This innovative text uses concrete examples and hands-on exercises to help readers clearly understand and apply the five steps of the nursing process. Wellness concepts and independent critical thinking, major emphases of this text, are incorporated into each step of the nursing process. Book provides extensive treatment of collaborative practice and delegation, critical thinking, case management and critical pathways. For those interested in understanding the nursing process within a framework for providing holistic care.
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Preface Students find this text easy, even enjoyable to use. Nevertheless, it is a serious text, with in-depth treatment of concepts. Because nurses need conceptual understanding of nursing process as well as the practical ability to plan and implement nursing care, this text balances conceptual and practical aspects. For example, Chapter 4 describes a diagnostic process, and Chapter 5 explains how to write diagnostic statements; Chapters 6 and 10 contain detailed explanations of how to create working care plans for real patients, while Chapters 6 and 7 discuss concepts related to choosing outcomes and interventions. CONTENT The nursing process provides a basic framework within which nurses apply the unique combination of knowledge, skills, and caring that constitute the art and science of nursing. The purpose of this book is to promote professional practice through effective use of the nursing process. To that end, the text integrates the following topics into the discussion of each nursing process step:
Collaborative Practice and Delegation. The text acknowledges the changing face of nursing and healthcare by emphasizing collaborative practice and expanding discussion of work delegation by nurses. Case management and critical pathways are treated extensively, as well. Critical Thinking. Critical thinking is important for nurses—perhaps in different degrees and for different uses, but at all levels of practice. The nursing process provides an excellent vehicle for encouraging critical thinking. Chapter 2 presents concepts of critical thinking as it relates to nursing, and subsequent chapters integrate critical thinking into assessment, diagnosis, planning, implementation, and evaluation. In addition, the "Nursing Process Practice" exercises are designed to foster critical thinking while learning nursing process. Each chapter includes special "Critical Thinking Practice" exercise, designed to teach a specific critical thinking skill. These are excellent for class discussion or small-group projects. The "Case Studies" at the end of each chapter provide opportunity for students to use both critical thinking and the nursing process to practice clinical decision-making safely in simulated situations. Standardized Nursing Language. Standardized language for problems, outcomes, and interventions is introduced and integrated throughout each chapter in order to help students prepare to use computerized information systems. The text includes discussions and illustrations of NANDA, NIC, NOC, the Omaha System, and the Home Health Care Classification. Culture and Spirituality. In order to reflect our multicultural society and promote holistic care, cultural and spiritual dimensions of each step of the nursing process are explored. For example, the Assessment chapter includes tools for both cultural and spiritual assessment. Ethical and Legal Issues. In order to increase awareness of ethical issues embedded in the practice of nursing, each chapter includes ethical and legal principles and considerations pertinent to that particular nursing process phase (eg, maintaining confidentiality of client data in the assessment phase). Home, Family, and Community Care. Examples and discussions are greatly expanded in this edition, reflecting the expanding role of nursing in homes and other community settings. Nursing Frameworks/Theories. Nursing models are integrated into the explanation of each nursing process phase in order to encourage theory-based practice. For example, assessment tools and nursing diagnoses are categorized according to different frameworks. In order to maintain flexibility, a single model was not chosen. Instead, several nursing frameworks are summarized and used. For some courses, teachers may choose to not use the nursing theories; for others, a particular framework could be chosen and emphasized. Professional Standards of Care. Nurses are more than just the means to organizational ends. Even in a bottom-line, outcomes-driven environment, nurses are accountable for the quality of the care they give: for what they know and what they do. To this end, the American Nurses Association (ANA) Standards of Clinical Nursing Practice are linked to each phase of the nursing process. These standards enable nurses to evaluate their own behaviors—not merely the patient outcomes they help produce. Wellness Concepts. Wellness language and examples are used throughout the text in order to promote awareness of health promotion as a vital part of nursing practice. Most chapters include a section in which wellness concepts are related to the chapter material; the end-of-chapter exercises also include wellness examples. TEACHING/LEARNING FEATURES I have used these chapters as learning units to teach nursing process to students of various levels, as well as in continuing education for practicing nurses. Student response has been overwhelmingly positive.
Interactive Format. Neither nursing process nor critical thinking can be mastered by memorizing facts and principles. Students need to practice applying the concepts; they need to "work problems," just as they do in a math class. This text provides many practice problems. The exercises are not just "recall and fill in the blanks:" They are application exercises, designed to promote high-level thinking skills. In addition to end-of-chapter exercises, "Thinking Points" are integrated within the chapters to help students reflect on their reading. Learning Aids. Each chapter begins with Learning Outcomes and a figure that serves as a visual guide to chapter content. "Key Point" boxes summarize selected content in easily remembered lists. Each chapter ends with a Summary of chapter content. Case Studies. In addition to the "Nursing Process Practice" and "Critical Thinking Practice" features, each chapter also contains a case study ("Applying Nursing Process and Critical Thinking") to allow students to use critical thinking within the framework of the nursing process. These cases focus on critical thinking and nursing process. They are not in tended to teach in-depth content about medical conditions and pathophysiology. Even beginning students can use the case studies. Detailed Answer Keys. For the "Nursing Process Practices," the answer keys give the rationale for both correct and incorrect answers and frequently demonstrate the thinking process used to arrive at the answers. This detailed feedback provides for truly interactive learning, as well as the kind of student-instructor dialogue that is so important for learning nursing process. Students are easily frustrated by the many ambiguities and seeming contradictions that arise when applying abstract nursing process concepts to concrete/specific situations. The answer key discussions are vital for easing this frustration and modeling the thinking inherent in the process. Because answers can vary widely, the answer keys for "Critical Thinking Practices" and the "Case Studies" provide suggested, not comprehensive, answers. Versatility. This text is suitable for nursing students as an introduction to nursing process or for use in the continuing education of professionals who may need refresher information and practice. It is effective for students who have had nursing process early in the curriculum and who later have difficulty applying it in a clinical course—simply assign a chapter and exercises to remediate the difficulty. The text is organized to accommodate the instructor's professional judgment—that is, it can be used in whole or in part, and for students of different levels, depending on what the instructor chooses to assign or emphasize. For example, for instructors who believe the concept of "possible problems" is too difficult for beginning students, that portion of Chapter 4 could be omitted without damaging the continuity of the material. Some teachers may choose to present Chapter 5 before Chapter 4. Some use Chapter 10 as a sort of "road map;" presenting it after Chapter 2; others prefer to use it at the end of the course, after all the phases of the nursing process have been taught. All approaches are workable. Independent Study. This text can be used for independent study and for distance learning, but it is in no way limited to that approach. It can be used as a text to supplement lectures, either in a separate course or when the nursing process is integrated in the curriculum. Care Plans—or not. This text makes clear that nursing process and a written care plan are not one and the same. For teachers who question the exclusive use of written care plans as a teaching strategy, this text will be helpful. I have found that the time I previously allotted to lecture can be used to discuss student questions about nursing process and patient care. Even more exciting, I assign fewer traditional care plans, and I need to make fewer comments on the plans they do write. I also spend less time in remedial conferences helping students with nursing process. Terminology. I use both client and patient in this book. Either can be appropriate, depending on the context. Client implies that nurses have independent functions, are increasingly accountable to individuals rather than institutions, and are not setting-bound; it also stresses that people are increasingly active in managing their own healthcare. On the other hand, most nursing still does occur in hospitals, and with ill people who are in a dependent state. Furthermore, most nurses are paid by an employing health agency, rather than directly by a client. In these situations, the term patient seems more accurate. I use a similar approach for denoting gender. I acknowledge and welcome the presence of men in nursing and, further, realize that patients are both men and women. However, terms like s/he and she/he are artificial and awkward to read, so I do not use them. Both nurses and patients are arbitrarily assigned gender and referred to either as he or she. In this text I often speak to the reader as "you" instead of "the nurse" or "the student:" For one thing, this suits my informal nature. But more importantly, I hope this will empower and engage the reader personally, promoting active involvement with the text. I welcome your comments.
Judith Wilkinson 11959 West 66th Street Shawnee, KS 66216 (913) 631-1089 firstname.lastname@example.org judithwilkinsonFrom the Back Cover:
A critical thinking approach to the nursing process!
Nursing Process & Critical Thinking uses concrete examples and hands-on exercises to help you understand and apply this fundamental decision-making process. Numerous case studies help develop effective problem-solving and critical thinking skills.
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