Need help with the Nursing process...suprise, suprise

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I was reading on hear a few weeks ago about the nursing process. I read a really great response that had an example about a car breaking down. Well, not all the information made it all the way to my long term memory. Now we're finally on the Nursing Process in Fundamentals and I need to read it again. It was really great, it was like an article, not a response to a discussion board. Could the person who wrote such a great response on the nursing process do it again? I really need you to explain the who thing, not just the car example, but all the info you gave, please?!?! With cherries on top?:redpinkhe:redbeathe:D:D

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Hello hollysaad

This post by Daytonite is probably the one you are referring to.

https://allnurses.com/general-nursing-student/nursing-process-359656.html

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Specializes in med/surg, telemetry, IV therapy, mgmt.

hearing about the nursing process is often new to many people. i am the author of that car analogy. here it is again for you:

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

another similar analogy of critical thinking and adaptation of the scientific process is how the criminal justice system works. when a crime is discovered police officers and detectives begin an investigation. their data collection process (assessment) is well known to us because of programs like csi. that data is extremely important because it proves the crime and connects the criminal to the act. the crime (diagnosis) unlike in nursing is already known for these professionals. their work involves data collection. but, you see, without that data, they wouldn't have a case. data is always the foundation of what follows. once the data and problem (crime) are established, the process moves onward into the court system where interventions are made and something gets done about the problem (planning). the criminal get punished, the victim gets relief, etc. the criminal has their day in court and their case goes to trial. if they are found guilty, sentence is passed and the intervention is implemented. evaluation may be handled differently. jailed criminals may get parole for good behavior.

the nursing process also expand on the 5 steps of the nursing process into what needs to be done for care planning. however, in reality, the nursing process is just a problem solving methid whose steps can be adapted to solving any problem. here is how it is adapted to solving patient's nursing problems:

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
    • a physical assessment of the patient
    • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
    • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
    • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.

[*]determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use). it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.

[*]planning (write measurable goals/outcomes and nursing interventions)

  • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
    • improve the problem or remedy/cure it
    • stabilize it
    • support its deterioration

    [*]how to write goal statements: see post #157 on thread https://allnurses.com/general-nursing-student/careplans-help-please-121128.html

    [*]interventions are of four types

    • assess/monitor/evaluate/observe (to evaluate the patient's condition)
      • note: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during step 1.

      [*]care/perform/provide/assist (performing actual patient care)

      [*]teach/educate/instruct/supervise (educating patient or caregiver)

      [*]manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

[*]implementation (initiate the care plan)

[*]evaluation (determine if goals/outcomes have been met)

for more information about the nursing process, see

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