Problem Solving and Nursing Process

By now you must have realized that the human responses, needs or patterns are the phenomena of concern to nurses who encounter two types of problems:

Actual Health Problems

Such as impact of illness on physiological (e.g. respiratory function, metabolism, homeostasis,level of consciousness), physical (e.g. comfort, nutrition, clothing), safety (e.g. from physical,psychosocial trauma/insult), socialization, self-concept and self-esteem (identity), industry,integrity, roles, achievement), and self-actualization (sense of spiritual fulfilment) status of clients.

Potential Health Problems

Such as risk for complications, failure or non-adherence to treatment/therapy, educational needs for information and concern to develop health oriented attitudes and skills.Human responses are dynamic in nature and change as the client progresses along the continuum between health and illness. The nurse assists the clients solve these problems through three types of nursing functions:

Types of Nursing Functions

•  Indepenent e.g. initiating intake and output recording.
•  Interdependent e.g. educating client about the therapeutic nutrition in consultation with the dietitian.
•  Dependent e.g. maintains intravenous therapy. That is carrying out doctors order on medication.

Remember, whatever the type of functions the nurse carries out, the nurse uses a problem solving approach or nursing process. This deliberate approach requires following skills:

•  Cognitive or mental abilities e.g. applying knowledge, thinking critically, analyzing,judgement and decision making.
•  Affective e.g. attitudes, values, acceptance and respect for self and clients, inter-actional activities.
•  Psychomotor e.g. technical skills such as administering medicines, dressing and bathing.

Comparison of the Problem-Solving Process and the Nursing Process

The problem process involves:

1) The systematic identification of a problem

2) Determination of goals related to the problem

3) Identification of possible solutions to achieve these goals

4) Implementation of selected solutions

5) Evaluation of goal achievement.

We use problem-solving approach in daily activities and nursing practice. For example, you use problem solving in deciding what to wear, when it is raining or while nursing a tracheotomy patient how to communicate.

The nursing process is a subset of problem solving process (see Fig.). You have already learnt the steps as:

1) Assessment

2) Nursing diagnosis

3) Planning

4) Implementation

5) Evaluation and modification of plan

The problem solving process and the nursing process are cyclic (Burns and Grove, 1987).


Corporation of the problem solving and the nursing process.

Problem solving through nursing process is described, Fig. in the following manner.

Problem solving/nursing process

In order to solve the nursing and medical problems of your clients, you must learn the use of systematic problem solving techniques. Identify the following prerequisites for efficient use of nursing process:

•  Comprehensive knowledge base
•  Experience and skills in the field
•  Professional commitment (such as belief, ethical base accurately).

Relationship between problem-solving and nursing process

Let us now go through each stage of this problem solving process for solving our client health problems. Apply this knowledge while practicing nursing in selected clinical areas.