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Nursing – Change Paper


A nation’s development and success depend on its people’s health. Additionally, the people being healthy means that the state has invested in the health systems and more so in the training of the nurses in matters relating to their training and constant improvement of skills. For the nation to fully achieve its set goals or obligations, it is important to invest in the nursing process of that particular state. To better understand the concept under discussion, the nursing process is generally defined as the systematic method of planning that acts as a guide for all nursing activities or actions in delivering client-centred or patient-focused care. According to experts and professionals, the nursing process is the scientific way of offering high-quality care to patients based on some set principles that need to be followed by nurses of a particular state or country. The article focuses on identifying areas of inefficiency in the nursing process, possible solutions to solve the issue, and evaluating the plan’s effectiveness.

Areas of Nursing Process That Are inefficient, unsafe, or Problematic in Nature

The nursing process is guided by five key steps that form the basis for the rational planning method for service delivery. The key steps involve assessment, diagnosing, planning, implementation and evaluation as the last step. Within the mentioned steps, some steps face problems in implementation, not forgetting the problematic nature of the areas or steps (Toney-Butler & Thayer, 2022). Generally observing the areas of the nursing process, all steps are vital in delivering client-based care, and almost all the areas are faced with challenges.

Additionally, the steps directly relate to each other hence it is right to say that a problem in the first stage translates to a challenge to all other steps of the nursing process. The first step is assessment, which is faced with many challenges since the nurses must be more careful in this particular step. In the mentioned area of the nursing process, the nurses and other medical professionals are involved in massive data collection. The step also requires excellent critical thinking skills. Despite the collection of massive data at the particular stage, the nurses have to interact with many patients, hence the need for multitasking abilities to record accurate information. Additionally, the assessment step in the nursing process is described as naturally challenging to the nursing team and professionals because of the many techniques involved. Other reasons why the stage is insecure and problematic are the high number of patients compared to the nursing team and also lack of adequate skills in the nursing team.

Secondly, planning is the other area facing challenges in the nursing process. In addition to the mentioned causes of the problems in the assessment stage, the nursing process is also affected by inadequate planning. The causes of inadequate planning include the high number of patients and lack of adequate clinical experience. Mostly insufficient planning is caused by nurses being overwhelmed by the number of patients hence failing to enforce the proper nursing process. The number of patients in the facilities affects the planning step because there is no adequate time to plan effectively for each patient.

The other area facing a massive challenge is the determination of nursing diagnosis. Researchers have proved that many medical practitioners and nurses lack experience or practical skills since the majority only possess theoretical knowledge. In the diagnosis step or stage, the nurses must have both practical and theoretical knowledge to achieve the objectives and follow the nursing process.

Proposed Plan Based on Chosen Change Theory and Explanation on How to Implement Change

People can use different change theories to achieve the needed results in the nursing process, but the most suitable change model for this particular assessment is the ADKAR model. Jeffrey Hiatt created the model, which in full means Awareness, Desire, Knowledge, Ability and Reinforcement (ADKAR) (Sharma, 2019). Without proper planning and involvement of the nurses in implementing the change theory, there will be resistance; hence it is vital to involve the entire team while introducing the new model. The theory enlightens the nurses on the importance of the nursing process. It brings forward the importance of having the desire to provide quality services and, most importantly, having good knowledge of the process.

The proposed change model will also help the nursing team overcome some challenges, such as the planning factor in the nursing process. The ADKAR model advocates for working together as a team and coming up with possible solutions. The model also increases the interaction between the nurses, which in the long run creates a good working environment. Additionally, the change theory advocates for knowledge acquisition. The skills acquired and in coordination with the change plan, nurses will greatly match the patient expectations with services provided in the institutions. The change plan theory will also leave all parties involved in the nursing process more enlightened, hence solving the major challenges in the nursing process.

In the implementation aspect, the change theory will be professionally introduced and closely related to the existing plan and push for change, minimizing resistance. Additionally, to achieve maximum adoption of the new plan, it is important to promote information sharing since it will help to alter or change the existing employee beliefs (AlManei et, 2018). The team’s mental preparation is also vital in implementing a new theory; the nurses and the entire team will need to be adequately prepared and supported mentally for a successful change theory implementation.

Criteria to Evaluate the Effectiveness of the Plan and the Timeline for Change Proposal

The effectiveness of any plan is mainly and professionally evaluated using external experts in conjunction with different data collection and analysis methods. Interviews are widely recommended because they give good chances to collect the required information. Questionnaires are also vital since the nurses in this particular assignment will give non-biased information (De Groot et, 2019). The information collected will then be analyzed by the experts and come to a conclusion depending on their rating of the performance. The patients’ opinions matter in the exercise since the objective is to achieve patient-based care. The timeline for determining the plan’s effectiveness can be after one year; additionally, the evaluation needs to be done annually.

Effect of the Change in the Nursing Profession

Effects of implementing a new plan or strategy cut across both the positive and negative effects on the nursing profession at large. The right approach to the new plan results in positive results. The change will positively impact this particular assignment since professionals will execute it. The quality of services being provided will increase hence more satisfaction in terms of patient-based service (Doenges et, 2019). Improved employee relations and patient-to-nurse relationships will improve with the implementation of the new plan. The new plan will also eliminate the challenges in the nursing process, and zero error services will be achieved.


The nursing process is the basis for providing patient-centred care. In different states, the nurses are required to follow the laid procedure in providing the services. Even though there are challenges in the process, such as lack of practical skill and a large number of patients, professionals can overcome the challenges by implementing a new change plan that will help overcome challenges. The proposed change plan is the ADKAR model for the particular assessment mentioned above. The positive effects of the model implementation, such as improved service provision and good relations in the working environment, have been discussed adequately. In conclusion, every nursing professional needs to equip themselves with the right skills and understand the nursing process professionally.


AlManei, M., Salonitis, K., & Tsinopoulos, C. (2018). A conceptual lean implementation framework based on change management theory. Procedia cirp72, 1160-1165.

De Groot, K., Triemstra, M., Paans, W., & Francke, A. L. (2019). Quality criteria, instruments, and requirements for nursing documentation: A systematic review of systematic reviews. Journal of advanced nursing75(7), 1379-1393.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nursing care plans: Guidelines for individualizing client care across the life span. FA Davis.

Sharma, K. (2019). 10 Proven Change Management Models. The Whatfix Blog | Drive

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Toney-Butler, T., & Thayer, J. (2022). Nursing Process. .


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