b. Once the specific needs of the patient have been identified, the health care
team members go to the next step, which is the planning phase.
a. Once the needs of the patient have been identified, several questions must
be asked by the health care team in order to develop the nursing care plan. A plan of
care is goal-oriented, with short-term and long-term goals identified. When you have
identified the needs of the patient in the assessment phase, you also begin to determine
what the results of fulfilling those needs should be. Do you expect results on a short- or
long-term basis? How, specifically, will those goals be achieved? What action will be
taken, and by whom? What shall be done first, second, last, and so on? The practical
nurse supports the professional nursing staff in the planning of nursing care by:
(1) Assisting the professional nurses in determining the nursing care
priorities and planning the nursing care to be provided.
(2) Working with other team members to develop a written plan of care.
(3) Participating in the development of long-term and/or preventive health
plans with the patient and his family.
b. After the patient's needs have been identified and the plan of care has been
developed, the process of implementation begins.
a. In order to participate in the implementation of the planned nursing care, the
M6 practical nurse must be clinically proficient and capable of providing and/or
supervising nursing care. This care includes basic nursing care procedures such as
obtaining and interpreting vital signs, collecting blood specimens, and changing wound
dressings. Nursing care also includes activities involved with patient comfort and safety
such as bathing the patient, administering range-of-motion exercises, and application of
restraints to a disoriented patient. Also within the scope of practical nursing duties is
the administration of medications and intravenous therapy. The practical nurse must
also be able to reinforce the teaching done by the professional staff. To achieve patient
awareness and cooperation, it is necessary to explain the "how" and "why" of nursing
care procedures. This is especially important if the patient will have continuing
treatments, medications, or special instructions at home with little or no supervision from
the health care team. With this clinical nursing proficiency, the practical nurse supports
the professional nursing staff in the implementation of the planned nursing care by:
(1) Applying a working knowledge of patients' rights and protecting the rights
and privacy of the patient and his family.