I dont understand the nursing process when it comes to pharmacology

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Come to think of it I do not understand the nursing process at all

I know the nursing process is

1. Assessment

2. Diagnosis

3. Planning

4. implantation

5. Evaluation

Too add more to it it is even harder for me to understand the nursing process when it comes to pharmacology. Are you always suppose to assess your patient before giving a drug. Are you always suppose to have a nursing diagnosis for your patient. You have to plan on what drug you give to your patient which is not even the nurses job to decide what drug the patient needs. I know implantation is when you actually do it and then there is evaluation which did the drug actually work. I work as a nurses aide in a nursing home and when ever I get a resident that asks for Tylenol or ibuprofen I get the nurse and the nurse just gives the drug for them to take. I do not really understand do you only study the nursing process in pharmacology in nursing school or is it a whole different thing once you are working as a nurse.

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Assessment- pt states pain in right leg 7/10 pain scale. Area is a new surgical wound.

Diagnosis- pain r/t surgical wound e/b walking to bathroom

Planning- to admin pain meds, reposition.

Implementation- admin meds

Evaluation- pt sleeping comfortably.

This is based on the example of pain you stated. Do we work it out every time and have an exact nursing dx? In the real world not likely. BUT it is always there even when we don't think about it, it becomes second nature.

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Specializes in Rehab/Brain/Stroke/Spine.

Each and Every time you give a med, you must ask yourself, "does this drug make "make sense" with my patient?".

For example, Tordal IV is ordered for pain, you have already noted your pt. has a high Creat. and/or history of renal disease. So, the order does not fit. You clarify it, and call the Dr. Why? b/c they make errors. IF they are GOOD physicians they will not be offended.

Tordal is contraindicated for pt.'s with Renal disease/insuff.

You have a pt. with a potassium level of 5.5, this pt. has an order for K-Dur po daily. You note previous potassium levels on K-Dur have been normal mid range. giving the K-Dur does not "fit".... call, clarify, etc. (find out why pt's K jumped in 24 hours)

A pt. has Ancef 1 GM ordered post-op spinal fusion, pt.'s weight determines that under p/p they should get 2GM.

hope the examples helped, Pharmacology and med pass are extremely important for a RN!

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Specializes in Critical Care/Vascular Access.

Like I always tell my preceptees: nursing school and all its specifics and technicalities are to train you HOW to think, not necessarily WHAT to think. The nursing process is a good example. In clinicals during nursing school, you had x number of care plans to put together for your patients. Now that I'm a nurse, I never draw up a literal care plan, but the care plans in school taught me how to go about looking at a patient and caring for them. The nursing process is driven in while you're in school to teach you how to approach a problem with your patient. After you learn it and repeat many times, it comes naturally without you actually thinking through the steps one by one. When a patient of mine calls out for something, say.....pain medication, I naturally go through the process without actually thinking about it. I go look at them, ask them what their pain level is, etc, consider what procedure they've had done or what they're in the hospital for, look at what meds you available for them and what would be the best based on your previous assessment, administer it, go back in later to make sure they're comfortable. Voila. I just went through the nursing process without once actually thinking, "what comes next in the nursing process", it just makes sense.

If you pay attention, you will find too that the way the nursing process teaches you to think is a good way to look at many of life's problems outside of work in your personal life, not just medical ones on the job.......

By the way, not to call you out, but the fourth step is "implementation", as in to implement your plan......not "implantation". ;)

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Pain is not evidenced by walking to the bathroom. It may be reported as increased when walking, but the evidence is by patient's verbal report and/or nonverbal expressions of pain.

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Do you use this process only when you give them medication for the very first time. Lets say you gave someone new medication for the very first time will you have to always use this process continuously after that even after you know it works for them

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Pain is not evidenced by walking to the bathroom. It may be reported as increased when walking but the evidence is by patient's verbal report and/or nonverbal expressions of pain.[/quote']

I was using e/b as to mean exacerbated by.

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Specializes in Acute Care, Rehab, Palliative.
Do you use this process only when you give them medication for the very first time. Lets say you gave someone new medication for the very first time will you have to always use this process continuously after that even after you know it works for them

You would use it every time. It becomes second nature so you are not consciously going through the steps.

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Specializes in Emergency & Trauma/Adult ICU.

If I understand your question correctly, you are saying that you don't believe you are observing nurses where you work consciously and outwardly performing the 5 steps of the nursing process for each and every nursing action that they take.

You are correct.

An experienced nurse, particularly one working in an LTC setting where s/he knows the patients well, does not need to verbalize the nursing process/problem solving that goes into his/her actions out loud all the time. If the nurse trusts the rapport the CNA has with the residents (that's you) -- when you passed on the resident's report of pain the nurse may have thought to him/herself "yes, it has been about 4-5 hours since Mr. X last had Tylenol. I can see him over there rubbing his knee where his arthritis bothers him chronically. Tylenol/Ibuprofen is the med he's ordered on an ongoing basis, and it generally works well to control his pain." This chronic pain is probably addressed in the patient's care plan in his chart.

I'm just throwing out this one scenario as an example of the fact that just because the nurse doesn't *verbalize* to you each of these thought processes out loud, doesn't mean that the assessment-diagnosis-planning-implementation-evaluation process is not occurring. You're having to consciously go through each of these steps right now because it's new to you. With some time and experience, your actions will be smoother and flow more naturally.

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Do you use this process only when you give them medication for the very first time. Lets say you gave someone new medication for the very first time will you have to always use this process continuously after that even after you know it works for them

There are many medications that at any given time may or may not "work". A nurse assesses always. Daily medications also need assessments. For instance, a blood pressure medication may in some instances need to be re-evaluated due to a too low (or sometimes too high) of a blood pressure. If a resident is ill, then sometimes medications need to be looked at closely as to if it is going to be in the patient's best interest to give. All need a doctor's order, and all changes or holding of medications need a doctor's order/

Pain is what a patient says it is. Therefore. a nurse should look at the pain control options available, and depending on assessment, give accordingly. Then follow up to be sure that the medication was effective.

The nursing process becomes clearer when you are in the position to look at your orders, assess well, re-assess well and the patient outcome. It is difficult to just observe what a nurse is doing as opposed to having all of the backround information.

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Yeah the whole nursing process seems so confusing to me even when it involves in making care plans as well. Im trying to get a better grasp on it.

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I was using e/b as to mean exacerbated by.

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Yet another example of how nonstandard abbreviations cause miscommunication.

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