H. Criticisms

CRITICISMS OF THE NURSING PROCESS & ROPER LOGAN & TIERNEY' S MODEL

Assessment

• It is only a “snap shot” and is often not referred to after the initial assessment or updated

• There is the danger of a “reductionist” approach in which patients are made to “fit” into the boxes rather than allowing flexibility

• It is only one among several nursing assessment tools (water low, moving & handling, nutrition, pain etc) in addition to other medical.

• Paramedical records

• Patients may lie or conceal “incriminating” or embarrassing information

• Psychological, sexual, spiritual or issues surrounding death may not be mentioned

Planning and Giving Care

• The patient’s may not be consulted, empowered to cooperate, or compliant in their care

• With increasing skill mix CSW’s now provide most of the physical care, But the often have not been taught (or expected) to read care plans, may not report back(or realize the significance of) changes to the RN who is writing the evaluation and may or may not document the care they have given

• Patient care is fragmented “task nursing” rather than holistic nursing

Evaluation

• There is not enough time

• It is just paper work that takes nurses away from hands-on-care

• We are bad at reading: so care plans are not consulted nurses rely on verbal handovers and their notes. (But these are only as good as the individuals memory and continuity of care

• Evaluation tends to concentrate on objective measurable activity it may not be appropriate to describe “therapeutic” care interventions or set measurable goals