Fundamentals of Assessment and Care Planning for Nurses

Ian Peate, Professor Ian Peate, OBE

• Publisher: Wiley-Blackwell
• Year: 2019
• Print ISBN: 9781119491750
• eBook ISBN: 9781119491743
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

All nursing students are required to meet the seven standards produced by the Nursing & Midwifery Council (NMC) before being entered onto the professional register. Fundamentals of Assessment and Care Planning for Nurses addresses two of these important standards, helping readers become proficient in assessing patient needs, and planning, providing and evaluating care.

This timely publication adopts a practical approach with NMC proficiencies at its core, providing guidance and insight into the application of key skills and demonstrating competency in real-life settings.

• Centres around a fictitious nuclear family to provide a practical basis to the various chapters and assessment
• Offers mnemonics to enable comprehensive history taking and systematic physical assessment
• Helps readers address socio-cultural considerations they may face in practice
• Includes links to literature that provides further support and additional information

Fundamentals of Assessment and Care Planning for Nurses is an important resource for pre-registration nursing students and Nursing Associates who are required to demonstrate proficiency in the new NMC standards, and other registered practitioners seeking to update their knowledge.

Chapter 1
The nature of nursing

Aim

The aim of this chapter is to introduce the reader to the nature of nursing and offer an overview of how care is offered.

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Learning outcomes

By the end of the chapter the reader will be able to:

1. Provide a timeline outlining key points in the development of contemporary nursing practice
2. Identify how care provision over the years has impacted on contemporary practice
3. Discuss how the NHS was formed and its current role in the provision of health and social care
4. Consider local, national, and international care perspectives

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Introduction

The past is where lessons have been learnt and the future is where those lessons learnt are applied. However, living in the past can hinder progress. In an unidentified source, ‘you cannot tell where you are going unless you know where you have been’ is the key theme of this chapter. Much is to be learnt from the past in order to help us in the future, to learn from our mistakes and to help us and the services we provide to develop in an appropriate and patient‐centred manner.

Before the mid‐nineteenth century, nurses, whether employed in hospitals or in private homes, were very often uneducated and usually had no formal training. In Britain in the 1840s nursing sisterhoods were founded to improve standards of nursing, these mimicked the Catholic nursing orders in other European countries. St John’s House, an Anglican Nursing Sisterhood founded in 1848, was one example of these. As a thank‐you to Florence Nightingale for her accomplishments during the 1854–1856 Crimean War, a fund was raised by public donations to allow her to establish a training school for nurses in London, the Nightingale School set up at St Thomas’ Hospital in 1860. Other hospitals, both voluntary hospitals and workhouse infirmaries, formed their own training schools, and many of these were run by superintendents who had trained at the Nightingale School. Nightingale based her curriculum on the following beliefs:

• Nutrition is an important part of nursing care.
• Fresh, clean air is beneficial to the sick.
• Sick people require occupational and recreational therapy.
• Nurses should help identify and meet patients’ personal needs and these include the provision of emotional support.
• Nursing should be directed towards two conditions: health and illness.
• Nursing is separate and distinct from the practice of medicine and as such should be taught by nurses.
• Nurses need continuing education.

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Review

Think about the list of Nightingale’s beliefs (those that were a part of her nursing curriculum) and reflect on the course or programme of study you are enlisted on and determine if these beliefs are still the foundation of nursing education today.

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Provision was also provided to train district nurses to care for the sick and poor in their own homes, and in 1887 the Queen’s Institute of District Nursing was founded.

The 1919 Nurses Registration Act set up the General Nursing Council, which was charged with maintaining a register of nurses to ensure that in future all nurses were appropriately trained. As a result of a shortage of nurses, the Nurses Act established in 1943 provided a roll of assistant nurses.

In 1930 county councils took over the workhouse infirmaries from the Boards of Guardians and the London County Council also acquired all the hospitals that had been previously managed by the Metropolitan Asylums Board. Most hospitals and mental institutions in 1948 passed to the National Health Service (NHS), with the majority of them becoming the responsibility of the regional hospital boards. Four boards assumed responsibility in London and the South East, as well as the North East, North West, South East, and South West Metropolitan Hospital Boards. In each hospital region an Area Nurse Training Committee was established, with the aims of financing, advising and improving all nurse training institutions in the region.

County councils became responsible for district nursing as well as for other personal health services in 1948. All health services were transferred to the newly formed regional and area health authorities in 1974, replacing the regional hospital boards, and in 1982 area health authorities were abolished. There have been numerous other reorganisations that have followed.

The National Health Service

The NHS is over 70 years old, and the NHS and those people it offers a service to today are very different now than in 1948 when it was born. This difference between t...

Table of contents

• Cover
• Table of Contents
• Preface
• Acknowledgements
• Meet the family
• Chapter 1: The nature of nursing
• Chapter 2: The provision of care
• Chapter 3: Critical thinking and clinical decision making
• Chapter 4: The nursing process
• Chapter 5: Care plans
• Chapter 6: Models of nursing
• Chapter 7: The skills of assessment and planning care
• Chapter 8: Assessment tools
• Chapter 9: Assessing the musculoskeletal system
• Chapter 10: Assessing the circulatory system
• Chapter 11: Assessing the cardiac system
• Chapter 12: Assessing the gastrointestinal system
• Chapter 13: Assessing the renal system
• Chapter 14: Assessing the respiratory system
• Chapter 15: Assessing the male reproductive system
• Chapter 16: Assessing the female reproductive system
• Chapter 17: Assessing the nervoussystem
• Chapter 18: Assessing the endocrine system
• Chapter 19: Assessing the immune system
• Chapter 20: Assessing the skin
• Index
• End User License Agreement