The nursing process is a systematic method of patient-focused care.
The nursing process is a problem-solving activity that requires the cognitive skills of critical thinking in order to be fully realized. Nearly every nurse-patient encounter allows opportunity for the nurse to guide the patient toward a higher level of health and wholeness.
Yet this depends upon the nurses’ ability to think critically about those encounters.
The nursing process is used to identify, treat, and prevent potential and actual health problems and to promote wellness. You will use this method throughout your nursing career.
This process is what unites the various types of nursing care.
1. Memorize ADPIE
ADPIE is the acronym for the entire nursing process.
It stands for
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
You need to have this memorized in order use the nursing process effectively.
At first you may need to write out each step of the nursing process and that’s okay.
I’ve created a FREE ‘Nursing Process’ PDF that you can download now and go through the nursing process with me.
Here is a quick overview of each element of ADPIE.
Assessment is collecting and analyzing data from a patient and is the first step of the nursing process. The assessment includes all data collected about the patient.
This includes all pertinent physiological, psychological, sociological, and spiritual information about the patient. This information is collected by objective and subjective methods.
Examples of objective data are vital signs, wound appearance, and description of ambulation.
Examples of subjective data are pain as described by the patient or how the patient is feeling (i.e., dizziness, headache, chest pain.)
Diagnosis is when we take the assessment findings and make a nursing diagnosis to identify actual or potential health and medical risks.
NANDA developed the nursing diagnosis.
Use Maslow’s hierarchy of needs to prioritize your nursing diagnoses. Then use the nursing diagnoses to create the care plan.
Planning is based on the assessment and diagnosis you’ve already made for your patient. The planning process includes nursing interventions that directly impact the nursing diagnosis.
Implementation is the action behind the plan. This is where you intervene with the nursing interventions you created as part of your nursing plan.
These are actions you have taken to help the patient such as giving medications, providing education, or monitoring vital signs.
Evaluation is the final step of ADPIE.
Ask yourself: Is the plan working? Is the plan in the process of being successful? Are the desired outcomes being met?
The evaluation step leads the nursing process right back to assessment, the first step of the nursing process.
2. Use ADPIE to ace NCLEX
The NCLEX-RN exam is designed to test your critical thinking skills, which include the nursing process. The NCLEX-RN exam questions require that you sift through multiple problems and needs, sorting and prioritizing them.
When reading through NCLEX questions, you can expect they are testing your assessing, diagnosing, planning, implementing, and evaluating processes. This is why you need to memorize ADPIE.
From there you will identify key words within the question that point to each part of ADPIE.
An assessment question might contain the words collect, determine, gather, assess, identify, do first, or observe.
An implementation or intervention question may contain the words action, implement, intervene, intervention, or next.
Questions that are testing you on evaluation and interpretation might use words such as evaluate, check, assess, decide, clarify, or describe.
Always ask: What part of the nursing process is this question addressing?
3. Take the nursing process into practice
Whether you intend to work inpatient or outpatient, the nursing process will direct the care you give your patients over and over again.
The nursing process will guide your assessment and allow you to create accurate and thorough patient care plans. It will direct you in implementing and evaluating your care plan.
The nursing process is the most critical tool for a systematic problem-solving approach to patient care. It is the very heart of what makes nursing a unique profession in and of itself.
If you have any questions about the nursing process, leave it in the comments! I’d love to help!!
Cheers!
Applying the Nursing Process
Need a Real-life Nursing Process Step-by-Step?
Let me tell you a story . . .
Consider one of my past home health patients, Francis.
She was 69-year-old status post pacemaker insertion who had returned home from the hospital a few days prior. Francis was staying with her daughter and would only sleep on the couch.
In fact, Francis refused to move off the couch except to use her walker to go the bathroom. After four days of this behavior, her daughter was frustrated and immediately attempted to get me “on her side” in dealing with the issue of getting her mother off the couch.
Assessment
I felt my first step was listening to Francis’ side of the story (subjective data.) Of course I gathered objective data as well: vital signs, etc.
I was curious about what ideas might be contributing to her lack of mobility.
As it turned out Francis was scared.
Diagnosis
Scared that too much activity would stress the pacemaker. Scared that it would stop working and her heart would stop beating. Scared that she would die.
Nurses must ‘think on their feet’ and a large part of that ability is being able to juggle the nursing process while at the same time apply the skills of critical thinking.
After acknowledging Francis’ fears, she was able to relax and hear my input.
Plan and Implementation
I recommended three things:
- Gentle range of motion three times daily (showing that movement did not affect the pacemaker).
- Training on how to take and record her pulse rate (a record would provide even more assurance of the consistency of the pacemaker).
- Ensuring that she knew the date of her follow up appointment with the cardiologist for regular pacemaker checks.
Using critical thinking to apply the nursing process was crucial in this instance.
Simply assessing the situation, diagnosing, and implementing a care plan would not have been as useful here as being able to apply the specific best practices of internal pacemaker post-op care (i.e., ROM exercises, taking her pulse rate and follow-up doctor appointments).
Evaluation
I was able to go back to her home in one week and assess how my interventions had helped. Francis showed me her heart rate list and was up walking daily.
As a nurses, we are often in a position to sense even subtle changes and trends in a patient’s condition and are able to know their unique strengths and personalities. Using focused assessment allows for specific directing of best-practice interventions leading to improved patient outcomes.
The interdependent relationship of thinking and decision-making that is inherent within the nursing process is crucial to best practice.
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Questions about the Nursing Process? I’d love to help. Leave a comment below.
