Health Assessment Essay: Nursing Role and Holistic Care

This essay provides a comprehensive overview of health assessment within the nursing context, addressing the definitions of health and assessment, and highlighting the importance of health assessment in planning and delivering holistic care. It emphasizes the role of registered nurses (RNs) in patient care, and the application of clinical reasoning cycles to prioritize patient problems and develop effective communication strategies with patients and the care team. The essay explores the significance of the Nursing and Midwifery Board of Australia (NMBA) standards in guiding nursing practice and providing safe and quality service. Furthermore, it presents case scenarios to illustrate the practical application of health assessment, considering factors like socioeconomic history, physical assessment, age-specific information, and cultural considerations to facilitate patient-centered care and improve patient satisfaction. It emphasizes the integration of effective communication, critical thinking, and a culturally competent approach in nursing practice.

RUNNING HEAD: NURSING
NURSING
Name of Student
Name of University
Author note

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As a registered nurse (RN), it is important to develop certain practices which is
clinically effective while building communication with the patients and the other
professionals, in order to optimize the clinical care to a patient- centered one. It is important
for the nurses to develop an effective clinical reasoning cycle to help assess the patient
condition better in order to effectively plan the nursing assessments followed by the nursing
interventions. In the clinical reasoning cycle, the situation followed by collecting the
subjective and objective cues of the patient has to be collected (Hunter & Arthur, 2016).
SECTION A
Health is the state of social, physical and psychological without being affected by any
diseases completely (complete absence of a disease). The term ‘Assessment’ can be defined
as process of information gathering using the appropriate clinical and the investigative tests
(that is examination) – in context to the person’s pathophysiological status and state of health.
In the nursing context – the ‘health assessment’ is defined as a gathering or collection process
of patient information regarding his physical, psychological, physical and overall
psychosocial in addition to his spiritual frame of mind , in order to plan the nursing
interventions in the most appropriate manner and clinically reasoned pathway (Dalton, Gee &
Levett-Jones, 2015).
Holistic care is an important part in the nursing context of clinical care as it fuses all
the physical, psychological, social and spiritual aspect of interventions – to deliver a
complete and fulfilling nursing service to the patient. The nursing holistic care cures not only
the biological aspects of the disease (the patient is suffering from) but also helps in extending
a fulfilling, compassionate and all-encompassing care to the patient (Koivisto et al., 2016). In
a holistic care, the esteem and dignity of the patient is addressed and the importance of
nursing holistic is held in the fact that ‘holistic’ nursing care addresses and fulfills the
humanistic needs of the patient, thus contributing to higher patient satisfaction (Kinchen,

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2015). In a case scenario of depression, the nurse can give a holistic care - biomedical care
(with antidepressants) along with talk therapy and empathy building with the patient
(addressing the humanistic and the psychological needs) (Croft et al., 2018). In depression,
there is shifting of self-image, social identity and blurring of self-concept and hence a holistic
care must be integrated with strengthening of the family network and social connections of
the person. A Biopsychosocial (BPS) model of care can be incorporated in the nursing care
delivery, to provide a holistic centered care.
SECTION B
In nursing, the ‘health assessment’ depends on the observed and deduced signs and
symptoms with apt usage of nursing critical thinking and clinical reasoning cycle. The
nursing ‘health assessment’ is as important as the medical assessment (done by the attending
doctors) and the former (that is nursing health assessment) – provides a better insight into the
picture of continuously changing patient situations. According to the Nursing and Midwifery
Board of Australia (NMBA) – the nurses must be apt enough to think critically and analyze
the nursing practice (Standard 1). In the clinical reasoning cycle, prioritizing the patient
problems after collecting subjective and objective cues from the patients must take into
consideration – the standard 1 of NMBA (Bester & Van Deventer, 2015). Standard 2 of
NMBA guides a registered nurse to engage in a professional and therapeutic relationship with
the patient and the other team members of the care team. While planning the nursing plan of
care using the clinical reasoning cycle (that follows after ‘setting the clinical priorities’ stage
in clinical reasoning cycle) – the RN must use the right effective communication to develop
collaborative relationship with the patients, nurses and the members of other discipline,
involved in the care process. NMBA standard 4 is critical to the use of clinical reasoning
cycle by the Registered nurse as the standard guides the RN to comprehensively perform the
clinical nursing assessments. Standard 5 of NMBA that refer to fostering of a nursing plan to

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handle and intervene the patient condition effectively – corresponds to the ‘establishing
goals’ and ‘taking action’. Standard 6 of Nursing and Midwifery board of Australia guides
the RN to provide a safe, responsive and appropriate service to the patients and a quality
service must be delivered. Hence, effective communication, critical thinking, effective
clinical reasoning process must be used by the registered nurse (through an appropriate
application of CRC) in order to deliver a quality, safe service.
SECTION C
In case scenario 1 – the situation of the patient A is that he is 76 years old and
admitted to an aged care facility. The presenting symptoms of the patient is osteoporosis,
hearing deficit, constipation. His daughter visits him on a weekly basis. In this case – the
socioeconomic history is an important part of the assessment as it would shed light in to
demographic data of the subject. In physical assessment, the speech and hearing assessment
of the patient (in collaboration with a speech and hearing therapist) has to be undertaken
(Levett-Jones, Courtney-Pratt & Govind, 2019). The fall risk assessment has to be done by
the nurse, relating the osteoporosis, the bowel and bladder continence to be checked as well.
In addition to these, the developmental, age specific information, lifestyle and cultural
aspects has to be taken care by the nurse, in order to develop a communication (effective
communication with the nurse). In aged care facility, it is important that the nurse use an
effective communication – addressing the dignity and esteem needs of the elderly patient.
Developmentally, the patient is elderly and a humanistic communication is important to
spiritually empower the subject, for a more effective patient centered care. Other age related
information is hearing deficit – hence a more empathic, non-verbal communication has to be
facilitated by the nurse (Booth & Kaylor, 2018). Lifestyle changes has to be done by the
registered nurse, in order to improve the nutritional status and fall risk status of Mr. A.

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In the scenario 3, the situation is that Mr. C is a fifty four year old man who
underwent a bowel surgery today and the person is from Torres Strait Islander background.
The two assessment which are very important, is taking down the present medical and the
surgical history plus doing a post-surgical physical assessment. The physical assessment of
the registered nurse must assess for urinary incontinence, any signs related to emptying of the
urinary bladder, any proneness to urinary tract infections (UTI) and the registered nurse must
also check for the frequency of urination. Any signs relating to bowel incontinence, bowel
frequency and bowel movements should be checked, by the nurse. The age specific nursing
consideration in this case, is building of a respectful and culturally dignified communication
with the subject. Socially - the framework of the family has to be strengthened in order to
receive a better support from Mr. C’s wife. As for interaction – a very culturally competent
communication has to be undertaken. In the setting, the health check-ups, as in nursing
assessments of the patient has to be undertaken on a regular basis.
Conclusion
It is very important for the registered nurse to use the critical reasoning of the patient
conditions are to be done in order to prioritize the problems, in terms of severity. It is critical
for a registered nurse to develop an effective communication with the patients and their
families and also with the other members of the care team. It is very important that the
registered nurses uses a culturally competent communication with the patient and their
families in order to deliver a proper patient centered care and increase patient satisfaction.
The clinical reasoning cycle must be aptly included in nursing assessment.

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