5 Stages of the Nursing Process – Best Explanation in 2022

This article provides an overview and a detailed explanation on the 5 Steps/Stages of the Nursing Process.

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Nursing Process

The nursing process is defined as a systematic, rational method of planning that guides all nursing actions in delivering holistic and patient-focused care. The nursing process is a form of scientific reasoning and requires the nurse’s critical thinking to provide the best care possible to the client.

What is the purpose of the nursing process?

The following are the purposes of the nursing process:

  1. To identify the client’s health status and actual or potential health care problems or needs (through assessment).
  2. To establish plans to meet the identified needs.
  3. To deliver specific nursing interventions to meet those needs.
  4. To apply the best available caregiving evidence and promote human functions and responses to health and illness (ANA, 2010).
  5. To protect nurses against legal problems related to nursing care when the standards of the nursing process are followed correctly.
  6. To help the nurse perform in a systematically organized way their practice.
  7. To establish a database about the client’s health status, health concerns, response to illness, and the ability to manage health care needs.

Characteristics of the nursing process

The following are the unique characteristics of the nursing process:

  1. Patient-centered – The unique approach of the nursing process requires care respectful of and responsive to the individual patient’s needs, preferences, and values. The nurse functions as a patient advocate by keeping the patient’s right to practice informed decision-making and maintaining patient-centered engagement in the health care setting.
  2. Interpersonal – The nursing process provides the basis for the therapeutic process in which the nurse and patient respect each other as individuals, both of them learning and growing due to the interaction. It involves the interaction between the nurse and the patient with a common goal.
  3. Collaborative The nursing process functions effectively in nursing and inter-professional teams, promoting open communication, mutual respect, and shared decision-making to achieve quality patient care.
  4. Dynamic and cyclical –The nursing process is a dynamic, cyclical process in which each phase interacts with and is influenced by the other phases.
  5. Requires critical thinking – The use of the nursing process requires critical thinking which is a vital skill required for nurses in identifying client problems and implementing interventions to promote effective care outcomes.

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The Five Step Nursing Process

Alexa is a health writer and registered nurse with over a decade of experience in neonatal and pediatric cardiac intensive care. After working her way from the Atlantic to Pacific as a travel nurse, she can now be found caring for members of the community in her hometown of Charleston, SC.

As a nurse, your primary duty is ensuring your patients receive safe delivery of care as outlined by the plan of care created by the medical team. Throughout your shift, you will be constantly collecting and analyzing patient information, and you’ll be charged with what to do with this information. By following the nursing process, you’ll take a systematic approach to manage your patients’ needs. The nursing process provides a framework of practice for the nurse to follow to guarantee that the patient has their needs met. In this article, we explain what the nursing process is, and the steps that are involved in this universal nursing tool.

The five steps of the nursing process

The nursing process is an evidence-based, five-step process used to help guide nurses to think holistically about their patient’s overall picture and plan of care. Nurses learn the nursing process during nursing school and informally use this process when taking care of patients in the professional setting.

When planning how a shift will play out with patients, the nurse must use clinical judgment to create a general plan for the day. The nursing process allows the nurse to gather information, prioritize problems, and set goals for each patient. As nurses gain more experience, the nursing process comes naturally when making decisions for patient care.

The steps are as follows:

  1. Assessment phase
  2. Diagnosis phase
  3. Planning phase
  4. Implementing phase
  5. Evaluation phase

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1. Assessment phase

During the assessment phase, the nurse will look at any subjective and objective data collected in the patient’s history. An example of objective data could be oxygen saturation trends from the chart, or documentation demonstrating that the patient’s oxygen liter flow was increased several times overnight. Subjective data could be information you got during nursing handoff- perhaps the overnight nurse mentioned that the patient was looking “air-hungry” and using accessory muscles to breathe.

What you will want to do during the assessment phase is gather all of this information and make your assessment about what is going on. Your nursing assessment starts before you see the patient, but continues throughout the shift. If the physician were to ask you if the patient looked worse than before, you could provide the details you gathered during your nursing assessment.

2. Diagnosis phase

During the diagnosis phase, you’ll take those assessment findings and formulate a few nursing diagnoses that will guide your care for the shift. A nursing diagnosis is separate from the medical diagnosis and will be subjective based on your nursing judgment. A medical diagnosis must be determined by the physician, for example, “acute respiratory failure.” A nursing diagnosis should be more focused on addressing the problems your patient will face during your shift, for example, “impaired gas exchange” or “risk for impaired mobility.” By creating a nursing diagnosis, you’re already prioritizing the patient’s needs.

Because patients often have multiple problems, you’ll want to follow Maslow’s hierarchy of needs to prioritize these problems. For example, addressing the patient’s oxygen requirements are more important than their ability to go for a walk. Creating nursing diagnoses based on the information you have about this patient will help anticipate any challenges you’ll need to address on your shift.

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Stages of The Nursing Process
Stages of The Nursing Process

3. Planning phase

The planning phase is also referred to as the outcomes phase and it is the stage that helps the nurse start formulating a plan of action. During this phase, the nurse will create some goals for the shift. What do you want to make sure happens on your shift? Again, safety is the top priority, so you’ll want to plan goals that prioritize airway, breathing and circulation first. Your first goal might be something like, “The patient will maintain an oxygen saturation of at least 92% this shift.”

For each of the medical issues, the nurse must assign a simple, achievable and measurable goal for a positive outcome for the patient. Generally, these are short-term goals and are evaluated on a shift-by-shift basis.

4. Implementing phase

As the nurse, what are the action items you will take to see that these goals are met? During the implementation phase, you’ll create a few nursing interventions to help achieve the patient’s goals. For example, “Will titrate oxygen liter flow to maintain saturations above 92% this shift.”

Once you’ve addressed airway and breathing, you can create additional action items that will help meet the goals from the planning phase. What will help your patient’s oxygen levels stay up? The next goals could be something like, “Will encourage patient to use incentive spirometry 10 times an hour,” or “Will ambulate patient three times a shift and encourage cough and deep breathing.”

5. Evaluation phase

The final phase of the nursing process is the evaluation phase. It takes place following the interventions to see if the goals have been met. During the evaluation phase, the nurse will determine how to measure the success of the goals and interventions. For a patient with respiratory issues, one evaluation tool would be to trend the patient’s oxygen saturation levels throughout the shift. Ask yourself, “Were you able to wean the oxygen or did you have to increase the liter flow?”

Here are a few possible outcomes that the nurse can use to classify the intervention:

  • Patient’s condition improved: Patient maintained O2 saturations above 92% this shift, no use of accessory muscles, the patient is now off oxygen
  • Patient’s condition stabilized: The nurse was able to wean oxygen this shift
  • Patient’s condition deteriorated: Oxygen liter flow was increased twice today, continue to monitor

It’s important to set measurable goals so that you can customize the patient’s plan of care if the goals are not being met.

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Related FAQs

1. What are the steps in the nursing process in order of occurrence?

The steps of the nursing process include assessment, nursing diagnosis, planning, intervention, and evaluation. These five steps are used cyclically and repeatedly during patient care.

2. What are the 4 types of nursing assessments?

In order to effectively determine a diagnosis and treatment for a patient, nurses make four assessments: initial, focused, time-lapsed and emergency.

3. What is the most important step of the nursing process?

Diagnosis – This phase in the nursing process is one of the most important. We must consider all external factors of the patient (environmental, socioeconomic, and physiological etc.) when developing a diagnosis, which can be challenging at times.

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