i$$ness.
Marta Roger Se#er
8Science of Unitar- Man9
Nursing:s +entra$ focus is te
stud- of te unit- of (an and te
process of $ife' &ic is e"pressed
in assu(ptions.
Suc assu(ptions inc$ude tose
tat (an is a unified &o$e' an open
s-ste( e"canging energ- &it te
en#iron(ent' unidirectiona$ &it
cange' a#ing pattern and
organi)ation.
Nursing is concerned &it u(an
ea$t and &e$fare.
Since te patient:s energ- and
en#iron(ent a#e an effect on er
ea$t and &e$fare' te nurse &i$$ first
ca$$ te neig*or a*out te dog. Te
nurse &i$$ te( identif- te patient:s
tota$ patterns of *ea#ing' especia$$-
in ter(s of er (o#ing aead to&ard
ea$t and (o*i$it-. +ange in te
patient:s a*i$it- to (o#e and *eco(e
independent &i$$ guide care.
Dorotea Ore(
,. Teor- of Se$f6+are
3 Re$ates to regu$ating
structura$ integrit-' u(an
functioning' and de#e$op(ent'
&ic is continuous trougout
$ife.
.. Teor- of Se$f6+are Deficits
6 Se$f6care deficits are
predicti#e of a nursing
re!uire(ent.
0. Teor- of Nursing S-ste(s
6 Nursing s-ste(s refer to te
approac to practice *- &ic
te nurse acts in re$ation to te
patients se$f6care deficits.
Nursing is u(an ser#ice &ic
focuses on te need for se$f6care
pro#ided *- te indi#idua$ or te
nurse in order to sustain $ife or
reco#er fro( disease.
Se$f6care *asic needs are7
,. Uni#ersa$ 6 need for air'
&ater' food
.. Re$ated to ea$t de#iation 6
canges in e"tre(ities or ea$ing
0. De#e$op(enta$ 6 re$ated to
ci$dren and teir needs.
Te nurse identifies te uni#ersa$
se$f6care re!uests of (aintaining
*onds of affection' $o#e' and
friendsip and a$$o&s te patient to
ca$$ er neig*or and arrange for te
dog:s care.
Te nurse &i$$ ana$-)e er patient:s
a*i$it- to care for erse$f in re$ation to
er ea$t de#iation needs.
Later se &i$$ eiter pro#ides care
to (eet te deficits or educate te
patient to (eet er o&n needs.
I(ogene @ing
8S-ste(s Fra(e&or%9
Nursing is a process in#o$#ing
perceptions' Budg(ent' actions'
reactions' interactions' and
transactions tat $ead to a goa$
attain(ent. Te focus of nursing is
re$ated to u(an *eings interacting
&it teir en#iron(ent in order to
acie#e ea$t. ;ea$t in#o$#es
u(an gro&t and de#e$op(ent'
adBust(ent to stresses' and te use
of resources &itin a cu$ture.
Persona$' interpersona$' and
socia$ s-ste(s so& te re$ationsip
a(ong te concepts identified
&itin te teor-.
Te nurse and patient percei#e te
initia$ goa$ as tat of (eeting te
needs of te patient:s dog' and te
nurse ca$$s te neig*or direct$-.
Te interaction *et&een te patient
and nurse *eco(es te focus in ter(s
of te patient:s i((o*i$it- and er
a*i$it- to furter de#e$op and adBust to
stresses and use resources a#ai$a*$e to
er.
Te indi#idua$:s perception of er
*od- i(age' er a*i$it- to
co((unicate &it oters' and er
fears of $one$iness &i$$ inf$uence er
a*i$it- to regain ea$t.
/ett- Neu(an Assist ps-ciatricE(enta$ ea$t Te nurse rea$i)es tat te patient
8S-ste( Mode$9 nursing students in teir ear$-
encounters &it c$ients in
co((unit- (enta$ ea$t centers.
Nursing is a tota$ person
approac in &ic &e #ie& te
indi#idua$ in re$ationsip to stress.
Te ai( is to reduce stress
factors and ad#erse conditions tat
interfere &it &e$$ness *-
increasing te a(ount of energ- tat
is stored.
;u(ans a#e to stressors.
Nursing identifies te patient:s
a*i$it- to defend or resist suc
stressors and de#e$ops te (eans to
pre#ent furter stress.
Stressors occur &itin' *et&een'
and outside te indi#idua$.
as e"perienced se#era$ stressors and
as reduced energ- &it &ic to dea$
&it er situation. In order to reduce
er stressEconcern for er dog' se
contacts te neig*or and arranges for
te pet:s care.
E(pasis &i$$ *e p$aced on
pre#enting furter stress in te patient
and (ini(i)ing er $oss of energ- due
to i((o*i$it-. Te $atter concern can
*e acco(p$ised *- i(pro#ing er
$ines of defense' suc as troug
e"ercise and E or rest' and *- assisting
er in resisting oter stressors' suc as
te fee$ing of e$p$essness.
Sr. +a$$ista Ro-
8Adaptation Mode$9
Nursing #ie&s te person as an
adapti#e s-ste( &ic reacts to
sti(u$i in four (odes.
Tese adapti#e (odes are
re$ated to p-sio$ogica$ needs' suc
as te need for f$uids and o"-gen'
te se$f6concept' ro$e functioning'
and interdependence.
Persons e"perience adaptation
pro*$e(s &ic need to *e
(ini(i)ing in order to a$$o& te(
to cope &it oter sti(u$i and to
(aintain ea$t.
Te (aBor initia$ sti(u$us tat is
interfering &it te patient:s a*i$it- to
adapt to er condition and te
en#iron(ent of te e(ergenc- roo( is
er concern for er dog. Tis re$ates to
er se$f6concept' ro$e' and
interdependence.
+a$$ing er neig*or and reducing
te (aBor sti(u$i &i$$ a$$o& te nurse
to focus on oter sti(u$i' suc as er
p-sio$ogica$ need for (o#e(ent and
er a*i$it- to adapt to i((o*i$it-.
Luci$$e @in$ein
8Independent Nurse
Practitioner9
Te for(a$ o*Becti#e of nursing
is caring for te *od-' (ind' and
sou$ of a person.
Te focus is te person:s ea$t
state in re$ation to is se$f6care
practices and te nurse as a se$f6care
agent. It is troug %no&$edge and
e"perience and te continuous
contact &it te c$ient tat te
outco(e of care &i$$ *e (ore
predicta*$e.
Te nurse recogni)es tat te
patient is i((o*i$e and cannot care
for erse$f and er dog. Se contacts
te neig*or and tose proceeds to
focus continuous$- on te patient:s
a*i$it- to care for er *ased on er
strengt <suc as er a*i$it- to (o#e
er $eft side= and er deficits <suc as
er ina*i$it- to &a$%=.
Se &i$$ #ie& te patient as
*eco(ing increasing$- ea$t- as se
*eco(es (ore independent and as
greater se$f6care assets.
Fean Datson
8Interpersona$ +aring Teor-9
Its (aBor concepts caring'
interpersona$ re$ations' needs'
gro&t.
Te science of caring in#o$#es
te interpersona$ process in re$ation
to (eeting certain u(an needs to
pro(ote ea$t and gro&t of
Te nurse' after rea$i)ing tat te
patient:s i((ediate need is to a#e er
dog cared for' ca$$s te neig*or.
Tis assists te nurse is esta*$ising
a supporti#e6trusting re$ationsip'
&ic inc$udes fait and ope &it te
patient in re$ation to er potentia$' in
indi#idua$s and fa(i$ies troug a
u(anistic a$truistic s-ste( of
#a$ues.
Fait' ope' and te de#e$op(ent
of a e$ping6trust re$ationsip
&itin a supporti#e' protecti#e' and
correcti#e en#iron(ent are
essentia$.
order to faci$itate er ea$t' gro&t'
and de#e$op(ent.
Ida Fean Or$ando
8I((ediate needs9
Nursing focuses on (eeting
patient:s i((ediate needs' tis
re$ie#es or di(inises teir distress
or i(pro#e teir i((ediate sense of
ade!uac- of &e$$ *eing.
Patients genera$$- re!uire e$p
&en tere are p-sica$ $i(itations'
&en tere are ad#erse reactions to
te setting' and &en te- cannot
co((unicate teir needs.
Te nurse:s practice centers
around o*ser#ation' reporting'
recording and tose actions
perfor(ed &it or for te patient.
Te i((ediate need for te patient
is a#ing te nurse contact te
neig*or.
Te nurse &i$$ ten focus on te
&o(an:s p-sica$ $i(itations' o*ser#e
te effect of te e(ergenc- roo( on
er reaction' and assist er to
co((unicate er needs.
L-dia ;a$$
8+ore' +are' +ure Mode$9
Nursing in#o$#es te care or
nurturing of patients' te core or
terapeutic use of se$f' and te cure
of disease &it te e$p of oter
ea$t care professiona$s.
Tese interre$ated aspects differ
in teir e(pasis depending on te
patient:s present situation and teir
a*i$it- to cope.
Recogni)ing te &o(an:s fee$ings
a*out er dog <core=' te nurse &i$$
contact te neig*or i((ediate$-. Te
nurse' in pro#iding nurturance <care='
&i$$ a$so faci$itate and carr- out te
p-sician:s prescription <cure=' and
assist te &o(an in coping &it er
ina*i$it- to (o#e and face te future.
Te nurse &i$$ focus on te
&o(an:s (essages a*out o& se
fee$s a*out er present state and
encourage er to (a%e conscious
decisions on er o&n *ea$f.
Ernestine Dieden*ac
8A e$ping Art9
Nursing integrates tougts'
fee$ings' and o#ert actions in order
to (eet a patient:s need for e$p
&ic is set *- a *ea#iora$
sti(u$us' affected *- a set of #a$ues
and *e$iefs in order to fu$fi$$ a
specific purpose.
Te (aBor co(ponents of
practice' and art.
Practice inc$udes %no&$edge'
Budg(ent' and procedura$ and
co((unication s%i$$s.
Te patient:s *ea#ior is affected
*- er *e$iefs and #a$ues re$ating to
er dog and its care. In order to
faci$itate tis care' te nurse ca$$s te
neig*or and assures te patient te
dog is recei#ing attention.
Te patient:s reaction to te nurse
and to er i((o*i$it- &i$$ assist te
nurse in e"p$oring te patient:s a*i$it-
to reso$#e er pro*$e(s.
Te nurse &i$$ ad(inister care to
te patient if te p$an of care is
accepted *- te patient.
Four pasesEco(ponents7
,. Identification inc$udes assessing patients needs.
.. Ministration in#o$#es pro#iding e$p.
0. >a$idation is e#idence tat e$p resu$ted in patients a*i$it- to function.
1. +oordination of resources is integrating te nurses: ser#ice &it te ser#ice of oters in te ea$t tea(.
Le#ine
8+onser#ation Mode$9
;u(an respond to te
en#iron(ent o$istica$$-.
Nursing is *ased on four
conser#ation7
a. princip$es of energ-
*. structura$ integrit-
c. persona$ integrit-
d. socia$ integrit-
O*ser#ation' te scientific
approac' and co((unications
affect patient6centered nursing
inter#entions.
In order to preser#e te patient:s
socia$ and persona$ integrit- and to
faci$itate er a*i$it- to participate in
er care' te nurse &i$$ ca$$ te
neig*or to care for te dog. Se &i$$
ten assess er energ- $e#e$' er
fee$ings a*out er &o$eness and
*eing i((o*i$e' er re$ationsips &it
oters' and er o&n *od-:s a*i$it- to
ea$ structura$$-.
Dorot- E. Fonson
8/ea#iora$ S-ste( Mode$9
a. A *ea#iora$ s-ste( inc$udes a$$
te patterned repetiti#e and
purposefu$ &a-s of a#ing a ig$-
co(p$e" s-ste( contains parts or
su*s-ste(s &ic can *e descri*ed
and ana$-)ed. Eac su*6s-ste( as
dri#es and goa$s' a predisposition to
act' a scope of action' and a
*ea#ior.
*. Te- inc$ude attac(ent or
affi$iati#e' se"ua$' e$i(inati#e'
aggressi#eEprotecti#e' acie#e(ent'
ingesti#e' restorati#e' and
dependenc- su*s-ste(s.
c. Nurturance' protection' and
sti(u$ation of te su*s-ste(s.
d. Nurturance' protection' and
sti(u$ation of te su*s-ste( are te
*asis of nursing practice.
Te nurse' *eing a&are of te
patient:s attac(ent to er dog' &i$$
ca$$ te neig*or. Se &i$$ protect and
sti(u$ate te (o*i$it- of te patient
during er care in order to faci$itate
purposefu$ &a-s of a#ing and to
restore er sense of independence.
Nursing +aracteristic
,. Te science under$-ing te discip$ine of nursing is a u(an science. In oter &ords' nursing
focuses on te u(an *eing7 te person and isEer tota$it-. Tis inc$udes ea$t' i$$ness'
e"periences' responses' interactions' *ea#iors' concerns' pro*$e(s' is en#iron(ent' a$$ te oter
tings tat sape te actions and reactions of te u(an *eing. Te goa$ of nursing is to assist
indi#idua$s to adapt to teir i$$ness and to te en#iron(ent.
.. Nursing is a practice6oriented discip$ine. Its pri(ar- (ission is re$ated to practice' &ic is te
practice of pro#iding nursing care. To pro#ide a teor- *ased nursing practice' (e(*ers of te
nursing profession see% %no&$edge' engage in researc and de#e$op teories' not for te sa%e of
%no&$edge a$one' *ut pri(ari$- to i(pro#e nursing practice. Nursing as a discip$ine re!uires
%no&$edge content and process.
0. Nursing is a caring discip$ine. +aring is a centra$ concept of nursing and its considered te
professions essence. Te art of nursing as *een istorica$$- considered s-non-(ous for caring'
(ore often &it caring &o(en' (oters' te re$igious.
1. Nursing is a ea$t6oriented discip$ine. ;ea$t is integra$ to nursing. It is troug teir perspecti#es
of ea$t tat nurse (a%es teir assess(ent of patient:s condition' p$an for inter#entions e#a$uate
inter#entions' (a%e canges in inter#entions.
Persona$ and Professiona$ Gua$ities of a Nurse
,. +aregi#er
Assist te c$ient p-sica$$- and ps-co$ogica$$- &i$e preser#ing te c$ient:s dignit-.
Enco(passes te p-sica$ ps-cosocia$' de#e$op(enta$' cu$tura$' and spiritua$ $e#e$s.
.. +o((unicator
Nurses co((unicate &it te c$ient' support persons' oter ea$t professiona$s' and
peop$e in te co((unit-.
Nurses identif- c$ient pro*$e(s and ten co((unicate tese #er*a$$- or in &riting to
oter (e(*ers of te ea$t tea(.
0. Teacer
Te nurse e$ps c$ients $earn a*out teir ea$t and ea$t care procedures te- need to
perfor( to restore or (aintain teir ea$t.
Nurses a$so teac un$icensed assisti#e personne$ to &o( te- de$egate care and te- sare
teir e"pertise &it oter nurses and ea$t professiona$s.
1. +$ient ad#ocate
Acts to protect te c$ient
Te nurses represent te c$ient:s needs and &ises to teir ea$t professiona$s' suc as
re$a-ing te c$ient:s &ises for infor(ation to te p-sician.
Te- a$so assist c$ients in e"ercising teir rigts and e$p te( spea% up for te(se$#es.
2. +ounse$or
;e$ping a c$ient to recogni)e and cope &it stressfu$ ps-co$ogica$ or socia$ pro*$e(s' to
de#e$op i(pro#ed interpersona$ re$ationsips' and to pro(ote persona$ gro&t.
4. +ange agent
Nurses act to (a%e canges in a s-ste(
Nurses act &en assisting oters to (a%e (odifications in teir o&n *ea#ior.
5. Leader
Inf$uences oters to &or% togeter to acco(p$is a specific goa$.
Effecti#e $eadersip is a $earned process re!uiring an understanding of te needs and
goa$s tat (oti#ate peop$e' te %no&$edge to app$- te $eadersip s%i$$s' and te
interpersona$ s%i$$s to inf$uence oters.
?. Manager
A nurse (anages te nursing care of indi#idua$s' fa(i$ies and co((unities.
Nurse6(anager a$so de$egates nursing acti#ities to anci$$ar- &or%ers and oter nurses'
and super#ises and e#a$uates teir perfor(ance.
Managing re!uires %no&$edge a*out organi)ationa$ structure and d-na(ics' autorit- and
accounta*i$it-' $eadersip' cange teor-' ad#ocac-' de$egation' and super#ision and
e#a$uation.
A. +ase (anager
Nurse case (anagers &ord &it te (u$tidiscip$inar- ea$t care tea( to (easure te
effecti#eness of te case (anage(ent p$an and to (onitor outco(es.
,C. Researc consu(er
Nurses often use researc to i(pro#e c$ient care
,,. E"panded career ro$es
Nurses are fu$fi$$ing e"panded career ro$es
a. Nurse practitioner
*. +$inica$ nurse specia$ist
c. Nurse (id&ife
d. Nurse educator
e. Nurse researcer
f. Nurse anestetist
g.
Different Fie$ds in Nursing
,. Institutiona$ nursing <ospita$ staff nursing=
.. +o((unit- ea$t nursing <scoo$ nursing Eindustria$ nursingEpu*$ic ea$t nursing=
0. Independent nursing practice
1. Nursing in education
2. Nursing in oter fie$ds
O#er#ie& of te Professiona$ Nursing Practice
Le#e$ of Proficienc- according to /enner
Stage I No#ice
No e"perience <eg nursing student=
Perfor(ance is $i(ited' in f$e"i*$e' and go#erned *- conte"t6free and regu$ations rater tan
e"perience.
Stage II Ad#anced /eginner
De(onstrates (argina$$- accepta*$e perfor(ance
Recogni)es te (eaningfu$ 8aspects9 of a rea$ situation
;as e"perienced enoug rea$ situations to (a%e Budg(ents a*out te(
Stage III +o(petent
;a#e . or 0 -ears of e"perience.
De(onstrates organi)ations and p$anning a*i$ities
Differentiates i(portant factors fro( $ess i(portant aspects of care
+oordinates (u$tip$e co(p$e" care de(ands
Stage I> Proficient
;as 0 to 2 -ears of e"perience
Percei#es situations as &o$es rater tan in ter(s of parts' as in Stage II
Uses (a"i(s as guides for &at to consider in a situation
;as o$istic understanding of te c$ient' &ic i(pro#es decision (a%ing
Focuses on $ong ter( goa$s
Stage > E"pert
Perfor(ance is f$uid' f$e"i*$e' and ig$- proficient no $onger re!uires ru$es' guide$ines' or
(a"i(s to connect an understanding of te situation to appropriate action
De(onstrates ig$- s%i$$ed intuiti#e and ana$-tic a*i$it- in ne& situations
Is inc$ined to ta%e a certain action *ecause 8it fe$t rigt9
ARTI+LE >I 7 Nursing Practice
Section .?. Scope of Nursing.
A person sa$$ *e dee(ed to *e practicing nursing &itin te (eaning of tis Act &en eEse
sing$- or in co$$a*oration &it anoter' initiates and perfor(s nursing ser#ices to indi#idua$s' fa(i$ies and
co((unities in an- ea$t care setting. It inc$udes' *ut not $i(ited to' nursing care during conception'
$a*or' de$i#er-' infanc-' ci$dood' todd$er' prescoo$' scoo$ age' ado$escence' adu$tood' and o$d age.
As independent practitioners' nurses are pri(ari$- responsi*$e for te pro(otion of ea$t and pre#ention
of i$$ness. A (e(*ers of te ea$t tea(' nurses sa$$ co$$a*orate &it oter ea$t care pro#iders for te
curati#e' pre#enti#e' and rea*i$itati#e aspects of care' restoration of ea$t' a$$e#iation of suffering' and
&en reco#er- is not possi*$e' to&ards a peacefu$ deat.
It sa$$ *e te dut- of te nurse to7
a. Pro#ide nursing care troug te uti$i)ation of te nursing process. Nursing care inc$udes' *ut not
$i(ited to' traditiona$ and inno#ati#e approaces' terapeutic use of se$f' e"ecuting ea$t care
tecni!ues and procedures' essentia$ pri(ar- ea$t care' co(fort (easures' ea$t teacings' and
ad(inistration of &ritten prescription for treat(ent' terapies' ora$ topica$ and parentera$
(edications' interna$ e"a(ination during $a*or in te a*sence of antenata$ *$eeding and de$i#er-.
In case of suturing of perinea$ $aceration' specia$ training sa$$ *e pro#ided according to protoco$
esta*$isedH
*. esta*$is $in%ages &it co((unit- resources and coordination &it te ea$t tea(H
c. Pro#ide ea$t education to indi#idua$s' fa(i$ies and co((unitiesH
d. Teac' guide and super#ise students in nursing education progra(s inc$uding te ad(inistration of
nursing ser#ices in #aried settings suc as ospita$s and c$inicsH underta%e consu$tation ser#icesH
engage in suc acti#ities tat re!uire te uti$i)ation of %no&$edge and decision6(a%ing s%i$$s of a
registered nurseH and
e. Underta%e nursing and ea$t u(an resource de#e$op(ent training and researc' &ic sa$$
inc$ude' *ut not $i(ited to' te de#e$op(ent of ad#ance nursing practiceH
Pro#ided' Tat tis section sa$$ not app$- to nursing students &o perfor( nursing functions
under te direct super#ision of a !ua$ified facu$t-7 Pro#ided' furter' Tat in te practice of nursing in a$$
settings' te nurse is dut-6*ound to o*ser#e te +ode of Etics for nurses and upo$d te standards of safe
nursing practice. Te nurse is re!uired to (aintain co(petence *- continua$ $earning troug continuing
professiona$ education to *e pro#ided *- te accredited professiona$ organi)ation or an- recogni)ed
professiona$ nursing organi)ation7 Pro#ided' fina$$-' tat te progra( and acti#it- for te continuing
professiona$ education sa$$ *e su*(itted to and appro#ed *- te /oard.
/oard Reso$ution No. ..C
Series of .CC1
+ode of Etics for Registered Nurses
,. >a$ues' custo(s' and spiritua$ *e$iefs e$d *- indi#idua$s sa$$ *e respected.
.. Indi#idua$ freedo( to (a%e rationa$ and unconstrained decisions sa$$ *e respected.
0. Persona$ infor(ation ac!uired in te process of gi#ing nursing care sa$$ *e e$d in strict confidence.
1. ;u(an $ife is in#io$a*$e.
2. Gua$it- and e"ce$$ence in te care of te patients are te goa$s of nursing practice.
4. Accurate docu(entation of actions and outco(es of de$i#ered care is te a$$(ar% of nursing
accounta*i$it-.
5. Registered Nurses are te ad#ocates of te patients7 te- sa$$ ta%e appropriate steps to safeguard
teir rigts and pri#i$eges.
?. Registered Nurses are a&are tat teir actions a#e professiona$' etica$' (ora$' and $ega$ di(ensions.
A. Te- stri#e to perfor( teir &or% in te *est interest of a$$ concerned.
,C. Te Registered Nurse is in so$idarit- &it oter (e(*ers of te ea$tcare tea( in &or%ing for te
patient:s *est interest.
,,. Te Registered Nurse (aintains co$$egia$ and co$$a*orati#e &or%ing re$ationsip &it co$$eagues and
oter ea$t care pro#iders.
,.. Te preser#ation of $ife' respect for u(an rigts' and pro(otion of ea$t- en#iron(ent sa$$ *e a
co((it(ent of a Registered Nurse.
,0. Te esta*$is(ent of $in%ages &it te pu*$ic in pro(oting $oca$' nationa$' and internationa$ efforts to
(eet ea$t and socia$ needs of te peop$e as a contri*uting (e(*er of societ- is a no*$e concern of a
Registered Nurse.
,1. Maintenance of $o-a$t- to te nursing profession and preser#ation of its integrit- are idea$.
,2. +o(p$iance &it te *-6$a&s of te accredited professiona$ organi)ation <PNA=' and oter
professiona$ organi)ations of &ic te Registered Nurse is a (e(*er is a $oft- dut-.
,4. +o((it(ent to continua$ $earning and acti#e participation in te de#e$op(ent and gro&t of te
profession are co((enda*$e o*$igations.
,5. +ontri*ution to te i(pro#e(ent of te socio6econo(ic conditions and genera$ &e$fare of nurses
troug appropriate $egis$ation is a practice and a #isionar- (ission.
Lega$ aspect of Nursing Practice
T-pes of La&s
,. Pu*$ic $a&
Refers to te *od- of $a& tat dea$s &it re$ationsips *et&een indi#idua$s and te
go#ern(ent and go#ern(enta$ agencies.
+ri(ina$ $a& 3 dea$s &it actions against te safet- and &e$fare of te pu*$ic. Eg
o(icide' (ans$augter and teft.
+$assification7
a. Fe$onies 3 a cri(e of a serious nature suc as (urder' punisa*$e *- a ter( in prison.
*. Misde(eanor 3 an offense of a $ess serious nature and is usua$$- punisa*$e *- a fine
or sort ter( Bai$ sentence or *ot. Eg s$apping a c$ient:s face
.. Pri#ate $a&
/od- of $a& tat dea$s &it re$ationsip a(ong pri#ate indi#idua$s.
A$so %no&n as +i#i$ $a&
+$assification7
a. +ontract $a& 3 in#o$#es te enforce(ent of agree(ents a(ong pri#ate indi#idua$s or
te pa-(ents of co(pensation for fai$ure to fu$fi$$ te agree(ents.
*. Tort $a& 3 enforces duties and rigts a(ong pri#ate indi#idua$s tat are not *ased on
contractua$ agree(ents. Eg neg$igence and (a$practice
+$assification of Tort La&
,. Unintentiona$ Torts
a. Neg$igence
Misconduct or practice tat is *e$o& te standard e"pected of an ordinar-' reasona*$e'
and prudent person.
*. Gross neg$igence
In#o$#es e"tre(e $ac% of %no&$edge' s%i$$' or decision (a%ing tat te person c$ear$-
sou$d a#e %no&n &ou$d put oters at ris% for ar(.
c. Ma$practice
8Professiona$ neg$igence9 3 neg$igence tat occurred &i$e te person &as perfor(ing as
a professiona$ suc as p-sicians' dentists' $a&-ers' and genera$$- inc$udes nurses.
Si" e$e(ents (ust *e present for a case to *e pro#en7
a. Dut- 3 nurse is in#o$#e in pro#iding care and fo$$o&ing an accepta*$e standard of care
*. /reac of dut- 3 tere (ust *e a standard of care tat is e"pected in te specific situation *ut tat
te nurse did not o*ser#e.
c. Foreseea*i$it- 3 a $in% (ust e"ist *et&een te nurse:s act and te inBur- suffered
d. +ausation 3 it (ust *e pro#ed tat te ar( occurred as a direct resu$t of te nurse:s fai$ure to
fo$$o& te standard of care and te nurse cou$d a#e %no&n tat fai$ure to fo$$o& te standard of
care cou$d resu$t n suc ar(.
e. ;ar( or InBur-
f. Da(ages
.. Intentiona$ Torts
a. Assau$t 3 an atte(pt or treat to touc anoter person unBustifia*$-. Eg c$ose fist
*. /atter- 3 &i$$fu$ toucing of a person or te person:s c$otes or e#en so(eting te person is
carr-ing tat (a- or (a- not cause ar(. Toucing &itout per(ission
c. Fa$se i(prison(ent 3 8unBustifia*$e detention of a person &itout $ega$ &arrant to confine te
person9. Eg restrain &itout doctor:s order
d. In#asion of pri#ac- 3 is a direct &rong of a persona$ nature
Four t-pes of in#asion7
Use of te c$ient:s na(e or $i%eness for profit' &itout consent
Unreasona*$e intrusion
Pu*$ic disc$osure of pri#ate facts
Putting te person in a fa$se $igt
Points to o*ser#e in order to a#oid $ega$ pro*$e(s
,. /e fa(i$iar &it te Pi$ippine Nursing La&
.. /e a&are of te $a&s tat affect nursing practice
0. At te start of e(p$o-(ent get a cop- of te agenc-:s ru$es' regu$ations and po$icies
1. Upgrade -our s%i$$s and co(petence
2. Accept on$- suc responsi*i$it- tat is in te scope of -our e(p$o-(ent and -our Bo* description
4. Do not de$egate -our responsi*i$it- to oters
5. Deter(ine &eter -our su*ordinates are co(petent in te &or% -ou are assigning te(
?. De#e$op good interpersona$ re$ationsip &it -our co6&or%ers' &eter te- are -our superiors'
peers or su*ordinates
A. +onsu$t -our superiors for pro*$e( tat (a- *e too *ig for -ou to and$e
,C. >erif- orders tat are not c$ear to -ou or tose tat see( to *e erroneous
,,. Te doctors sou$d *e infor(ed a*out te patients: conditions' te effects of (edication and
treat(ents or te patients $ac% of progress
,.. Te nurse sou$d *e a&are of te #a$ue necessit- of %eeping accurate and ade!uate records
,0. Patients are entit$ed to infor(ed consent
,1. /e fa(i$iar &it Artic$e ,A of te Re#ised Pena$ +odeH E#er- person (ust' in te e"ercise of
isEer rigt and in te perfor(ance of isEer duties' act and Bustice' gi#e e#er-one isEer due
and o*ser#e onest- and good fait and fo$$o& te go$den ru$e
/i$$ of Rigts of te Patients7
,. Te patient as te rigt to consider and respect care.
.. Te patient as te rigt to o*tain fro( is p-sician co(p$ete current infor(ation concerning is
diagnosis' treat(ent and prognosis &ic eEse is reasona*$- e"pected to understand.
0. Te patient as te rigt to %no& &at ospita$ ru$es and regu$ations app$- to is conduct as
patient.
1. Te patient as te rigt to e"a(ine and recei#e an e"p$anation of is *i$$ regard$ess of source of
pa-(ent.
2. Te patient as te rigt to refuse treat(ent to te e"tent per(itted *- $a& and to *e infor(ed of
te (edica$ conse!uences of is action.
4. Te patient as te rigt to e"pect co((unications and records pertaining to is care &ic sou$d
*e treated as confidentia$.
5. Te patient as te rigt to e#er- consideration of is pri#ac- concerning is o&n (edica$ care
progra(.
?. Te patient as te rigt to e"pect tat te ospita$ (ust (a%e reasona*$e response to te re!uest
for patient ser#ice. Te ospita$ (ust pro#ide e#a$uation ser#ice andEor referra$ as indicated *- te
urgenc- of te case.
A. Te patient as te rigt to e"pect reasona*$e continuit- of care. ;e as te rigt to %no& in
ad#ance &at ti(e p-sicians are a#ai$a*$e and &ere.
,C. Te patient as te rigt to *e ad#ised if te ospita$ proposes to engage in or perfor( u(an
e"peri(entation affecting is care or treat(ent. Te patient as te rigt to refuse to participate in
suc a researc proBect.
+o((unication S%i$$s
Intercange of infor(ation *et&een t&o or (ore peop$e
E"cange of ideas or tougts
Mode of +o((unication
,. >er*a$ co((unication 6 &a- of co((unicating tat uses &ritten or spo%en $anguage
a. Face and intonation
*. Si(p$icit-
c. +$arit- and /re#it-
d. Ti(ing and Re$e#ance
e. Adapta*i$it-
f. +redi*i$it-
g. ;u(or
.. Non#er*a$ co((unication 6 &a- of co((unicating tat uses facia$ e"pressions' gestures' and
*od- $anguage.
a. Persona$ appearance
*. Posture and Gait
c. Facia$ e"pression
d. Gesture
+o((unication Process
,. Sender 3 te person &it infor(ation to sare
.. Message 3 for( of infor(ation de$i#er to te recei#er
0. Recei#er 3 te person for &o( te infor(ation is intended.
1. Response 3 te recei#er $ets te sender %no& &eter te (essage &as recei#ed and understood.
;o& to *e a good co((unicator
,. Den -ou are te sender' (a%e sure -our (essage is c$ear
a. Tin% a*out &at -ou &ant to sa-. Present te infor(ation in a $ogica$' organi)ed &a-.
*. If -our (essage is &ritten' (a%e sure -our and&riting is neat and -our spe$$ing is
accurate.
c. Spea% c$ear$- at a nor(a$ pace' and a#oid (u(*$ing. Un$ess te person is earing
i(paired' tere is no reason to raise -our #oice.
d. Use &ords tat te person -ou are spea%ing to understands. Den appropriate' use si(p$e'
co((on &ords in p$ace of (ore tecnica$ &ords' if necessar-' use an interpreter.
e. Face te person -ou are spea%ing to.
f. Ma%e sure tat te person -ou are spea%ing to is a*$e to p-sica$$- recei#e te (essage.
.. Den -ou are te recei#er' *e good $istener
a. Focus -our attention on te spea%er
*. Sit do&n and do not appear rused or in a urr-
c. Ma%e e-e contact &it te spea%er
d. Do not interrupt or tr- finis te spea%er:s sentences
0. Learn tecni!ues for encouraging peop$e to ta$%
a. As% open ended !uestion instead of 8-esEno9 !uestion.
*. See% feed*ac%
c. O*ser#e for non#er*a$ cues
1. A#oid *ea#iors tat *$oc% effecti#e co((unication
a. A#oid *eing Budg(enta$
*.A#oid assu(ing tat anoter person %no&s &at -ou are tin%ing
c. A#oid 8turning out9 oter
d.A#oid negati#e *od- $anguage
2. Den caring for a person &o spea%s a foreign $anguage
a. Use and gestures or picture *oard to co((unicate #er- *asic ideas
*. Iou (a- need to use an interpreter to a#oid (isunderstanding
4. Den co((unicating &it a person &o as a earing $oss7
a. Face te person &en -ou are spea%ing to i( or er
*. Use a note pad to &rite do&n i(portant !uestions or directions so tat te person can
read te(.
c. +onsider $earning sign $anguage or using a sign $anguage interpreter.
d. Ma%e sure te earing aid is turn on and tat te #o$u(e is turned up ig enoug.
5. Den caring for a person &o as trou*$e spea%ing7
a. As% 8-esEno9 !uestion &en a$$ -ou need is *asic infor(ation.
*. If -ou cannot understand &at te person is sa-ing' p$ease te$$ te person tat -ou did not
understand and $oo% for oter &a-s to e$p te person co((unicate.
Terapeutic +o((unication
,. Using si$ence
Accepting pauses or si$ences tat (a- e"tend for se#era$ seconds or (inutes &itout
interBecting an- #er*a$ response.
.. Pro#iding genera$ $eads
Using state(ents or !uestions tat encourage te c$ient to #er*a$i)e' coose a topic of
con#ersation' and faci$itate continued #er*a$i)ation.
+an -ou te$$ (e o& it is for -ouJ
0. /eing specific and tentati#e
Ma%ing state(ents tat are specific rater tan genera$' and tentati#e rater tan a*so$ute
Rate -our pain in te sca$e of C 6 ,C
1. Using open ended !uestions
As%ing *road !uestions tat $ead or in#ite te c$ient to e"p$oreA e$a*orate' c$arif-' descri*e'
co(pare or i$$ustrateC tougts or fee$ings.
I:d $i%e to ear (ore of tatK
2. Using touc
Pro#iding appropriate for(s of touc to reinforce caring fee$ings.
Putting an ar( o#er te c$ients: sou$der.
4. Restating or paraprasing
Acti#e$- $istening for te c$ient:s *asic (essage and ten repeating tose tougts and
fee$ings in si(i$ar &ords.
Tis con#e-s tat te nurse as $istened and understood te c$ient:s *asic (essage and a$so
offers c$ients a c$earer idea of &at te- a#e said.
Iou ad difficu$t eating -esterda-K
5. See%ing c$arification
A (etod of (a%ing te c$ient:s *road o#era$$ (eaning of te (essage (ore understanda*$e.
It is used &en paraprasing is difficu$t of &en te co((unication is ra(*$ing or gar*$ed.
I:( not sure I understand tat
?. Perception cec%ing or see%ing consensua$ #a$idation
A (etod si(i$ar to c$arif-ing tat #erifies te (eaning of specific &ords rater tan te
o#era$$ (eaning of (essage.
Iou (eanK.
A. Offering se$f
Suggesting one:s presence' interest' or &is to understand te c$ient &iout (a%ing an-
de(ands or attacing conditions tat te c$ient (ust co(p$- &it to recei#e te nurse:s
attention.
I:$$ sta- &it -ou unti$ -our daugter arri#es
,C. Gi#ing infor(ation
Pro#iding in a si(p$e and direct (anner' specific factua$ infor(ation te c$ient (a- or (a-
not re!uest.
Iour surger- is scedu$ed for ,, AM to(orro&
,,. Ac%no&$edging
Gi#ing recognitions' in a nonBudg(enta$ &a-' of a cange in *ea#ior' an effort te c$ient as
(ade' or a contri*ution to a co((unication.
Iou tri((ed -our *eard and (ustace and &ased -our air
,.. +$arif-ing ti(e or se!uence
;e$ping te c$ient c$arif- an e#ent' situation or appening in re$ationsip to ti(e.
+$ient7 I #o(ited tis (orning
Nurse7 &as tat after *rea%fastJ
,0. Presenting rea$it-
;e$ping te c$ient to differentiate te rea$ fro( te unrea$
,1. Focusing
;e$ping te c$ient e"pand on and de#e$op a topic o i(portance
,2. Ref$ecting
Directing ideas' fee$ings' !uestions or content *ac% to c$ient to ena*$e te( to e"p$ore teir
o&n ideas and fee$ings a*out a situation.
,4. Su((ari)ing and p$anning
Stating te (ain points of discussion to c$arif- te re$e#ant points discussed.
/arriers to +o((unication
,. Stereot-ping
Offering genera$i)ed and o#ersi(p$iried *e$iefs a*out groups of peop$e tat are *ase on
e"periences too $i(ited to *e #a$id.
T&o -ear6o$ds are *rats
.. Agreeing and disagreeing
A%in to Budg(enta$ responses' agreeing and disagreeing i(p$- tat te c$ient is eiter rigt or
&rong and tat te nurse is in a position to Budge tis.
+$ient7 I don:t tin% Dr. /road is a #er- good doctor. ;e doesn:t see( interested in is
patients
Nurse7 dr. *road is ead of te Depart(ent of Surger- and is an e"ce$$ent surgeon
0. /eing defensi#e
Atte(pting to protect a person of ea$t care ser#ices for( negati#e co((ents.
Tese responses pre#ent te c$ient fro( e"pressing true concerns.
1. +a$$enging
Gi#ing a response tat (a%es c$ients pro#e teir state(ent or point of #ie&.
+$ient7 I fee$ as if I a( d-ing
Nurse7 o& can -ou fee$ tat &a- &en -our pu$se is 4CJ
2. Pro*ing
As%ing for infor(ation cief$- out of curiosit- rater tan &it te intent to assist te c$ient
+$ient7 I didn:t as% te doctor &en e &as ere
Nurse7 &- didn:t -ouJ
4. Testing
As%ing !uestions tat (a%e te c$ient ad(it to so(eting. Tese response per(it te c$ient
on$- $i(ited ans&ers and often (eet te nurse:s need rater tan te c$ient:s.
Do do -ou tin% -ou areJ
5. ReBecting
Refusing to discuss certain topics &it te c$ient
?. +anging topics and su*Bects
Directing te co((unication into areas of se$f interest rater tan considering te c$ient:s
concerns is often a se$f protecti#e response to a topic tat causes an"iet-.
A. Un&arranted reassurance
Using c$icLs or co(forting state(ent of ad#ice as a (eans to reassure te c$ient. Tese responses
*$oc% te fears' fee$ings' and oter tougts of te c$ient.
,C. Passing Budg(ent
Gi#ing opinions and appro#ing or disappro#ing responses' (ora$i)ing' or i(p$-ing one:s o&n
#a$ues.
,,. Gi#ing co((on ad#ice
Te$$ing te c$ient &at to do
Nursing Process
Identif- a c$ient:s ea$t status and actua$ or potentia$ ea$t care pro*$e(s or needs' to esta*$is
p$ans to (eet te identified need' and to de$i#er specific nursing inter#entions to (eet tose need.
+aracteristic of Nursing Process
,. It is a regu$ar$- repeated e#ent or se!uence of e#ents tat are continuous$- canging rater tan
sta-ing te sa(e.
.. +$ient centered
0. Adaptation of pro*$e( so$#ing and s-ste(s teor-.
1. Decision (a%ing is in#o$#ed in e#er- pase of te nursing process.
2. SMART
Nursing Process
Pase and Description Purpose Acti#ities
,. Assessing
+o$$ecting' organi)ing'
#a$idating and
docu(enting c$ient data
To esta*$is a data*ase a*out
te c$ient:s response to ea$t
concerns or i$$ness and te
a*i$it- to (anage ea$t care
needs.
Esta*$is a data*ase7
a. O*tain a nursing ea$t
istor-
*. +onduct a p-sica$
assess(ent
c. Re#ie& c$ient records
d. Re#ie& nursing $iterature
e. +onsu$t support persons
f. +onsu$t ea$t
professiona$s
Update data as needed
Organi)e data
>a$idate data
+o((unicateEdocu(ent data
.. Diagnosing
Ana$-)ing and
s-ntesi)ing data
To identif- c$ient strengts and
ea$t pro*$e(s tat can *e
pre#ented or reso$#ed *-
co$$a*orati#e and independent
nursing inter#entions.
To de#e$op a $ist of nursing
and co$$a*orati#e pro*$e(s
Interpret and ana$-)e data
a. +o(pare data against
standards
*. +$uster or group data
Generate tentati#e
-poteses
c. Identif- gaps and
inconsistencies
Deter(ine c$ient:s strengts'
ris%s' diagnoses' and
pro*$e(s.
For(u$ate nursing diagnoses
and co$$a*orati#e pro*$e(
state(ents.
Docu(ent nursing diagnoses
on te care p$an.
0. P$anning
Deter(ining o& to
pre#ent' reduce or reso$#e te
identified c$ient pro*$e(s'
o& to support c$ient
strengts and o& to
i(p$e(ent nursing
inter#entions in an organi)ed'
indi#idua$i)ed' and goa$6
directed (anner.
To de#e$op an indi#idua$i)ed
care p$an tat specifies c$ient
goa$sEdesired outco(es' and
re$ated nursing inter#entions.
Set priorities and
goa$sEoutco(es in
co$$a*oration &it c$ient.
Drite goa$. Desired outco(es.
Se$ect nursing strategies
inter#entions.
+onsu$t oter ea$t
professiona$s
Drite nursing orders and
nursing care p$an
+o((unicate care p$an to
re$e#ant ea$t care pro#iders.
1. I(p$e(enting
+arr-ing out te p$anned
nursing inter#entions.
To assist te c$ient to (eet
desired goa$sEoutco(es
Pro(ote &e$$ness
Pre#ent i$$ness and disease
Restore ea$t
And faci$itate coping &it
Reassess te c$ient to update
te data*ase
Deter(ine need for nursing
assistance
Perfor( p$anned nursing
inter#entions
a$tered functioning +o((unicate &at nursing
actions &ere i(p$e(ented
a. Docu(ent care and c$ient
responses to care
*. Gi#e #er*a$ reports as
necessar-
2. E#a$uating
Measuring te degree to
&ic goa$sEoutco(es a#e
*een acie#ed and identif-ing
factors tat positi#e$- or
negati#e$- inf$uence goa$
acie#e(ent.
To deter(ine &eter to
continue' (odif-' or ter(inate
te p$an of care
+o$$a*orate &it c$ient and
co$$ect data re$ated to desired
outco(es
Fudge &eter goa$sEoutco(es
a#e *een acie#ed
Re$ate nursing actions to
c$ient outco(es
Ma%e decisions a*out pro*$e(
status
Re#ie& and (odif- te care
p$an as indicated or ter(inate
nursing care.
Docu(ent acie#e(ent f
outco(es and (odification of
te care p$an.

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