Nursing Process

The Five Steps of the Nursing Process

Based on a nursing theory developed by Ida Jean Orlando in the late 1950's as she observed nurses in action, the Nursing Process is an essential part of the nursing care plan.

The Nursing Process is a systematic problem-solving approach used to identify, prevent and treat actual or potential health problems and promote wellness.

The first step of the Nursing Process is assessment, which includes the collection, organization, validation, and documentation of the data. It involves taking vital signs, performing a head to toe assessment, listening to the patient's comments and questions about his health status, observing his reactions and interactions with others.

The second step of the Nursing Process is diagnosis. Diagnosing includes analyzing the data, identifying health problems, health risks, and the strengths the patient has, and formulating the nursing diagnoses.

The third step of the Nursing Process is planning. It includes prioritizing the patient's problems and diagnoses, formulating goals and desired outcomes for the patient to meet, selecting nursing interventions to enable the patient to meet those goals, and writing the nursing orders. Setting goals to improve the outcomes for the patient are a primary focus of the nursing process. Planning also involves making plans to carry out the necessary interventions to achieve those goals.

The fourth step of the Nursing Process is implementation. It includes reassessing the client, determining the nurse's need for assistance, implementing the nursing orders and documentation of nursing actions. All members of the health care team should be informed of the patient's status and nursing diagnosis, the goals and the plans.

The fifth step of the Nursing Process is evaluation. Evaluation includes collecting data related to the desired outcomes, comparing the data to see if the patient's goals or outcomes desired were met, relating the nursing actions to the goals and outcomes, evaluating the status of the problem, and continuing, modifying or terminating the patient care plan. Evaluation involves not only analyzing the success of the goals and interventions, but examining the need for adjustments and changes as well. The evaluation incorporates all input from the entire health care team, including the patient.


The Nursing Process is a cycle that never ends. As patient needs change, the Nursing Process allows the nurse to change the patient's plan of care to ensure that care is tailored to the patient's present needs. It is a systematic, rational method of identifying a patient's health care status as well as actual or potential health problems, to establish plans to meet the patient's identified needs, and to deliver specific nursing interventions that address those needs.