Models of Nursing

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The focus of this assignment is to outline the assessment process within nursing and show its practical use and importance. The assignment is broken down into different elements, including defining what assessment means and its importance within the nursing process leading on to the various sources of information which are used to inform nurses upon their assessments. The STAMP assessment tool will be explored to show how it supports the assessment process in practice. Finally, suggestions will be made as to how nurses develop a positive relationship with patients to assist the assessment process. The ideas developed throughout the assignment will be backed up using the wealth of literature available.

The nursing process was introduced in the United Kingdom by Yura and Walsh in 1967 (White, 2005, p128). This was an attempt to direct traditional nursing away from intuitional and ritual practice. The purpose of developing this process was to develop a method for applying a scientific problem-solving approach to nursing practice (Haberman, 2005). Alfaro-LeFevre, (2006, p4) summarises this process into a systematic six staged sequence. He defines them as follows: - Assess, diagnose, identify, plan, implement and evaluate. Every phase within this process outlined above have an individual role yet they are all interdependent with one another (Royal College of Nursing (RCN), 2009, section three). Barrett, Wilson and Woodlands, (2009) expand this process further, adding that this is a cyclical, on-going process which continues throughout the nursing process.

Benner (1984, pp42-43) expands on the nursing process stating that many different models of nursing have been established to augment this procedural, elemental staged approach giving structure to the care delivery whilst meeting a patients individual needs. The various different models represent a varied range of values and beliefs that guide the nurse through the problem-solving process. Roper Logan and Tierney (1980) argue that the nursing process on its own is vacuous, unless used within the context of a conceptual framework or nursing model.

Assessment is both the initial stage of the nursing process and a continuing element in every other step of this process (Atkinson & Murray, 2000, pp25). In their classic work, Roper, Logan and Tierney (2000, pp.124) consolidate this point, noting that the word assessment has been adopted as the title of the first phase of the nursing process. They clarify that this does not mean it is a once only activity, but it includes: gathering information from or about the client, reviewing that collected information, then recognizing the person’s problems and prioritizing from amongst those problems, whilst following the nursing process. This ascertains the care/treatment and services an individual requires throughout the nursing process.

Additionally, the word ‘assessment’ in its broad sense can be defined as ‘an activity which includes gathering data, interpreting the significance of the data and deciding on whether there is need for further action,’ (Campbell and Glasper, 1995, p.127). Linking this definition to the nursing process, it can be interpreted as the manner in which the nurse collects and evaluates data about their client (family, community or individual). Mason and Webb (1997) highlight that the nursing diagnosis and the nursing assessment are very closely related, being that the diagnosis a clinical judgement, which is made as a result of the assessment process.

In their findings Barrett, Wilson & Woollands (2009) observe that assessment is not just about recording a list of problems; it is more about identifying what the client can do as well as finding out what the client cannot do. Field and Smith (2008) support this further, suggesting that assessment should be an individualised person- centred approach taking the whole overall picture into account, covering all aspects of a person’s life such as culture,...
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