Many times the students in my psych clinicals ask this same question. I have been a RN for over 28 years full time and have been teaching since 2004. I think the problem with trying to describe the ideals are the "nurse-isms". It can be confusing to decipher what is being said.
First of all, we are not part of the "medical" profession. We are the Nursing Profession. How do we differ? Look at the definition: "the diagnosis and treatment of actual and potential HUMAN RESPONSES to illness/disease" We do not focus on the medical diagnosis, we look at how our patient (individual, family, community) is responding to the illness/disease/disorder (whatever!). Of course we do need to be knowledgable about the diagnosis so we know what to assess for. We do not "cure", in fact we do "care". We help the patient acheive their highest level of functioning (who's theory is that), by taking caritive measures (who is that?), etc. Do we always know the formal names to our behaviors, not necessarily.
It is the same regarding the nursing process/nursing care plan. Many times the students will say "The nurse said they never do care plans". Really? The nursing process is the basic framework of nursing (ADPIE). These phases are also the exact parts of the nursing care plan. What I respond is: in practice while I may no longer write a nursing care plan (yes, we used to have an area for this in the MR) I do use the nursing process. I collect subjective and objective data re: my patient, I analyze the significance and determine what I think is going on for the patient, I discuss with the patient how we will address the problem, select appropriate actions to help meet the goal and take a look to see if it works. Isn't that a care plan? The nursing process? When I document, I address each step of the nursing process as well-regardless of the format used (PIE, DAR, narrative, etc)
For those who don't care for NANDA, it is those impairments that are typically used in the multidisciplinary treatment plans (Potential for violence, alterations in sensory perceptions, alterations in thought process, etc). If my patient is schizophrenic, you bet I care about the presence of hallucinations or delusions (those are the symptoms (responses) I assess for based on the medical dx). If they are present, I want to decrease/eliminate them. I medicate, I engage in a 1:1 to provide support and diversions,and check back to see if it worked. The person that spoke about Maslow is correct in that application of a theory-basic needs need to be met before progress can be made. Different levels of care happen at different phases of the patient's illness, theory addresses this as well. Sometimes you have to slow down and really take a look at what you're doing and why. You may surprise yourself! Embrace nursing, it's a great profession.
My NY 2 cents.....
