the nursing process assignment

What is the Nursing Process?

Characteristics of the nursing process, history of the nursing process.

Understanding the nursing process is key to providing quality care to your patients. The nursing process is a cyclical process used to assess, diagnose, and care for patients as a nurse. It includes 5 progressive steps often referred to with the acronym:

• Planning/outcomes
• Implementation

In this article, we’ll discuss each step of the nursing process in detail and include some examples of how this process might look in your practice. 

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The nursing process is a patient-centered, systematic, evidence-based approach to delivering high-quality nursing care. It consists of five steps: assessment , diagnosis , outcomes/planning, implementation, and evaluation.

The Nursing Process (ADPIE)

1. Assessment

To begin the nursing process, assessment involves collecting information about the patient and their health. This information is used to identify any problems, or potential problems, that may need to be addressed while you’re caring for a patient. 

Example: If you’re admitting an older patient who is falling and getting injured at home, you’ll want to do a thorough physical and mental health assessment, including a medical history to try and determine why this is happening. 

Some important things you’ll want to find out are:

• What medications and over-the-counter products is the patient taking
• History of alcohol and recreational drug use
• Where the person lives and the layout of their home, including scatter rugs they may be tripping over: clutter, pets, stairs, slippery tubs they’re climbing into or out of, fluid or food spills on floors, lighting, mobility aids they use, etc.

2. Diagnosis

The Nursing Diagnosis is the second step in the nursing process and involves identifying real or potential health problems for a patient based on the information you gathered during the assessment. 

Example: Using the falls patient example above, you may identify from your assessment that the patient is falling because they’re tripping on things in their environment that they don’t see, like their pet cat lying on the floor and loose scatter rugs. 

Based on this, you might form a diagnosis such as “Falls related to poor vision, cluttered environment, unsteady gait, Lt. hip pain due to previous fall.”

3. Outcomes/Planning

Planning or Outcomes is the third step in the nursing process. This step involves developing a nursing care plan that includes goals and strategies to address the problems identified during the assessment and diagnosis steps. 

Example: Continuing with the example above, you will likely recommend that the patient keep their environment,

• Free of scatter rugs
• Check to ensure the cat is not underfoot before they mobilize
• Suggest the patient use a walker for support when mobilizing
• Recommending that the patient schedule an eye exam to get their vision checked if they have not had one in the last year or two would also be a good idea or if they’ve noticed any changes in their vision lately.

4. Implementation

As the fourth step of the nursing process, implementation involves putting the plan of care into action. 

Example In the above example, this would include: 

• Making sure the patient’s environment is free of clutter and tripping hazards while in the hospital or a skilled nursing facility.
• Teaching the patient to wear proper footwear before mobilizing.
• Assisting the patient with mobility as needed, including putting proper footwear on the patient if needed.
• Speaking to the patient and family about removing scatter rugs from the patient’s home, scheduling an eye exam, and ensuring proper footwear is worn for mobilizing at home.
• Discussing with the patient and family about getting the patient a walker to assist with mobility on discharge and providing one while the patient is admitted.

5. Evaluation

The last step of the nursing process is evaluation , which involves determining whether or not the goals of care have been met. 

Example Here you would look back at the patient’s medical record to see if the patient has had any further falls since implementing the preventative actions above. 

If so, you would repeat the nursing process over and reassess why this is still happening and plan new actions to prevent future falls.

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The nursing process is also characterized by the following elements. 

1. Dynamic and Cyclic

The nursing process is an evolving process that continues throughout a patient’s admission or illness and ends when the problems identified by the nurse are no longer an issue.

2. Patient-Centered and Goal-Directed

The entire nursing process is sensitive to and responsive to the patient's needs, preferences, and values. As nurses, we need to act as patient advocates and protect the patient’s right to make informed decisions while involving the patient in goal setting and attainment.

3. Collaborative and Interpersonal

This describes the level of interaction that may be required between nurses, patients, families and supports, and the interprofessional healthcare team. These aspects of the nursing process require mutual respect, cooperation, clear communication, and decision-making that is shared between all parties involved.

4. Universally Applicable

As a widely and globally accepted standard in nursing practice, the nursing process follows the same steps, regardless of where a nurse works. 

5. Systematic and Scientific

The nursing process is also an objective and predictable process for planning, conducting, and evaluating patient care that is based on a large body of scientific evidence found in peer-reviewed nursing research.

6. Requires Critical Thinking

Most importantly, it’s essential that nurses use critical thinking when planning patient care using the nursing process. This means as nurses, we must use a combination of our knowledge and past experiences with the information we have about a current patient to make the best decisions we can about nursing care.

The nursing process was introduced in 1958 by Ida Jean Orlando. Today, it continues to be the most widely-accepted method of prioritizing, organizing, and providing patient care in the nursing profession.

It’s characterized by the key elements of:

• Critical thinking
• Client-centered methods for treatment
• Goal-oriented activities
• Evidence-based nursing research and findings

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• The nursing process helps nurses to provide quality patient care by taking a holistic view of each patient they plan care for.
• The nursing process is an evidence-based approach to caring for patients that helps nurses provide quality care and improve patient outcomes.
• Ida Jean Orlando introduced the nursing process in 1958.
• The primary focus of the nursing process is the patient or client. The process is designed to meet the real and potential healthcare needs of the patient/client and to prevent possible illness or injury.

Leona Werezak BSN, MN, RN is the Director of Business Development at NCLEX Education. She began her nursing career in a small rural hospital in northern Canada where she worked as a new staff nurse doing everything from helping deliver babies to medevacing critically ill patients. Learning much from her patients and colleagues at the bedside for 15 years, she also taught in baccalaureate nursing programs for almost 20 years as a nursing adjunct faculty member (yes! Some of those years she did both!). As a freelance writer online, she writes content for nursing schools and colleges, healthcare and medical businesses, as well as various nursing sites.

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The Nursing Process

The common thread uniting different types of nurses who work in varied areas is the nursing process—the essential core of practice for the registered nurse to deliver holistic, patient-focused care. Assessment An RN uses a systematic, dynamic way to collect and analyze data about a client, the first step in delivering nursing care. Assessment includes not only physiological data, but also psychological, sociocultural, spiritual, economic, and life-style factors as well. For example, a nurse’s assessment of a hospitalized patient in pain includes not only the physical causes and manifestations of pain, but the patient’s response—an inability to get out of bed, refusal to eat, withdrawal from family members, anger directed at hospital staff, fear, or request for more pain mediation.

Diagnosis The nursing diagnosis is the nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs. The diagnosis reflects not only that the patient is in pain, but that the pain has caused other problems such as anxiety, poor nutrition, and conflict within the family, or has the potential to cause complications—for example, respiratory infection is a potential hazard to an immobilized patient. The diagnosis is the basis for the nurse’s care plan.

Outcomes / Planning Based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient that might include moving from bed to chair at least three times per day; maintaining adequate nutrition by eating smaller, more frequent meals; resolving conflict through counseling, or managing pain through adequate medication. Assessment data, diagnosis, and goals are written in the patient’s care plan so that nurses as well as other health professionals caring for the patient have access to it.

Implementation Nursing care is implemented according to the care plan, so continuity of care for the patient during hospitalization and in preparation for discharge needs to be assured. Care is documented in the patient’s record.

Evaluation Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed.

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What’s the Nursing Process and Its Components?

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If there’s one thing you’ll need to understand while in nursing school, it’s the nursing process. The nursing process gives you a framework to care for patients, and is broken down into components. 

Since 1958, the systematic nursing process has guided nurses as they strive to provide patient-focused care. Well-known psychiatric health nurse Ida Jean Orlando developed the system to bring critical thinking, problem-solving skills, and evidence-based practices (EBP) together with the knowledge and experience of the nurses to create a holistic, patient-first method of care. 

Since then, the system has become fundamental in nursing.

We’ll explore the nursing process and the five main components (or steps) you’ll rely on to help you navigate the nursing field. Here’s what you need to know as you prepare for nursing school and your future.

What is the nursing process?

The nursing process provides nurses with a rational and systematic way of evaluating their patients and delivering holistic care in a patient-first paradigm.

This process is used to determine patients’ health problems and needs and identify the nursing interventions and processes that nurses can use to provide the best care for their patients. The process can also help nurses remain more organized as they determine the care they’ll provide.

Another purpose of the nursing process is to outline how nurses should act, which can protect them if any legal problems or challenges arise due to the care a patient receives following the process.

The 5 components of the nursing process

There are five main parts of the nursing process that you’ll need to know as a nursing professional:

1. Nursing Assessment

During the first step of the process, the registered nurse works to understand the patient’s condition and needs. They’ll do this by collecting a variety of data points, such as the patient’s health history, and using their critical thinking skills to collect observations.

The types of nursing assessment data needed to complete this step include:

• Objective data: These include vital signs, patient weight, pulse, intake and output, etc.
• Objective observations: These include skin color, the ability of the patient to make eye contact, how easily the patient can get out of bed, and the sounds of the lungs.
• Patient data points: These subjective data points include the patient’s current physical feelings — such as feeling nauseated — and even emotional feelings, like anger or fear.
• Any other useful nonverbal data: This can include the patient’s overall appearance and body language.

The information in these different categories can all be collected from primary, secondary, and tertiary sources. The primary source would be the patient themselves. You would note client responses to your questions as primary source data. 

Secondary sources are people with whom the patient might confide (such as family or close friends); tertiary sources might include textbooks or journals that provide an outside look at data points and data collection.

As a nurse, you’ll collect this information through physical examinations and by speaking with the patient and those with them. You should carefully record all of the data collected for later reference. 

2. Nursing Diagnosis

During the diagnosis portion of the nursing process, a nurse brings together all the different data points they collected regarding their patient. Then, they’ll use their experience, clinical judgment, and expertise to understand how the different points relate to each other so they can provide a nursing diagnosis. 

This diagnosis will articulate the patient’s needs and condition. Sometimes, patients might even require more than one diagnosis.

Nurses can consult the current list of nursing diagnoses offered by the North American Nursing Diagnosis Association (NANDA). These diagnoses follow Maslow’s Hierarchy of Needs, helping nurses understand how to help patients improve their overall health.

The diagnosis that the nurse lands on will then be used to guide them through the rest of the nursing process.

3. Nursing Planning

During the planning portion of the process, the nurse will now work to organize their thoughts and ideas surrounding the actions they’ll take to treat the patient. This care planning step helps everyone involved in nursing care know the course of action pursued, the team’s goals for that action, and what they expect to happen for the patient.

It’s important to note that planning is an ongoing portion of the nursing process. There is an initial planning stage, which is conducted immediately after evaluating the patient. Then, there’s an ongoing planning stage that will regularly be conducted as the patient is cared for.

The nurse will need to watch how the patient’s condition changes in response to their care, determine where to focus their attention on a given day, and set evolving goals based on the patient’s progress.

Finally, when the patient is ready to be discharged, the nurse will need to set a discharge plan of care. These plans articulate the support that the patient should have as they leave the clinical care setting and explain how the patient should coordinate care with other health care professionals.

The biggest thing is that the goals set by nurses should be SMART . A SMART goal is:

M easurable

A ttainable

T ime-oriented

Goals that follow these criteria can be easily evaluated, with nurses being able to tell how well they achieved their aim. Health professionals need to set both long-term goals and short-term goals.

Of course, all of this should be articulated in a nursing care plan , which explains the care needed and the risk factors the patient faces. A well-outlined plan can help ensure good communication between different nurses and members of the patient’s health care team.

4. Nursing Implementation

During the implementation stage, the nurse involved in patient care puts the plan into action. Based on the diagnosis and plan outlined in the above steps of the nursing process, the nurse will have predetermined medical nursing interventions that they’ll take to try to achieve their patient-related goals.

A part of this process also often involves informing the patient about the care they’re receiving (and why they’re receiving it) so they can do a better job of articulating whether the interventions work.

The interventions taken by nurses typically fall under a few different types of classifications:

• Interventions designed to target patient behavior: Behavioral interventions help adjust patient behavior for better health outcomes, such as helping with stress management or encouraging exercise.
• Interventions that help communities or families as a whole: These types of interventions benefit the patient as well as those around them, such as providing HIV education or helping family members better understand their loved one’s illness and how to care for them.
• Interventions to help patients in a clinical setting: Nurses follow interventions to help patients receive the best possible care and be safe while in the hospital. For example, they might regularly help patients adjust positions to avoid bed sores.
• Interventions to promote safety: Patients may also require help understanding how to use different medical devices. They also need to know how to move around independently.
• Interventions to help patients physically: Interventions to improve the patient’s physical health might include tasks like inserting an IV or helping the patient with physical hygiene. These also play a critical role in nursing care.

The Nursing Interventions Classification (NIC) publication helps create a standardized process for describing the problems that patients face. 

This can help nurses easily use the notes produced by other nurses, see the nursing diagnosis, and apply the recommended nursing interventions because everyone has a common vocabulary to work worth. This can aid communication between nurses and provide more consistent care for patients.

5. Nursing Evaluation

Finally, nurses will need to continually monitor and evaluate the success of the interventions they’re taking to make sure they’re effectively helping the patient.

During the evaluation phase, nurses should compare the patient outcomes they see with the desired outcomes they identified as goals during the planning portion of the nursing process.

This means regularly reassessing patients to determine if a new type of care is needed or if the plan needs to be adjusted.

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Nursing process.

Tammy J. Toney-Butler ; Jennifer M. Thayer .

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Last Update: April 10, 2023 .

• Introduction

In 1958, Ida Jean Orlando started the nursing process that still guides nursing care today. Defined as a systematic approach to care using the fundamental principles of critical thinking, client-centered approaches to treatment, goal-oriented tasks, evidence-based practice (EDP) recommendations, and nursing intuition. Holistic and scientific postulates are integrated to provide the basis for compassionate, quality-based care. [1] [2] [3]

The nursing process functions as a systematic guide to client-centered care with 5 sequential steps. These are assessment, diagnosis, planning, implementation, and evaluation.

Assessment is the first step and involves critical thinking skills and data collection; subjective and objective. Subjective data involves verbal statements from the patient or caregiver. Objective data is measurable, tangible data such as vital signs, intake and output, and height and weight.

Data may come from the patient directly or from primary caregivers who may or may not be direct relation family members. Friends can play a role in data collection. Electronic health records may populate data and assist in assessment.

Critical thinking skills are essential to assessment, thus the need for concept-based curriculum changes.

The formulation of a nursing diagnosis by employing clinical judgment assists in the planning and implementation of patient care.

The North American Nursing Diagnosis Association (NANDA) provides nurses with an up-to-date list of nursing diagnoses. A nursing diagnosis, according to NANDA, is defined as a clinical judgment about responses to actual or potential health problems on the part of the patient, family, or community.  

A nursing diagnosis encompasses Maslow's Hierarchy of Needs and helps to prioritize and plan care based on patient-centered outcomes. In 1943, Abraham Maslow developed a hierarchy based on basic fundamental needs innate to all individuals. Basic physiological needs/goals must be met before higher needs/goals can be achieved such as self-esteem and self-actualization. Physiological and safety needs provide the basis for the implementation of nursing care and nursing interventions. Thus, they are at the base of Maslow's pyramid, laying the foundation for physical and emotional health. [4] [5]

Maslow's Hierarchy of Needs

• Basic Physiological Needs: Nutrition (water and food), elimination (Toileting), airway (suction)-breathing (oxygen)-circulation (pulse, cardiac monitor, blood pressure) (ABCs), sleep, sex, shelter, and exercise.
• Safety and Security: Injury prevention (side rails, call lights, hand hygiene, isolation, suicide precautions, fall precautions, car seats, helmets, seat belts), fostering a climate of trust and safety (therapeutic relationship), patient education (modifiable risk factors for stroke, heart disease).
• Love and Belonging: Foster supportive relationships, methods to avoid social isolation (bullying), employ active listening techniques, therapeutic communication, and sexual intimacy.
• Self-Esteem: Acceptance in the community, workforce, personal achievement, sense of control or empowerment, accepting one's physical appearance or body habitus.
• Self-Actualization: Empowering environment, spiritual growth, ability to recognize the point of view of others, reaching one's maximum potential.

The planning stage is where goals and outcomes are formulated that directly impact patient care based on EDP guidelines. These patient-specific goals and the attainment of such assist in ensuring a positive outcome. Nursing care plans are essential in this phase of goal setting. Care plans provide a course of direction for personalized care tailored to an individual's unique needs. Overall condition and comorbid conditions play a role in the construction of a care plan. Care plans enhance communication, documentation, reimbursement, and continuity of care across the healthcare continuum.

Goals should be:

• Measurable or Meaningful
• Attainable or Action-Oriented
• Realistic or Results-Oriented
• Timely or Time-Oriented

Implementation

Implementation is the step that involves action or doing and the actual carrying out of nursing interventions outlined in the plan of care. This phase requires nursing interventions such as applying a cardiac monitor or oxygen, direct or indirect care, medication administration, standard treatment protocols, and EDP standards.

This final step of the nursing process is vital to a positive patient outcome. Whenever a healthcare provider intervenes or implements care, they must reassess or evaluate to ensure the desired outcome has been met. Reassessment may frequently be needed depending upon overall patient condition. The plan of care may be adapted based on new assessment data.

• Issues of Concern

According to a 2011 study conducted in Mekelle Zone hospitals, nurses lack the knowledge to implement the nursing process into practice and factors such as nurse-patient ratios inhibit them from doing so. Ninety percent of study participants lacked sufficient experience to apply the nursing process to standard practice. The study also concluded that a shortage of available resources, coupled with increased workloads due to high patient-nurse ratios, contributed to the lack of the nursing process implementation in the delivery of patient care. [6] [7] [8]

• Clinical Significance

The utilization of the nursing process to guide care is clinically significant going forward in this dynamic, complex world of patient care. Aging populations carry with them a multitude of health problems and inherent risks of missed opportunities to spot a life-altering condition.

As explored by Salmond and Echevarria, healthcare is changing, and the traditional roles of nurses are transforming to meet the demands of this new healthcare environment. Nurses are in a position to promote change and impact patient delivery care models in the future. [9] [10]

• Other Issues

Critical thinking skills will play a vital role as we develop plans of care for these patient populations with multiple comorbidities and embrace this challenging healthcare arena. Thus, the trend towards concept-based curriculum changes will assist us in the navigation of these uncharted waters. 

Concept-Based Curriculum

Baron further explores this need for a concept-based curriculum as opposed to the traditional educational model and the challenges faced with its implementation. A direct impact on quality patient care and positive outcomes. Nursing practice and educational environments form a bond with clinical knowledge and expertise, and that bond facilitates the transition into the current workforce as an indispensable team player and leader in this new wave of healthcare. 

Learning should be the focus and the integration into current practice. Learning is a dynamic process, propelled by a force that must coexist within the same learning milieu between educator and student, preceptor and novice, mentor, and trainee. 

IN the future, nurses must be able to problem-solve in a multitude of situations and conditions to meet these new adversities: challenging nurse-patient ratios, multifaceted approaches to prioritization of care, fewer resources, navigation of the electronic health record as well as functionality within the team dynamic and leadership style.

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Maslow's Hierarchy of Needs for Nursing Contributed by Tammy J. Toney-Butler, AS, RN, CEN, TCRN, CPEN

Disclosure: Tammy Toney-Butler declares no relevant financial relationships with ineligible companies.

Disclosure: Jennifer Thayer declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Toney-Butler TJ, Thayer JM. Nursing Process. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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The nursing process is something often discussed in nursing theory. Most nurses use the nursing process without realizing it is a part of their careers. That is, it comes as second nature to them rather than thinking out each step as they take it. If you’re just beginning to learn about nursing and nursing theory , understanding the nursing process can help you gain a deeper appreciation for how nurses care for their patients, as well as better prepare you to implement the process into your own nursing process.

What is the nursing process?

The nursing process is a set of steps followed by nurses in order to care for patients. How a particular nurse uses the nursing process varies based on the nurse, the patient, and the situation, but the process generally follows the same steps: assessment, diagnosis, plan, implementation, evaluation.

The first step, assessment, is used to get the patient’s history, as well as a list of symptoms or complaints. Using the information gathered in the assessment, the nurse and other health care professionals can form a diagnosis. The diagnosis is the determination of what’s wrong with the patient, if anything. The assessment and diagnosis allow the nurse to develop a nursing care plan, which is a plan of action for how to care for the patient. This step includes goals set by both the nurse and patient, and determining how best to meet those goals. The implementation sets the nursing care plan in motion in order to meet the patient’s goals.

Finally, the patient is evaluated by the nurse to show whether or not goals were met. Evaluation may be done during the implementation phase in order to make changes to the nursing care plan as needed. For example, if the patient gets worse, he or she may need to be reassessed to come up with a different diagnosis and plan of action. The nurse may also be evaluated at this point to determine how he or she cared for the patient.

Why is the nursing process used?

The nursing process is used to regulate patient care and how nurses interact with patients. By following a particular set of steps in the nursing process, a nurse knows exactly what to do to care for a patient and what comes next.

The nursing process also allows nurses to keep better track of patient care in terms of record-keeping. As a nurse is writing up notes about a patient, he or she can mentally go through the nursing process and make notes about each step. This will help ensure that the nurse does not forget a step or notes about an aspect of patient care, and the rest of a patient’s health care team will be able to follow the process the nurse used, as well.

How are nursing theories applied to the nursing process?

Some nursing models deal directly with the nursing process. That is, these theories guide nurses in how to treat patients from assessment through evaluation. Other nursing theories give a modified version of the nursing process, adapting them to fit the model of nursing. However, there are also nursing theories that don’t apply to the nursing process. These theories may only apply to a specific aspect of nursing, such as assessment, rather than the nursing process as a whole.

An Example of the Nursing Process

The nursing process can be a confusing concept for nursing students to grasp. Below is an example of the process from start to finish in a story like fashion:

Implementation

Nursing Care Plans (NCP) Ultimate Guide and List

Writing the  best   nursing care plan  requires a step-by-step approach to complete the parts needed for a care plan correctly. This tutorial will walk you through developing a care plan. This guide has the ultimate database and list of nursing care plans (NCP) and nursing diagnosis samples  for our student nurses and professional nurses to use—all for free! Care plan components, examples, objectives, and purposes are included with a detailed guide on writing an excellent nursing care plan or a template for your unit. 

Table of Contents

Standardized care plans, individualized care plans, purposes of a nursing care plan, three-column format, four-column format, student care plans, step 1: data collection or assessment, step 2: data analysis and organization, step 3: formulating your nursing diagnoses, step 4: setting priorities, short-term and long-term goals, components of goals and desired outcomes, types of nursing interventions, step 7: providing rationale, step 8: evaluation, step 9: putting it on paper, basic nursing and general care plans, surgery and perioperative care plans, cardiac care plans, endocrine and metabolic care plans, gastrointestinal, hematologic and lymphatic, infectious diseases, integumentary, maternal and newborn care plans, mental health and psychiatric, musculoskeletal, neurological, pediatric nursing care plans, reproductive, respiratory, recommended resources, references and sources, what is a nursing care plan.

A  nursing care plan (NCP)  is a formal process that correctly identifies existing needs and recognizes a client’s potential needs or risks. Care plans provide a way of communication among nurses, their patients, and other healthcare providers to achieve healthcare outcomes. Without the nursing care planning process, the quality and consistency of patient care would be lost.

Nursing care planning begins when the client is admitted to the agency and is continuously updated throughout in response to the client’s changes in condition and evaluation of goal achievement. Planning and delivering individualized or patient-centered care is the basis for excellence in nursing practice .

Types of Nursing Care Plans

Care plans can be informal or formal: An informal nursing care plan is a strategy of action that exists in the nurse ‘s mind. A  formal nursing care plan is a written or computerized guide that organizes the client’s care information.

Formal care plans are further subdivided into standardized care plans and individualized care plans:  Standardized care plans specify the nursing care for groups of clients with everyday needs.  Individualized care plans are tailored to meet a specific client’s unique needs or needs that are not addressed by the standardized care plan.

Standardized care plans are pre-developed guides by the nursing staff and health care agencies to ensure that patients with a particular condition receive consistent care. These care plans are used to ensure that minimally acceptable criteria are met and to promote the efficient use of the nurse’s time by removing the need to develop common activities that are done repeatedly for many of the clients on a nursing unit.

Standardized care plans are not tailored to a patient’s specific needs and goals and can provide a starting point for developing an individualized care plan .

Care plans listed in this guide are standard care plans which can serve as a framework or direction to develop an individualized care plan.

An individualized care plan care plan involves tailoring a standardized care plan to meet the specific needs and goals of the individual client and use approaches shown to be effective for a particular client. This approach allows more personalized and holistic care better suited to the client’s unique needs, strengths, and goals.

Additionally, individualized care plans can improve patient satisfaction . When patients feel that their care is tailored to their specific needs, they are more likely to feel heard and valued, leading to increased satisfaction with their care. This is particularly important in today’s healthcare environment , where patient satisfaction is increasingly used as a quality measure.

Tips on how to individualize a nursing care plan:

• Perform a comprehensive assessment of the patient’s health, history, health status, and desired goals.
• Involve the patient in the care planning process by asking them about their health goals and preferences. By involving the client, nurses can ensure that the care plan is aligned with the patient’s goals and preferences which can improve patient engagement and compliance with the care plan.
• Perform an ongoing assessment and evaluation as the patient’s health and goals can change. Adjust the care plan accordingly.

The following are the goals and objectives of writing a nursing care plan:

• Promote evidence-based nursing care and render pleasant and familiar conditions in hospitals or health centers.
• Support holistic care , which involves the whole person, including physical, psychological, social, and spiritual, with the management and prevention of the disease.
• Establish programs such as care pathways and care bundles. Care pathways involve a team effort to reach a consensus regarding standards of care and expected outcomes. In contrast, care bundles are related to best practices concerning care for a specific disease.
• Identify and distinguish goals and expected outcomes.
• Review communication and documentation of the care plan.
• Measure nursing care.

The following are the purposes and importance of writing a nursing care plan:

• Defines nurse’s role. Care plans help identify nurses’ unique and independent role in attending to clients’ overall health and well-being without relying entirely on a physician’s orders or interventions.
• Provides direction for individualized care of the client.  It serves as a roadmap for the care that will be provided to the patient and allows the nurse to think critically in developing interventions directly tailored to the individual.
• Continuity of care. Nurses from different shifts or departments can use the data to render the same quality and type of interventions to care for clients, therefore allowing clients to receive the most benefit from treatment.
• Coordinate care. Ensures that all members of the healthcare team are aware of the patient’s care needs and the actions that need to be taken to meet those needs preventing gaps in care.
• Documentation . It should accurately outline which observations to make, what nursing actions to carry out, and what instructions the client or family members require. If nursing care is not documented correctly in the care plan, there is no evidence the care was provided.
• Serves as a guide for assigning a specific staff to a specific client.  There are instances when a client’s care needs to be assigned to staff with particular and precise skills.
• Monitor progress. To help track the patient’s progress and make necessary adjustments to the care plan as the patient’s health status and goals change.
• Serves as a guide for reimbursement.  The insurance companies use the medical record to determine what they will pay concerning the hospital care received by the client.
• Defines client’s goals. It benefits nurses and clients by involving them in their treatment and care.

A nursing care plan (NCP) usually includes nursing diagnoses , client problems, expected outcomes, nursing interventions , and rationales . These components are elaborated on below:

• Client health assessment , medical results, and diagnostic reports are the first steps to developing a care plan. In particular, client assessment relates to the following areas and abilities: physical, emotional, sexual, psychosocial, cultural, spiritual/transpersonal, cognitive, functional, age-related, economic, and environmental. Information in this area can be subjective and objective.
• Nursing diagnosis . A nursing diagnosis is a statement that describes the patient’s health issue or concern. It is based on the information gathered about the patient’s health status during the assessment.
• Expected client outcomes. These are specific goals that will be achieved through nursing interventions . These may be long and short-term.
• Nursing interventions . These are specific actions that will be taken to address the nursing diagnosis and achieve expected outcomes . They should be based on best practices and evidence-based guidelines.
• Rationales. These are evidence-based explanations for the nursing interventions specified.
• Evaluation . These includes plans for monitoring and evaluating a patient’s progress and making necessary adjustments to the care plan as the patient’s health status and goals change.

Care Plan Formats

Nursing care plan formats are usually categorized or organized into four columns: (1) nursing diagnoses, (2) desired outcomes and goals, (3) nursing interventions, and (4) evaluation. Some agencies use a three-column plan where goals and evaluation are in the same column. Other agencies have a five-column plan that includes a column for assessment cues.

The three-column plan has a column for nursing diagnosis, outcomes and evaluation, and interventions.

This format includes columns for nursing diagnosis, goals and outcomes, interventions, and evaluation.

Below is a document containing sample templates for the different nursing care plan formats. Please feel free to edit, modify, and share the template.

Download: Printable Nursing Care Plan Templates and Formats

Student care plans are more lengthy and detailed than care plans used by working nurses because they serve as a learning activity for the student nurse.

Care plans by student nurses are usually required to be handwritten and have an additional column for “Rationale” or “Scientific Explanation” after the nursing interventions column. Rationales are scientific principles that explain the reasons for selecting a particular nursing intervention.

Writing a Nursing Care Plan

How do you write a nursing care plan (NCP)? Just follow the steps below to develop a care plan for your client.

The first step in writing a nursing care plan is to create a client database using assessment techniques and data collection methods ( physical assessment , health history , interview, medical records review, and diagnostic studies). A client database includes all the health information gathered . In this step, the nurse can identify the related or risk factors and defining characteristics that can be used to formulate a nursing diagnosis. Some agencies or nursing schools have specific assessment formats you can use.

Critical thinking is key in patient assessment, integrating knowledge across sciences and professional guidelines to inform evaluations. This process, crucial for complex clinical decision-making , aims to identify patients’ healthcare needs effectively, leveraging a supportive environment and reliable information

Now that you have information about the client’s health, analyze, cluster, and organize the data to formulate your nursing diagnosis, priorities, and desired outcomes.

Nursing diagnoses are a uniform way of identifying, focusing on and dealing with specific client needs and responses to actual and high-risk problems. Actual or potential health problems that can be prevented or resolved by independent nursing intervention are termed nursing diagnoses.

We’ve detailed the steps on how to formulate your nursing diagnoses in this guide:  Nursing Diagnosis (NDx): Complete Guide and List .

Setting priorities involves establishing a preferential sequence for addressing nursing diagnoses and interventions. In this step, the nurse and the client begin planning which of the identified problems requires attention first. Diagnoses can be ranked and grouped as having a high, medium, or low priority. Life-threatening problems should be given high priority.

A nursing diagnosis encompasses Maslow’s Hierarchy of Needs and helps to prioritize and plan care based on patient-centered outcomes. In 1943, Abraham Maslow developed a hierarchy based on basic fundamental needs innate to all individuals. Basic physiological needs/goals must be met before higher needs/goals can be achieved, such as self-esteem and self-actualization. Physiological and safety needs are the basis for implementing nursing care and interventions. Thus, they are at the base of Maslow’s pyramid, laying the foundation for physical and emotional health.

Maslow’s Hierarchy of Needs

• Basic Physiological Needs: Nutrition (water and food), elimination (Toileting), airway (suction)-breathing (oxygen)-circulation (pulse, cardiac monitor, blood pressure ) (ABCs), sleep , sex, shelter, and exercise.
• Safety and Security: Injury prevention ( side rails , call lights, hand hygiene , isolation , suicide precautions, fall precautions, car seats, helmets, seat belts), fostering a climate of trust and safety ( therapeutic relationship ), patient education (modifiable risk factors for stroke , heart disease).
• Love and Belonging: Foster supportive relationships, methods to avoid social isolation ( bullying ), employ active listening techniques, therapeutic communication , and sexual intimacy.
• Self-Esteem: Acceptance in the community, workforce, personal achievement, sense of control or empowerment, accepting one’s physical appearance or body habitus.
• Self-Actualization: Empowering environment, spiritual growth, ability to recognize the point of view of others, reaching one’s maximum potential.

The client’s health values and beliefs, priorities, resources available, and urgency are factors the nurse must consider when assigning priorities. Involve the client in the process to enhance cooperation.

Step 5: Establishing Client Goals and Desired Outcomes

After assigning priorities for your nursing diagnosis, the nurse and the client set goals for each determined priority. Goals or desired outcomes describe what the nurse hopes to achieve by implementing the nursing interventions derived from the client’s nursing diagnoses. Goals provide direction for planning interventions, serve as criteria for evaluating client progress, enable the client and nurse to determine which problems have been resolved, and help motivate the client and nurse by providing a sense of achievement.

One overall goal is determined for each nursing diagnosis. The terms “ goal outcomes “ and “expected outcome s” are often used interchangeably.

According to Hamilton and Price (2013), goals should be SMART . SMART stands for specific, measurable, attainable, realistic, and time-oriented goals.

• Specific. It should be clear, significant, and sensible for a goal to be effective.
• Measurable or Meaningful. Making sure a goal is measurable makes it easier to monitor progress and know when it reaches the desired result.
• Attainable or Action-Oriented. Goals should be flexible but remain possible.
• Realistic or Results-Oriented. This is important to look forward to effective and successful outcomes by keeping in mind the available resources at hand.
• Timely or Time-Oriented. Every goal needs a designated time parameter, a deadline to focus on, and something to work toward.

Hogston (2011) suggests using the REEPIG standards to ensure that care is of the highest standards. By this means, nursing care plans should be:

• Realistic. Given available resources. 
• Explicitly stated. Be clear about precisely what must be done, so there is no room for misinterpretation of instructions.
• Evidence-based. That there is research that supports what is being proposed. 
• Prioritized. The most urgent problems are being dealt with first. 
• Involve. Involve both the patient and other members of the multidisciplinary team who are going to be involved in implementing the care.
• Goal-centered. That the care planned will meet and achieve the goal set.

Goals and expected outcomes must be measurable and client-centered.  Goals are constructed by focusing on problem prevention, resolution, and rehabilitation. Goals can be short-term or long-term . Most goals are short-term in an acute care setting since much of the nurse’s time is spent on the client’s immediate needs. Long-term goals are often used for clients who have chronic health problems or live at home, in nursing homes, or in extended-care facilities.

• Short-term goal . A statement distinguishing a shift in behavior that can be completed immediately, usually within a few hours or days.
• Long-term goal . Indicates an objective to be completed over a longer period, usually weeks or months.
• Discharge planning . Involves naming long-term goals, therefore promoting continued restorative care and problem resolution through home health, physical therapy, or various other referral sources.

Goals or desired outcome statements usually have four components: a subject, a verb, conditions or modifiers, and a criterion of desired performance.

• Subject. The subject is the client, any part of the client, or some attribute of the client (i.e., pulse, temperature, urinary output). That subject is often omitted in writing goals because it is assumed that the subject is the client unless indicated otherwise (family, significant other ).
• Verb. The verb specifies an action the client is to perform, for example, what the client is to do, learn, or experience.
• Conditions or modifiers. These are the “what, when, where, or how” that are added to the verb to explain the circumstances under which the behavior is to be performed.
• Criterion of desired performance. The criterion indicates the standard by which a performance is evaluated or the level at which the client will perform the specified behavior. These are optional.

When writing goals and desired outcomes, the nurse should follow these tips:

• Write goals and outcomes in terms of client responses and not as activities of the nurse. Begin each goal with “Client will […]” help focus the goal on client behavior and responses.
• Avoid writing goals on what the nurse hopes to accomplish, and focus on what the client will do.
• Use observable, measurable terms for outcomes. Avoid using vague words that require interpretation or judgment of the observer.
• Desired outcomes should be realistic for the client’s resources, capabilities, limitations, and on the designated time span of care.
• Ensure that goals are compatible with the therapies of other professionals.
• Ensure that each goal is derived from only one nursing diagnosis. Keeping it this way facilitates evaluation of care by ensuring that planned nursing interventions are clearly related to the diagnosis set.
• Lastly, make sure that the client considers the goals important and values them to ensure cooperation.

Step 6: Selecting Nursing Interventions

Nursing interventions are activities or actions that a nurse performs to achieve client goals. Interventions chosen should focus on eliminating or reducing the etiology of the priority nursing problem or diagnosis. As for risk nursing problems, interventions should focus on reducing the client’s risk factors. In this step, nursing interventions are identified and written during the planning step of the nursing process ; however, they are actually performed during the implementation step.

Nursing interventions can be independent, dependent, or collaborative:

• Independent nursing interventions are activities that nurses are licensed to initiate based on their sound judgement and skills. Includes: ongoing assessment, emotional support, providing comfort , teaching, physical care, and making referrals to other health care professionals.
• Dependent nursing interventions are activities carried out under the physician’s orders or supervision. Includes orders to direct the nurse to provide medications, intravenous therapy , diagnostic tests, treatments, diet, and activity or rest. Assessment and providing explanation while administering medical orders are also part of the dependent nursing interventions.
• Collaborative interventions are actions that the nurse carries out in collaboration with other health team members, such as physicians, social workers, dietitians, and therapists. These actions are developed in consultation with other health care professionals to gain their professional viewpoint.

Nursing interventions should be:

• Safe and appropriate for the client’s age, health, and condition.
• Achievable with the resources and time available.
• Inline with the client’s values, culture, and beliefs.
• Inline with other therapies.
• Based on nursing knowledge and experience or knowledge from relevant sciences.

When writing nursing interventions, follow these tips:

• Write the date and sign the plan. The date the plan is written is essential for evaluation, review, and future planning. The nurse’s signature demonstrates accountability.
• Nursing interventions should be specific and clearly stated, beginning with an action verb indicating what the nurse is expected to do. Action verb starts the intervention and must be precise. Qualifiers of how, when, where, time, frequency, and amount provide the content of the planned activity. For example: “ Educate parents on how to take temperature and notify of any changes,” or “ Assess urine for color, amount, odor, and turbidity.”
• Use only abbreviations accepted by the institution.

Rationales, also known as scientific explanations, explain why the nursing intervention was chosen for the NCP.

Rationales do not appear in regular care plans. They are included to assist nursing students in associating the pathophysiological and psychological principles with the selected nursing intervention.

Evaluation is a planned, ongoing, purposeful activity in which the client’s progress towards achieving goals or desired outcomes is assessed, and the effectiveness of the nursing care plan (NCP). Evaluation is an essential aspect of the nursing process because the conclusions drawn from this step determine whether the nursing intervention should be terminated, continued, or changed.

The client’s care plan is documented according to hospital policy and becomes part of the client’s permanent medical record, which may be reviewed by the oncoming nurse. Different nursing programs have different care plan formats. Most are designed so that the student systematically proceeds through the interrelated steps of the nursing process , and many use a five-column format.

Nursing Care Plan List

This section lists the sample nursing care plans (NCP) and nursing diagnoses for various diseases and health conditions. They are segmented into categories:

Miscellaneous nursing care plans examples that don’t fit other categories:

Care plans that involve surgical intervention .

Nursing care plans about the different diseases of the cardiovascular system :

Nursing care plans (NCP) related to the endocrine system and metabolism:

Care plans (NCP) covering the disorders of the gastrointestinal and digestive system :

Care plans related to the hematologic and lymphatic system:

NCPs for communicable and infectious diseases:

All about disorders and conditions affecting the integumentary system:

Nursing care plans about the care of the pregnant mother and her infant. See care plans for maternity and obstetric nursing:

Care plans for mental health and psychiatric nursing:

Care plans related to the musculoskeletal system:

Nursing care plans (NCP) for related to nervous system disorders:

Care plans relating to eye disorders:

Nursing care plans (NCP) for pediatric conditions and diseases:

Care plans related to the reproductive and sexual function disorders:

Care plans for respiratory system disorders:

Care plans related to the kidney and urinary system disorders:

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition) Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care  Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health   Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

Recommended reading materials and sources for this NCP guide: 

• Björvell, C., Thorell-Ekstrand, I., & Wredling, R. (2000). Development of an audit instrument for nursing care plans in the patient record.   BMJ Quality & Safety ,  9 (1), 6-13. [ Link ]
• DeLaune, S. C., & Ladner, P. K. (2011).  Fundamentals of nursing: Standards and practice . Cengage learning .
• Freitas, F. A., & Leonard, L. J. (2011). Maslow’s hierarchy of needs and student academic success .  Teaching and learning in Nursing ,  6 (1), 9-13.
• Hamilton, P., & Price, T. (2007). The nursing process, holistic.  Foundations of Nursing Practice E-Book: Fundamentals of Holistic Care , 349.
• Lee, T. T. (2004). Evaluation of computerized nursing care plan: instrument development .  Journal of Professional Nursing ,  20 (4), 230-238.
• Lee, T. T. (2006). Nurses’ perceptions of their documentation experiences in a computerized nursing care planning system .  Journal of Clinical Nursing ,  15 (11), 1376-1382.
• Rn , B. O. C., Rn, H. M., Rn, D. T., & Rn, F. E. (2000). Documenting and communicating patient care : Are nursing care plans redundant?.  International Journal of Nursing Practice ,  6 (5), 276-280.
• Stonehouse, D. (2017). Understanding the nursing process .  British Journal of Healthcare Assistants ,  11 (8), 388-391.
• Yildirim, B., & Ozkahraman, S. (2011). Critical thinking in nursing process and education .  International journal of humanities and social science ,  1 (13), 257-262.

67 thoughts on “Nursing Care Plans (NCP) Ultimate Guide and List”

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Thank you! Hope we’ve helped you write better nursing care plans!

Will definitely use this site to help write care plans. How should I cite this link when using APA format. Thank You

HI Can some one help me to do assignment on Impaired renal perfusion. 1.Goal 2.Related Action 3.Rational 4.Evaluate outcome

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Risk for ineffective thermoregulation would be a good one for you to do next for newborn.

Hi, i have learnt a lot THANK YOU. i would kindly like to learn more on paper 1 since am yet to sit for my nursing council exams and feel challenged on the paper.please do assist me thank you.

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What is a nursing care plan a mother in second stage of labour?

Please see: 36 Labor Stages, Induced and Augmented Labor Nursing Care Plans

What is the nursing care plan for pulmonary oedema?

I m interest in receiving a blank nursing care plan template for my students to type on. I was wondering if it was available and if so can you please direct me on where to find it?

Hi! You can download it here: Nursing Care Plan Template

I love this website!!! Is there a textbook version of the Nurseslabs that I can purchase??

Thank you Nurseslabs. This is a wonderful note you’ve prepared for all nurses. I would like a pdf of this. Thanks.

I wish I had had this resource when i was in nursing school 2008!!

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Hi Matt! I would like to purchase a textbook of your nursing care plan. Where I can purchase pls help!

Hi Criselda,

Sorry, we don’t have a textbook. All of our resources are here on the website and free to use.

Good day, I would like to know how can I use your website to help students with care plans.

Sincerely, Oscar A. Acosta DNP, RN

Oh I love your works. Your explanations

I’m glad I’ve met your website. It helps me a lot. Thank you

I love this, so helpful.

These care plans are great for using as a template. I don’t have to reinvent the wheel, and the information you provided will ensure that I include the important data without leaving things out. Thanks a million!

Hi, I have learnt a lot, this is a wonderful note you’ve prepared for all nurses thank you.

Matt, this page is very informative and I especially appreciate seeing care plans for patients with neurological disorders. I notice, though, that traumatic brain injury is not on your list. Might you add a care plan page for this?

Thanks alot I had gained much since these are detailed notes 🙏🙏

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Hi, is there a downloadable version of this, pdf or other files maybe this is awesome!

Hi Paul, on your browser go to File > Print > Save as PDF. Hope that helps and thanks for visiting Nurseslabs!

Matt, I’m a nursing instructor looking for tools to teach this. I am interested in where we can find “rules” for establishing “related to” sections…for example –not able to utilize medical diagnosis as a “related to” etc. Also, resources for nursing rationale.

Hello, please check out our guide on how to write nursing diagnoses here: https://nurseslabs.com/nursing-diagnosis/

Nursing care plan is very amazing

Thanks for your time. Nursing Care Plan looks great and helpful!

complete knowledge i get from here

great resource. puts it all together. Thank for making it free for all

Hello Ujunwa, Thanks a lot for the positive vibes! 🌟 It’s super important to us that everyone has access to quality resources. Just wondering, is there any specific topic or area you’d love to see more about? We’re always looking to improve and add value!

Great work.

Hi Abbas, Thank you so much! Really glad to hear you found the nursing care plans guide useful. If there’s a specific area or topic you’re keen on exploring more, or if you have any suggestions for improvement, feel free to share. Always aiming to make our resources as helpful as possible!

It has been good time me to use these nursing guides.

What is ncp for acute pain

For everything you need to know about managing acute pain, including a detailed nursing care plan (NCP), definitely check out our acute pain nursing care plan guide . It’s packed with insights on assessment, interventions, and patient education to effectively manage and alleviate acute pain.

Good morning. I love this website

what is working knowledge on nursing standard, and Basic Life Support documentation?

Thank you for the website, it is awesome. I just have one question about the 1st set of ABG (Practice Exam) – The following are the values: pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg…Definitely Respiratory Acidosis, but the HC03 is only 28 mmol/L..I thought HC03 of 28 mmol/L would be within the normal range and thus, no compensation, but the correct answer has partial compensation because of the HC03 value. What value ranges are you using for HC03. Thanks, EK Mickley, RN BSN

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Academic essays part 3: how to pass an assignment.

John Fowler

Educational Consultant, explores how to survive your nursing career

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John Fowler , Educational Consultant, explores academic writing

Writing an academic essay is a skill, and like any other skill it can be learnt and improved upon. This is easier if the skill is broken down into steps that can be identified, followed and practised. Whereas nurse educators recognise the need to teach practical skills by identifying the various steps involved in the process—such as nursing assessments or applying sterile dressings—they are not so good at helping students identify the essential components of a successful academic essay. If the student can appreciate why these components are essential, they can be honed and practised to improve academic performance. These principles can also be used to give structure for lecturers introducing an assignment or formulating individual feedback.

Essential components of a successful essay

I've been setting and marking essays for over 30 years, supporting a range of staff from first-year students to specialist nurses undertaking Masters and PhDs. From this, I've identified eight components that make up the skill of successful academic essay writing:

• Clear thinking and factually correct The essay is a clear and logical exploration of the question set, based on the best available evidence. This demonstrates that the student has understood the subject and researched the question, going beyond their own opinions.
• Use of evidence-based literature and correct referencing technique The subject is explored using published evidence from journals and appropriate sources such as www.nice.org.uk and Cochrane databases. This demonstrates that the student can extract up-to-date information from reliable sources and reference the sources correctly as per the specific university guidelines.
• Evaluation of the evidence Rather than just repeating that an author said ‘A+B = C’ the student asks questions of the reliability of the evidence in terms of research style and sample size. Do the findings from one clinical setting transfer to another setting? This demonstrates that although the student understands the importance of evidence-based practice, they are not just accepting that anything in print can be directly applied without question.
• Comparative analysis The essay is not just a list of what different authors have said. It demonstrates that the student has read different papers and has attempted to make sense of how the opinions and findings agree or disagree. For example: Brown and Smith (2015) identified ‘patient-controlled analgesia’ as an important factor in a patient's perception of postoperative pain on a surgical ward. This was supported by Raby (2019) with patients on a orthopaedic ward, but not identified by Raine (2018), whose work centred on palliative care wards .
• Use of own experience to comment on the literature The student uses their own experience to comment on the literature, either agreeing, disagreeing or offering an explanation. This is very different from the student stating an opinion and then saying Smith (2010) agrees with me . Thus in the example above of factors affecting a patient's pain perception, the student might add an opinion as to why the results from a palliative care setting did not identify patient-controlled analgesia as an important factor. It is important that the nurse's experience is offered as a possible explanation rather than as a solid fact.
• Identification of gaps in the literature Once the evidence from the literature has been collected the student can use their clinical experience to comment on possible gaps in the literature. This is a valuable way to use clinical experience. It demonstrates understanding of the principles regarding the topic set in the question and acknowledges that there are many aspect of nursing not fully explored in the literature. It can also demonstrate originality of thought and ideas.
• Development of an argument The essay is not just a collection of ‘stand alone’ paragraphs. There should be a structure to the essay in which the main theme of the question set is explored, with each paragraph exploring a different sub theme. These sub themes should build together, linking and complementing each other. As the essay progresses it develops the interaction of the themes and the deepening of the argument based on the assignment question.
• Clear conclusion The conclusion should be about 8-10% of the essay. It should draw out the findings from the body of the essay and present them clearly and concisely. The argument that has been developed in the essay should be summarised and the implications for nursing discussed. The student should be succinctly answering any points in the original question.

Essay writing is a skill. Too often students of all professions are left to develop this skill by trial and error, never really understanding why one essay achieved a high mark and the next one didn't. Once you begin to understand the various components of this skill then you can begin to incorporate and build them into your work. Understanding why they are important and then practising them will help you develop and improve this important skill.