Nursing Theory and process Nursing practice is the actual provision of nursing care In providing care nurses implement the nursing care plan using the nursing process This is based around a specific nursing theory which is selected in consideration with the care setting and the population served In providing nursing care the nurse uses both nursing theory and best practice derived from nursing research 67 The nursing process is made up of five steps 1 evaluate 2 implement 3 plan 4 diagnose and 5 assess Nurses are able to use this process from the American Nurses Association to determine the best care they can provide for the patient There are many other diverse nursing theories as well 68 In general terms the nursing process is the method used to assess and diagnose needs plan outcomes and interventions implement interventions and evaluate the outcomes of the care provided Like other disciplines the profession has developed different theories derived from sometimes diverse philosophical beliefs and paradigms or worldviews to help nurses direct their activities to accomplish specific goals Scope of activities Activities of daily living assistance Nurses manage and coordinate care to support activities of daily living ADL Often the provision of such care is delegated to nursing assistants This includes assisting in patient mobility such as moving an activity intolerant patient within bed Medication Medication management and administration are a part of most hospital nursing roles however prescribing authority varies between jurisdictions In many areas registered nurses administer and manage medications prescribed by a professional with full prescribing authority such as a nurse practitioner or a physician As nurses are responsible for evaluating patients throughout their care including before and after medication administration adjustments to medications are often made through a collaborative effort between the prescriber and the nurse Regardless of the prescriber nurses are legally responsible for the drugs they administer There may be legal implications when there is an error in a prescription and the nurse could be expected to have noted and reported the error In the United States nurses have the right to refuse any medication administration that they deem to be potentially harmful to the patient 69 In the United Kingdom there are some nurses who have taken additional specialist training that allows them to prescribe any medications from their scope of practice Patient education The patient s family is often involved in the education Effective patient education leads to fewer complications and hospital visits 71 Many times nurses are very busy and have a hard time giving information to the patient because they have so many other things going on Educating the patient and their family increases the chance for a better patient experience 72 Giving the best care requires informing the patient of what is going on and support While explaining procedure recovery and taking care of the patient nurses also have to help patients and their families cope with different medical situations 73 When speaking with the patient nurses have to be able to communicate in a way that can be understood by the patient Informing the patient may involve speaking in broad general terms using visuals or different reading materials and even including demonstrations if necessary The more the patient and their family understand what the nurse is saying the better healthcare the patient can receive without the assistance of a nurse Specialties and practice settings Nursing is the most diverse of all health care professions Nurses practice in a wide range of settings but generally nursing is divided depending on the needs of the person being nursed The major populations are communities public family individual across the lifespan adult gerontology pediatrics neonatal women s health gender related mental health informatics eHealth acute care hospitals ambulatory settings physician offices urgent care settings camps etc school college infirmaries Nurses with higher degrees allow for specialization within the medical field There are many specific nursing professions that can be separated into categories of care type age gender certain age group practice setting etc Nurses are able to specialize with a combination of these categories as well 1 There are also specialist areas such as cardiac nursing orthopedic nursing palliative care perioperative nursing obstetrical nursing oncology nursing nursing informatics telenursing radiology and emergency nursing Nurses practice in a wide range of settings including hospitals private homes schools and pharmaceutical companies Nurses work in occupational health settings 74 also called industrial health settings free standing clinics and physician offices nurse led clinics long term care facilities and camps They also work on cruise ships and in the military service Nurses act as advisers and consultants to the health care and insurance industries Many nurses also work in the health advocacy and patient advocacy fields at companies such as Health Advocate Inc helping in a variety of clinical and administrative issues 75 Some are attorneys and others work with attorneys as legal nurse consultants reviewing patient records to assure that adequate care was provided and testifying in court Nurses can work on a temporary basis which involves doing shifts without a contract in a variety of settings sometimes known as per diem nursing agency nursing or travel nursing Nurses work as researchers in laboratories universities and research institutions Nurses have also been delving into the world of informatics acting as consultants to the creation of computerized charting programs and other software Nurse authors publish articles and books to provide essential reference materials