Nursing practices is rooted in the use of the Nursing Process, a problem solving method used to develop evidence-based plans for patient care as they respond to actual or potential health problems. The Nursing curriculum incorporates assessment, nursing diagnosis, planning, implementation and evaluation as the five steps of the Nursing Process.
- Assessment – collecting and organizing relevant date.
- Nursing Diagnosis – identifying the causative factor(s) impacting the patient.
- Planning – identifying, in collaboration with the patient whenever possible, the measurable goal(s) that will resolve the identified Nursing diagnosis.
- Implementation – implementing actions to attain the defined goal(s).
- Evaluation – reassessing whether the of identified measurable goals have been achieved.
Providing Holistic Care
Students in the Program are expected to provide holistic care, to diverse individuals, in various stages of the life cycle. In order to achieve this, Marjorie Gordon’s Theory of the Eleven Functional Health Patterns is applied to all patient care. The Functional Patterns include:
- Health Perception and Health Management – patient’s perceived pattern of health and well-being; how health is managed (primary, secondary and tertiary levels of illness prevention)
- Nutritional Metabolic – pattern of food and fluid consumption relative to metabolic need; pattern indicators of local nutrient supply; skin integrity and thermo-regulation
- Elimination – patterns of excretory function (bowel, bladder)
- Activity Exercise – pattern of exercise, activity, leisure, recreation, cardiac and respiratory function
- Sleep Rest – patterns of sleep, rest, and relaxation
- Cognitive Perception – sensory perceptual and cognitive pattern (how well a patient perceives stimuli and interacts with the environment)
- Self Perception and Self Concept – self-concept patterns (e.g. body comfort, body image, feeling safe); perceptions of self (e.g., body image, self-esteem, personal identity)
- Role Relationship – pattern of role-engagements and relationships (e.g., developmental levels)
- Sexual Reproductive – patterns of satisfaction and dissatisfaction with sexuality pattern; reproductive patterns
- Coping Stress Tolerance – general coping pattern, effectiveness of the pattern in terms of stress tolerance
- Value Belief – patterns of values, beliefs (including spiritual); goals that guide choices or decisions (culture and concepts of caring)
Nursing Practice Roles
The eight nursing practice roles of the Associate Degree Nurse are implemented throughout the curriculum. These roles come from the Educational Competencies for graduates of Associate Degree Nursing Programs developed by the National League for Nursing Council of Associate Degree Nursing Competencies Task Force (2000).
Professional Behaviors: Professional behaviors within nursing practice are characterized by a commitment to the profession of nursing. The graduate of an associate degree nursing program adheres to standards of professional practice, is accountable for her/his own actions and behaviors, and practices nursing within legal, ethical, and regulatory frameworks. Professional behaviors also include a concern for others, as demonstrated by caring, valuing the profession of nursing, and participating in ongoing professional development.
Communication: Communication in nursing is an interactive process through which there is an exchange of information that may occur verbally, non- verbally, in writing, or through information technology. Those who may be included in this process are the nurse, client, significant support person(s), other members of the healthcare team, and community agencies. Effective communication demonstrates caring, compassion, and cultural awareness, and is directed toward promoting positive outcomes and establishing a trusting relationship.
Therapeutic communication is an interactive verbal and non-verbal process between the nurse and client that assists the client to cope with change, develop more satisfying interpersonal relationships, and integrate new knowledge and skills.
Assessment: Assessment is the collection, analysis, and synthesis of relevant data for the purpose of appraising the client’s health status. Comprehensive assessment provides a holistic view of the client which includes dimensions of physical, developmental, emotional, psychosocial, cultural, spiritual, and functional status. Assessment involves the orderly collection of information from multiple sources to establish a foundation for provision of nursing care, and includes identification of available resources to meet client needs. Initial assessment provides a baseline for future comparisons that can be made in order to individualize client care. Ongoing assessment and reassessment are required to meet the client’s changing needs.
Clinical Decision Making: Clinical decision making encompasses the performance of accurate assessments, the use of multiple methods to assess information, and the analysis and integration of knowledge and information to formulate clinical judgments. Effective clinical decision making results in finding solutions, individualizing care, and assuring the delivery of accurate, safe care that moves the client and support person(s) toward positive outcomes. Evidence based practice and the use of critical thinking provide the foundation for appropriate clinical decision making.
Caring Interventions: Caring interventions are those nursing behaviors and actions that assist clients in meeting their needs. These interventions are based on a knowledge and understanding of the natural sciences, behavioral sciences, nursing theory, nursing research, and past nursing experiences. Caring is the “being with” and “doing for” that assist clients to achieve the desired results. Caring behaviors are nurturing, protective, compassionate, and person-centered. Caring creates an environment of hope and trust, where clients choices related to cultural values, beliefs, and lifestyle are respected.
Teaching and Learning: Teaching and learning processes are used to promote and maintain health and reduce risks, and are implemented in collaboration with the client, significant support person(s), and other members of the healthcare team. Teaching encompasses the provision of health education to promote and facilitate informed decision making, achieve positive outcomes, and support self-care activities. Integral components of the teaching process include the transmission of information, evaluation of the response to teaching, and modification of teaching based on identified responses. Learning involves the assimilation of information to expand knowledge and change behavior.
Collaboration: Collaboration is the shared planning, decision making, problem solving, goal setting, and assumption of responsibilities by those who work together cooperatively, with open professional communication. Collaboration occurs with the client, significant support person(s), peers, other members of the healthcare team, and community agencies. The nurse participates in the team approach to holistic, client-centered care across healthcare settings. The nurse functions as advocate, liaison, coordinator, and colleague as participants work together to meet client needs and move the client toward positive outcomes. Collaboration requires consideration of client needs, priorities and preferences, available resources and services, shared accountability, and mutual respect.
Managing Care: Managing care is the efficient, effective use of human, physical, financial and technological resources to meet client needs and support organizational outcomes. Effective management is accomplished through the processes of planning, organizing, directing, and controlling.
The nurse, in collaboration with the healthcare team, uses these processes to assist the client to move toward positive outcomes in a cost effective manner, to transition within and across healthcare settings, and to access resources.