The call of a nurse is to provide an individual with assistance in all matters relating to his health or restoration of health, as well as the occurrence of a painless death. The activity of a specialist should be aimed at teaching a person how to cope without any help from outsiders, giving him full information so that he can soon become independent. In nursing, there is a special technology called the nursing process. It aims to improve the quality of life of patients by solving the difficulties that arise. Today we will talk about how the problems of the patient are identified and resolved in the nursing process .
Objectives of the Nursing Process
The nurse must guarantee an acceptable quality of life for the patient, depending on what condition he is in. Patient problem should be prevented, alleviated and minimized. If a person has an injury or a certain illness, the nurse must help him and his family to adapt to new living conditions. Independence and autonomy of the patient must be achieved and maintained, his basic needs must be satisfied or ensure a quiet death.
Stages of the nursing process
The nursing process proceeds step by step. At the first stage, the patient is examined. Then - the patient’s problem determination (nursing diagnosis). After this, the planning of nursing care for the patient occurs, the implementation of plans to solve the patient’s difficulties and performance assessment with subsequent correction. Today we will look at the second phase of the nursing process.
Nursing Diagnosis
To establish the patient’s difficulties, an individual care plan is developed so that the patient and his family can adapt to the changes that have arisen due to health problems. The nurse must first find out the needs of the patient, which he himself cannot satisfy, which leads to the formation of difficulties. The nurse conducts a nursing diagnosis of the patient's condition. In this case, the patient's problems are clarified. Here the formation of a medical judgment takes place, which describes the form of the patient's response to his illness and condition, indicating the causes of this reaction. In this case, a lot depends on the type of disease, changes in the external environment, medical procedures, living conditions of the patient, as well as on his personal circumstances.
Types of Patient Problems
In the nursing process, it is not the disease that is taken into account, but the patient's reaction to his condition and disease. Similar reactions can be of several types:
- Physiological. They are characterized by processes occurring in the patient's body. This may be, for example, a delay in the chair.
- Psychological. Such reactions are caused by anxiety that causes the disease, and lack of awareness about it, as well as an understatement of the severity of the disease.
- Spiritual reactions can be manifested in the desire to leave life with an incurable illness, in disagreements with the family, which arise due to illness, the choice of life values, and so on. Therefore, it is important to correctly identify the problems of the patient and relatives when caring for a seriously ill patient .
- Social. They are characterized by a desire to isolate themselves in the presence of a fatal infectious disease.
The nurse is not always able to solve all of the above difficulties. Therefore, in practice, they are usually divided into psychosocial and physiological.
Existing and potential problems of the patient
All the problems of the patient and relatives in the first hours of hospital stay are usually divided into existing, those that are currently available, and potential, presented in the form of further complications that can be prevented with a properly planned nursing process. Almost always, the patient has several types of difficulties, so they are all divided into priority and secondary. Priority issues include:
- emergency conditions ;
- quite painful problems for the patient;
- problems that can lead to complications;
- difficulties on the solution of which a positive result of treatment depends;
- those that limit the patient's ability to care for themselves.
When nursing diagnosis, it is necessary to take into account all the difficulties of the patient, which can be solved or adjusted by medical staff. They are distributed by weight and move on to the solution, starting with the most important. Prioritizing the problems of the patient and relatives in the first hours in the hospital , you can use the pyramid of needs according to A. Maslow. This technique allows you to identify primary needs, intermediate and secondary.
Principles of Nursing Diagnosis
In order for the analysis to be useful and focused, the following principles must be observed:
- Identification of needs that the patient cannot satisfy on his own.
- Identification of factors that cause the disease.
- Identification of the patient's strong and weak qualities, which contribute either to the development or to the prevention of difficulties.
- Predict the patient's further capabilities, their expansion or limitation.
Difficulties in making a nursing diagnosis
The nurse may express those difficulties whose resolution does not go beyond her authority. To understand the accuracy of the designation of the patient’s problem and the correct formulation of the nursing diagnosis, it is recommended to check the following:
- Is there a problem with lack of self-service? For example, the difficulty in breathing in a certain position of the patient is associated with a lack of self-care. It can be eliminated by a nurse.
- How much the diagnosis is clear to the patient.
- Will the nursing diagnosis be the basis for planning the nurse’s maneuvers? The intervention of a specialist will be correct if he finds out the reason that causes a certain condition of the patient.
- Will her difficulty become a patient problem?
- Is there only one patient problem in the diagnosis of a nurse. It is necessary to highlight several diagnoses, and also take into account the fact that the patient does not understand what worries him. For example, a patient’s problems with shigellosis can be associated not only with the disease, but also with treatment, the situation in the hospital, family relationships, and so on.
The task of diagnosing a nurse is to identify all existing or foreseeable difficulties of the patient in the way of restoring his good condition, identifying the most painful problems at present, forming a diagnosis and planning measures for patient care.
The content of the nursing process in the second stage
The patient should help the nurse correctly highlight the main thing when posing the patient's problem . All inconsistencies can disappear by discussing issues with the sister and the sick. If there are serious psychological and emotional difficulties, the medical worker takes responsibility for choosing the primary diagnoses. When the patient has just been admitted to the hospital or he is in an unstable state, the problems of the patient and relatives in the hospital are not immediately determined, this is done only after studying all the information, since conclusions made ahead of time provoke an incorrect diagnosis and poor nursing care. Often there are times when it is impossible to establish the patient’s problem. In this case, the usual statement of symptoms is carried out. In other cases, the disease is caused by adverse life situations. Then the nurse clarifies all these circumstances in detail. In this case, she will be able to help the patient to overcome the negative consequences.
Summary
At the second stage of the nursing process, the data that were obtained at the first stage during the examination of the patient is analyzed. Here, the medical staff should identify, for example, problems of the patient and relatives at different periods of fever , and formulate accurate diagnoses that prevent the patient from achieving a positive state, as well as those that the nurse can solve. It must be borne in mind that the patient’s difficulty can be associated not only with the disease, but also with treatment methods, the environment, relationships with relatives, and so on. Nursing diagnoses can change not only every day, but throughout the day.
It must be remembered that they differ from the diagnoses of doctors. The doctor makes a diagnosis and prescribes treatment, and the nurse helps the patient so that he can adapt and live with the disease. One ailment of a person can cause him a lot of difficulties, so there may be a number of diagnoses of a nurse. It is important not to forget that if there are no urgent physical disorders, the unsatisfaction of his psychosocial needs may have a danger to the patient’s life. Prioritizing the diagnosis, the nurse has the right to attract the relatives of the patient. At the same time, she should indicate the reasons that led to the emergence of problems, and also direct her actions to eliminate them. All nursing diagnoses are recorded in terms of nursing care (NIB).