The objective of this essay is to disseminate the nursing process and evaluate its contribution to the healthcare sector. The practical and theoretical aspects of the nursing process will be explored simultaneously. The nursing framework constitutes four stages: the actual assessment, planning, implementation and evaluation. This assignment is founded on a clinical placement which I undertook. The placement took place at mental health inpatient services that caters for patient with severe and enduring mental health difficulties. I will use a pseudonym, in substitution of the actual name of my client under the Nursing and Midwifery Council’s (NMC) (2002) jurisdiction to respect a patient’s confidentiality at all points. The communication and interpersonal skills that are essential in this particular sector will be examined in order to build therapeutic relationship with a patient, Bee et al (2008).
Nursing process is a problem-solving framework that allows the nurse to tailor the care they provide to suit a patient’s needs and condition (Hogston, 2011). Nurses are care givers and it is vital to establish the specific needs of a patient in order to supply effective provision (NMC, 2008). McKenna (1997) supports the use of nursing process in mental health as uncontroversial, stating that it is an unconventional process, although he does consider it relatively conducive to supply the right standard of care as it is a useful guideline for nurses to adhere to in their practice (McKenna, 1997).
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Assessment is an ongoing cycle of activities that nurses should undertake to collect precise information and implement a care plan that is tailored for a client (Baker, 1997). The information collected must be meaningful and necessary to describe a person’s thoughts, feeling, status and environment they exist in. I will focus on one particular client, who shall be referred to as YZ and articulate the nursing process and stages which is known colloquially as APIE: Assessment, Planning, Implementation, and Evaluation. APIE is a nursing process whose use is prevalent in order to meet the needs of clients. The process is continuous and it centres on an individual to deliver the desired results. However in order to utilise the APIE framework appropriately, there is a demand for assessment tools that enables a nurse to collect information. Information can be obtained through various avenues. The most widely used methods of data collection are interviews, observations, listening, physical examination and the use of verbal and non-verbal communication and open and closed questions (Palgrave, 2011). Measurement of the patient’s ability to function is also an assessment method used in comparison of that ability with the level of behaviour a client must display in order to bring about true self-sufficiency (Ward, 1992). McKenna (1997) identifies that a deficiency of the four stages model is the gap between assessment and planning. This necessitates an interim stage where the assessment results are cemented in order to guide the planning. He elaborates further that elements in the assessment and evaluation stage are equally the same. It is more or less one stage not two. Evaluation can be logically be known as re-assessment. The fissure between assessment and planning can be filled by the concept of ‘specific problem identification’ or can be referred as diagnosis or formulation (McKenna, 2007). According to YZ, the diagnosis of the problems is clear and specific. YZ’s issues include mental health state, financial problems, low self-esteem and speech incoherency. All these diagnosed problems will be addressed in care planning in order to fulfil YZ’s specific needs.
On placement I had an opportunity to explore two types of assessments tools, one of which was ‘Camberwell assessment of need short appraisal schedule’, which focuses on clients’ feelings, thoughts, status and the environment. Camberwell represents its information through a scale of zero to nine to establish clients’ needs. A client will participate in the scoring and nursing staff ask questions about the met and unmet needs. It consists of twenty-two questions that collates everything involved in a clients’ lifestyle, making it a comprehensive assessment.
HONOS is a holistic assessment tool widely used in in the mental health field. It was developed in 1993 by the Royal College of Psychiatrist. Initially, the purpose of the “HONOS” was to distribute a mechanism of recording towards the health of the nation whilst aiming to improve the social and health of mentally ill people. Wing, Curtis and Beevor (1996) after a preliminary test, devis
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