Day: December 19, 2009

In the 17th century, social reform was inevitable. Several nursing groups were organized. These groups gave money, time, and service to the sick and the poor, visiting them in their homes and ministering to their needs. Such groups included the Order of the Visitation of Mary, St. Vincent de Paul, and in 1633, the Sisters of Charity. The last group became an outstanding secular nursing order. They developed an educational program for the intelligent young women they recruited that included experience in a hospital as well as visits to the home. Receiving help, counsel, and encouragement from St. Vincent de Paul, the Sisters of Charity expanded their services to include caring for abandoned children. In 1640, St. Vincent established the Hospital for Foundlings in Paris. Later, in 1809, the Sisters of Charity established a nursing order in the United States, under the direction of Elizabeth Bayley Seton. Other branches of this order were to follow, variously
called the “Gray Sisters,” the “Daughters of Charity,” or the “Sisters of St. Vincent de Paul.” Those countries in Europe that remained Roman Catholic escaped some of the disorganization caused by the Reformation. During the 1500s, the Spanish and the Portuguese began traveling to the Americas. In 1521, Cortés conquered the capital of the Aztec civilization in Mexico and renamed it Mexico City. Early colonists to the area included members of Catholic religious orders, who became the doctors, nurses, and teachers of the new land. In 1524, the first hospital on the American continent, the Hospital of Immaculate Conception (Hospital de Nuestra Senora O Limpia Concepçion), was built in Mexico City. Continue reading “The Beginning of Change”

The fourth step in the nursing process is implementation. Implementation involves the execution of the nursing plan of care derived during the planning phase. It consists of performing nursing activities that have been planned to meet the goals set with the client. Nurses may delegate some of the nursing interventions to other persons assigned to care for the client—for example, the licensed practical nurses and unlicensed assistive personnel.
Implementation involves many skills. The nurse must continue to assess the client’s condition before, during, and after the nursing intervention. Assessment prior to the intervention provides the nurse with baseline data. Assessment during and after the intervention allows the nurse to detect positive or negative responses the client may have to the intervention. If negative responses occur during the procedure, the nurse must take appropriate action. If positive responses occur, the nurse adds this information to the database for use in evaluating the efficacy of the intervention. The nurse must also possess psychomotor skills, interpersonal skills, and critical thinking skills to perform the nursing interventions that have been planned. Continue reading “IMPLEMENTATION AND EVALUATION IN NURSING CARE”

The termination phase is the third and final stage of the of the therapeutic relationship. It focuses on the evaluation of goal achievement and effectiveness of treatment. It is important that the client has been prepared for the final stage of the relationship by encouraging discussion of feelings. Some clients welcome this final phase, whereas other clients who have become overly dependent on their nurse will be more resistant to saying goodbye. Planning for termination is actually initiated during the beginning of the relationship. A relationship that ends abruptly is likely to place the client at risk for difficulties such as increased:
• Anxiety levels
• Frustration
• Suspiciousness
• Unwillingness to engage in future relationships with health care providers
Evaluation is the primary goal for the client and nurse in the third stage of the nurse-client relationship. Continue reading “Termination Phase”