Part 1: Nursing process
All registered nurses on earth have some standard practices regardless of where they were trained. Whether working on a government health care center or a private health care center, there are several activities that all of them have in common. Despite the essential core, practice to deliver patient-focused care all nurses practices the following steps to maintain quality patient care.
i) Assessment
A registered nurse uses a systematic dynamic approach to gather the patient’s data so as to get a better understanding the patient. The nurse gets biographical data from the patient that includes the date of birth, name, and age. The nurse also collects data that has to do with the spiritual, physiological, sociological, psychological and economic status of the patient. At this stage, the nurse collects all data associated with the patient’s health records, family health records and any other information that explains more about the patient. The process is usually more of an interview, and it is the only stage where patient interaction is heaviest.
For example, if a patient is in the hospital because the body is in pain, the nurse’s assessment would include the manifestations of pain and the physical causes. The patient’s response to movement from one place to another, getting out of the bed, withdrawal from family members, not eating, and fear. All this could also be part of the nurse’s assessment so as to understand the patient better (Nursingworld.org, 2015).
ii) Diagnosis
In the diagnosis phase, the nurse makes an informed judgment about the patient’s health or potential health condition. A patient’s health condition may be so critical such that multiple diagnoses are made by the nurse. The determination process does not only show the actual description of the problem, but it also includes possible conditions that might result from the current patient’s condition. The judgment made by the nurse also tells whether the patient is ready to improve to a better health condition or whether the problem will be worse. With the data from the patient, the nurse is also likely to identify the conditions that might have caused other problems. Such conditions include lack of sleep, poor nutrition, and weight loss and other problems attached to the central patient’s condition. The diagnosis phase forms a basis of the planned patient care for the nurse.
An example of diagnosis is when an immobilized patient has a respiratory infection; the condition is a potential health hazard to the patient. iii) Planning
Based on the diagnosis, the nurse develops a measurable and achievable goal that will better the patient’s condition. The goals set are both short and long term to help the patient improve the health status. In cases where multiple diagnoses need to be achieved, the nurse starts with the riskiest condition so as to help eliminate it and put the boy in a better recovery state. The nurse prioritizes the symptoms that may cause higher risks in the patient’s health.
For example, a patient in the hospital and is not able to move from the bed might move from the bed to a different place three times day. A patient who has not been eating is given small amounts of nutritious meals more frequently. The patient’s assessment and diagnosis information is all kept in one file so that the nurse monitors the patient’s health status. The data is recorded at the time medical attention was sought, and conclusion about the health status and recovery can be made. iv) Implementation
In this phase, the nurse follows the action plan that is unique to each patient and focuses on the achievable patient’s health outcomes. The nurse monitors the patient and checks for signs of improvement and takes proper care of the patient. The nurse also gives valuable information to the patient regarding the health status and what how the patient should manage their health. All tasks performed by the