Apply the nursing process in the provision of direct and indirect care of individuals, families and communities in a variety of settings and across diverse populations.
In clinical at Orchard Park for Nursing 220, I helped out with several different patients. I can remember one specific woman who was an 80yo morbidly obese, COPD, with diabetes patient. She had a private room and lots of family as evidenced by the pictures, cards, and drawings all over her walls. She was mildly depressed but very funny. One day she asked me if I would shave her face. Naturally, I did and apparently I did such a good job she asked me the next day to shave her legs. I did that as well and the difference it made in her attitude and demeanor was amazing!
We have spent a great amount of time in Nursing 260 learning the Nursing Process. In Nursing 270 we were required to do a complete health history and physical exam write up on our lab partner. The nursing process along with Gordon's Functional Health Patterns were instrumental in the completion of my paper.
I expect to master the program outcomes for Nursing Process by the end of my time in Nursing 340, 350 and 440. (Portfolio, 2007)
The nursing process is made up of five
steps: assessment, diagnosis, planning, interventions, and evaluation. These
five steps set up a framework for each nursing to operate within. As our experience level increases these steps
become less regimented and more integrated into the flow of our everyday
process. We often run through the steps
without consciously thinking about them as when you are a new nurse. In nursing 340, Adult Med/Surg I, we were required to turn in weekly CARE PLANS. From there we progressed to a long form NURSING PROCESS PAPER which demonstrated our ability to synthesize the steps for one patient.
In nursing 440, Adult Med/Surg II, we were required to do both CARE PLANS and CONCEPT MAPS. The concept maps were another tool to help us understand the meaning of holistic care. I found the concept maps to be much more challeging, requiring a higher level of critical thinking than the care plans.These were necessary tools to help us work through the steps of the nursing process and recognize that a person exists holistically not as an adjunct to their disease.
This ability to critically think and use the nursing process was an integral part of succeeding in the nursing program itself. At first I was
overwhelmed with the magnitude of information we needed to retain, not to mention
the integration of that information to practice. During my first clinical at Orchard Park my
thought process was choppy at best. My critical thinking was very immature and
my confidence level was nonexistent. Fast forward three years and I am able to
assess a patient in triage according to their chief complaint. I can correctly ascertain acuity levels and
whether they should go fast track or main ED.
This was evident during one specific case when the child presented with
a chief complaint of fall. She was three
years old, had fallen out of her high chair.
There was no loss of consciousness, no vomiting; the child was happy,
interactive with a small bump on her forehead and right temple. Three years earlier, I would have thought
the child should go to fast track because there wasn’t anything visibly going
on. However, when considering children in triage for fast track or main ED you
have to consider the big picture. Will
the child require a CAT scan? Could there be no presenting symptoms but still is
an Epidural Bleed? Given the answer to
both of those questions is most likely, yes, head injuries almost always go to
the main ED. As a result of my integration of the five steps into a more
automatic process my effort to unify the five steps into a flowing thought
pattern.
The nursing process is one outcome that, in my estimation, can never be fully met. I believe I have demonstrated my ability to use the nursing process to successfully administer care. My evaluations from my clinical experiences have exemplified a core ability to critically think and synthesize information, having all been positive and all goals met. However, the nursing process is not static, it is an ever flowing process that never stops. You learn something new everyday whether it's in nursing or in other aspects of your life. Going forward I plan to keep my mind open to learning new things and continuing my education.
