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Nursing Career

Discover Nursing
I wanted a versatile career where I could help people so I decided to become a nurse. It ended up being much more than I expected it .
www.discovernursing.com

For information on baccalaureate and graduate nursing education, nursing career options, and financial aid, contact:. American Association of Colleges of ...
www.bls.gov

Nursing Careers
Nursing is a career filled with endless personal and professional rewards. If you choose nursing, you are choosing to spend your life helping others, ...
www.marylandhealthcareers.org

Nurse.com
Students - Nursing News, Careers, Education, Forums ...
So obviously, you're interested in a career as a nurse! ... Nursing Specialties: a detailed look at the more popular career specialties, with additional ...
www.nurse.com

Nurse.com
Nursing Excellence - Nursing News, Careers, Education ...
Click here to submit a nomination for the 2008 Nursing Excellence Awards ... Events, Career Fairs / Seminars / Tours / Nursing Excellence Awards / Virtual ...
www.nurse.com

Nursing as a Second Career
Considering nursing as a second career? Read this Q&A to find out which types of nursing programs are right for you.
www.allnursingschools.com

AACN - Education Center
The Bachelor of Science degree in nursing is the critical first step for a career in professional nursing. The American Association of Colleges of Nursing ...
www.aacn.nche.edu

Nurses for a Healthier Tomorrow
The Nurse Career. Nursing is poised to change the face of health care as never before. The Bureau of Labor Statistics reports employment among RNs will grow ...
www.nursesource.org

Choose Nursing: Exploring Career Options
Flight Nurses and Certified Registered Nurse Anesthetists are two examples. Check out what they do. Then take a look at other opportunities in nursing, ...
www.choosenursing.com

NCC
Whether you are a student at second-level school or a mature person considering your career options, or if you are already qualified as a nurse/midwife, ...
www.nursingcareers.ie

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Nursing Process

The nursing process is a process by which nurses deliver care to patients, supported by nursing models or philosophies. The nursing process was originally an adapted form of problem-solving and is classified as a deductive theory.

Characteristics of the nursing process

The nursing process is a cyclical and ongoing process that can end at any stage if the problem is solved. The nursing process exists for every problem that the patient has, and for every element of patient care, rather than once for each patient. The nurse's evaluation of care will lead to changes in the implementation of the care and the patient's needs are likely to change during their stay in hospital as their health either improves or deteriorates. The nursing process not only focuses on ways to improve the patient's physical needs, but also on social and emotional needs as well.

• Cyclic and dynamic
• Goal directed and client centered
• Interpersonal and collaborative
• Universally applicable
• Systematic

The nursing process is not something foreign or unusually complex. On the contrary, we use the nursing process method on a daily basis without even realizing it. For example, a trip to the gas station to get fuel requires Assessing the various prices and the number of people waiting to get gas among other things. A subsequent decision, or Diagnosis, is made based on the former criteria. This may include pulling into the gas station to fuel up or going down the road for better prices and/or less of a crowd. The price is right and there's not much of a crowd, we're pulling in. Now the Planning can take place. This may include which pump to use, how much gas to put in the tank, whether or not to clean the windows along with other things. We're at the pump and ready to fuel up. We must now Implement what we planned prior to pulling up to the pump. We've pulled up on the passenger side because the gas tank resides on this side, part of our plan. We've also given ourselves enough room to exit without getting blocked in by another vehicle, part of our plan also. We now uscrew the gas cap and begin fueling or Implementing what we planned. Things went well. We are fueled up and have exited the gas station without complication. Our Evaluation of the trip to the gas station would be a good one. We may choose to use this method in the future. The Nursing process is that simple in theory. However, as a nurse, the nursing process tool will be used for more complex and difficult situations but is applied the same way as the gas station analogy.

Skills

The nursing process involves skills a nurse should possess when he or she has to initiate the initial phase of the process. Having these skills contributes to the greater improvement of the nurse's delivery of health care to the patient, including the patient's level of health, or health status.

• Cognitive or Intellectual skills, such as analyzing the problem, problem solving, critical thinking and making judgements regarding the patient's needs. Included in these skills are the ability to indentify, differentiate actual and potential health problems through observation and decision making by synthesizing nursing knowledge previously acquired.
• Interpersonal skills, which includes therapeutic communication, active listening, conveying knowledge and information, developing trust or rapport-building with the patient, and ethically obtaining needed and relevant information from the patient which is then to be utilized in health problem formulation and analysis.
• Technical skills, which includes knowledge and skills needed to properly and safely manipulate and handle appropriate equipment needed by the patient in performing medical or diagnostic procedures, such as vital signs, and medication administrations.

Phases of the nursing process

The following are the steps or phases of the nursing process.

• Assessment (of patient's needs)
• Diagnosis (of human response needs that nursing can assist with)
• Planning (of patient's care)
• Implementation (of care)
• Evaluation (of the success of the implemented care)

Assessing Phase

The nurse should carry out a complete and holistic nursing assessment of every patient's needs, regardless of the reason for the encounter. Usually, an assessment framework, based on a nursing model or Waterlow scoring, is used. These problems are expressed as either actual or potential. For example, a patient who has been rendered immobile by a road traffic accident may be assessed as having the "potential for impaired skin integrity related to immobility".

Models for data collection

The following nursing models are used to gather the necessary and relevant information from the patient in order to effectively deliver quality nursing care.

• Gordon's functional health patterns
• Roy's adaptation model
• Body systems model
• Maslow's hierarchy of needs

Diagnosing Phase

Nursing diagnoses are part of a movement in nursing to standardize terminology which includes standard descriptions of diagnoses, interventions, and outcomes. Those in support of standardized terminology believe that it will help nursing become more scientific and evidence based.The purpose of this stage is to identify the patient's nursing problems.

Planning Phase

In agreement with the patient, the nurse addresses each of the problems identified in the planning phase. For each problem a measurable goal is set. For example, for the patient discussed above, the goal would be for the patient's skin to remain intact. The result is a nursing care plan.

Implementating Phase

The methods by which the goal will be achieved is also recorded at this stage. The methods of implementation must be recorded in an explicit and tangible format in a way that the patient can understand should he wish to read it. Clarity is essential as it will aid communication between those tasked with carrying out patient care.

Evaluating Phase

The purpose of this stage is to evaluate progress toward the goals identified in the previous stages. If progress towards the goal is slow, or if regression has occurred, the nurse must change the plan of care accordingly. Conversely, if the goal has been achieved then the care can cease. New problems may be identified at this stage, and thus the process will start all over again. It is due to this stage that measurable goals must be set - failure to set measurable goals will result in poor evaluations.

The entire process is recorded or documented in an agreed format in the patient's care plan in order to allow all members of the nursing team to perform the agreed care and make additions or changes where appropriate.

Nursing Assessment

Nursing assessment is the gathering of information about a patient's physiological, psychological, sociological, and spiritual status.

Stage one of the nursing process

Assessment is the first stage of the nursing process in which the nurse should carry out a complete and holistic nursing assessment of every patient's needs, regardless of the reason for the encounter. Usually, an assessment framework, based on a nursing model is used.

The purpose of this stage is to identify the patient's nursing problems. These problems are expressed as either actual or potential. For example, a patient who has been rendered immobile by a road traffic accident may be assessed as having the "potential for impaired skin integrity related to immobility".

Components of a nursing assessment

Nursing history

Taking a nursing history prior to the physical examination allows a nurse to establish a rapport with the patient and family. Elements of the history include:

• health status
• course of present illness including symptoms
• current management of illness
• past medical history including family's medical history
• social history
• perception of illness

Psychological and social examination

The psychological examination may include;

• Client’s perception (why they think they have been referred/are being assessed; what they hope to gain from the meeting)
• Emotional health (mental health state, coping styles etc)
• Social health (accommodation, finances, relationships, genogram, employment status, ethnic back ground, support networks etc)
• Physical health (general health, illnesses, previous history, appetite, weight, sleep pattern, diurinal variations, alcohol, tobacco, street drugs; list any prescribed medication with comments on effectiveness)
• Spiritual health (is religion important? If so, in what way? What/who provides a sense of purpose?)
• Intellectual health (cognitive functioning, hallucinations, delusions, concentration, interests, hobbies etc)

Physical examination

A nursing assessment includes a physical examination: the observation or measurement of signs, which can be observed or measured, or symptoms such as nausea or vertigo, which can be felt by the patient.

The techniques used may include Palpation, Auscultation and Percussion in addition to the "vital signs" of temperature, blood pressure, pulse and respiratory rate, and further examination of the body systems such as the cardiovascular or musculoskeletal systems.

Documentation of the assessment

The assessment is documented in the patient's medical or nursing records, which may be on paper or as part of the electronic medical record which can be accessed by all members of the healthcare team.

Assessment tools

A range of instruments has been developed to assist nurses in their assessment role. These include:

• the index of independence in activities of daily living
• the Barthel index
• the Crighton Royal behaviour rating scale
• the Clifton assessment procedures for the elderly
• the general health questionnaire
• the geriatric mental health state schedule

Other assessment tools may focus on a specific aspect of the patient's care. For example, the Waterlow score deals with a patient's risk of developing a Bedsore (decubitus ulcer), the Glasgow Coma Scale measures the conscious state of a person, and various pain scales exist to assess the "fifth vital sign".

Nursing Diagnosis

From Wikipedia, the free encyclopedia

A nursing diagnosis is a standardized statement about the health of a client (who can be an individual, a family, or a community) for the purpose of providing nursing care. Nursing diagnoses are developed based on data obtained during the nursing assessment.

The main organization for defining standard diagnoses in North America is the North American Nursing Diagnosis Association, now known as NANDA-International. Other international associations are AENTDE (Spanish), AFEDI (French language) and ACENDIO (Europe).

Nursing diagnoses are part of a movement in nursing to standardize the terminology involved. This includes standard descriptions of diagnoses, interventions and outcomes. Nurses who support of standardized terminology believe that it will help nursing become more scientific and evidence-based. Other nurses feel that nursing diagnoses are an ivory tower mentality and neither help in care planning nor in differentiating nursing from medicine.

Structure of diagnoses

The NANDA-International system of nursing diagnosis provides for five categories.

1. Actual diagnosis - a statement about a health problem that the client has and the benefit from nursing care. An example of an actual nursing diagnosis is: Ineffective airway clearance related to decreased energy as manifested by an ineffective cough.
2. Risk diagnosis - a statement about health problems that a client doesn't have yet, but is at a higher than normal risk of developing in the near future. An example of a risk diagnosis is: Risk for injury related to altered mobility and disorientation.
3. Possible diagnosis - a statement about a health problem that the client might have now, but the nurse doesn't yet have enough information to make an actual diagnosis. An example of a possible diagnosis is: Possible fluid volume deficit related to frequent vomiting for three days as manifested by increased pulse rate.
4. Syndrome diagnosis - used when a cluster of nursing diagnoses are seen together. An example of a syndrome diagnosis is: Rape-trauma syndrome related to anxiety about potential health problems as manifested by anger, genitourinary discomfort, and sleep pattern disturbance.
5. Wellness diagnosis - describes an aspect of the client that is at a low level of wellness. An example of a wellness diagnosis is: Potential for enhanced organized infant behaviour, related to prematurity and as manifested by response to visual and auditory stimuli.

Process of diagnoses

1. Collect data - statistical data relevant to achieving a diagnosis.
2. Cues/patterns - changes in physical status. (for example: lower urinary output)
3. Hypothesis - possible alternatives that could have caused previous cues/patterns.
4. Validation - taking necessary steps to rule out other hypothesis, to single out one problem.
5. Diagnosis - making a decision on the problem based on validation.
6. Strategies - taking necessary action to solve the problem and/or to provide adequate nursing care.