tina. . .i hate to burst your bubble here, but this is what you signed up for. adpie is
the nursing process. . .is
the problem solving method that nurses use. it is the
ultimate thing you will be expected to have learned by the time you graduate. you will be doing it all through nursing school. it is the
ultimate thing that your future employers
will expect you to know. every day of your life on the job as a future rn you will use adpie to solve problems. your worth as a working rn will be your ability to solve problems. that is what rns do--solve problems.
now, you already know this process and you've been doing it most of your life. you just haven't been labeling it adpie or calling it the nursing process. let me explain. you are listening to your portable radio and it suddenly stops working. what do you do? throw a fit? well, after that, what do you do? a - assess what might be wrong. you make a little examination of the radio trying to figure out what might be wrong. d - determine what the problem is. p - plan what you are going to do to fix the problem. i - put the plan into action (implement it). e - did it work? if so, you're good to go. if it didn't you go back to a and assess again and start the cycle all over. you have done this time and again in your life for all kinds of problems that came up from the electricity going out to problems with your car, screw ups with class schedules, people who didn't do what they promised for you, etc.
you are in college. part of the collegiate experience is taking something like the nursing process and ripping it apart into its individual parts and scrutinizing them. every college and every college program of study does this--not just nursing. welcome to the world of higher education. it's even worse if you go on to get a bachelor's, master's or phd.
you are only 5 weeks into a what?, 2-year program? why would anyone expect you to be an expert at this at 5 weeks? i write about adpie, the nursing process and nursing diagnosis all the time. i freely admit that i didn't "get" this stuff until well after i graduated and i'm no dummy. it's not necessarily true that there are very few things that you can independently implement for patients. you can find independent nursing interventions in your textbooks, care plan books and in this book: nursing interventions classification (nic)
, by joanne mccloskey mccloskey dochterman, gloria m. bulechek, and gloria m. bulechek. you will learn them from other nurses the longer you are in clinicals and a practicing nurse. and, it's true that you will not always stay at the hospital long enough to observe how a care plan worked out. that is going to be true of your entire career. being an rn means managing and directing care. an rn is a leader and supervisor of care and a care plan is one way we do that.
after a while and seeing many patients with the same problems, care plans
sometimes get pretty routine. you just haven't seen that happen yet because you are only 5 weeks into this.
while you are a student one
of the purposes of writing care plans is to help you learn not only the critical thinking but also learning
about the medical condition and treatment that the patient you are adpie'ing is experiencing. please keep that in mind. if you have a patient with pneumonia, part of your care plan should be looking up as much as you can find about pneumonia, how the doctor diagnoses and treats it, the drugs commonly given for it and the nursing interventions for it--not just what your particular patient only needs. this is what will make you a great nurse.
i have written about adpie (actually referred to it as the nursing process) on these two threads:
please don't make it more difficult than nursing school has done with it. follow the steps in the order of adpie. the biggest problem i see students having are that they skip around and ultimately end up getting confused and lost in what they are doing. the major, major first step of the process is your assessment. it is the foundation of the process and every written care plan. everything rests upon the assessment because it results in determining the patient's signs and symptoms, or abnormal assessment data (nanda calls them defining characteristics). your goals/outcomes, nursing interventions and evaluation is based upon the signs and symptoms the patient displayed. adpie is nothing more than a problem solving process written down on paper in a specific format dictated by your instructors. an employer may dictate some other specific written format they want you to use, but the problem solving process you use will be the same
. adpie is:
the steps of the nursing process
a problem solving process for nurses
- (a) assessment (collect data and list out the abnormal data)
- (d) nursing diagnosis (group your abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnosis to use)
- (p) planning (write measurable goals/outcomes and nursing interventions)
- (i) implementation (initiate the care plan)
- (e) evaluation (determine if goals/outcomes have been met)