What Is the Nursing Process? A Guide for Effective Patient Care

Written by: University of Tulsa • Aug 19, 2026

Nurse Standing in a Hospital Room Wearing Scrubs and Holding a Clipboard.

The primary goal of any health care facility is to provide high-quality care that achieves the best patient results. Nurses are crucial to meeting this goal, as their work often puts them on the front lines during various stages of patient care. Because nursing responsibilities vary so much, certain guardrails are necessary to enable nurses to focus their knowledge and skills to deliver optimal care and contribute to a facility’s goals.

The nursing process provides these guardrails. This multi-layered strategy helps nurses provide holistic, evidence-based patient care that’s flexible enough to respond to precise patient needs as they evolve. For those interested in earning an accelerated bachelor of nursing degree, it is important to understand the nursing process and why it is key to providing quality nursing care.

What Is the Nursing Process?

The nursing process is a systematic series of methodologies designed to break down nursing care into specific steps. These steps provide standards for nurses to build their strategies for different phases of patient care delivery. These standards can keep a nurse’s practice focused in a way that enables them to concentrate on and complete tasks that potentially improve patient outcomes.

It is a complex concept with overlapping steps that form a singular cohesive strategy. At the same time, defining the various parts of the nursing process provides a better understanding of how they fit within the overall context of nursing care.

History of the Nursing Process

In 1958, nurse theorist Ida Jean Orlando recognized that the nursing profession needed more guardrails to streamline nursing care. To build these guidelines, Orlando integrated principles she developed through her research of the mental health field into the nursing field, highlighting the importance of nurse communication with patients and other health care associates. According to a biography of Orlando published on the website NurseLabs, this integration is essential because “patients have their own meanings and interpretations of situations, and therefore nurses must validate their inferences and analyses with patients before concluding.”

Orlando’s nursing theory, which was published in 1961, was designed to explore the relationship within the nurse/patient dynamic. By dividing the dynamic into five distinctive yet interconnected steps, the theory made it possible to recognize the ways in which this dynamic can fluctuate within the course of treatment. This theory emphasized patient behavior, equating how behavioral changes could be interpreted as new patient needs. It also highlighted the nurse’s role in reacting to these needs as they evolved, pointing out how well-developed competencies like critical-thinking skills could lead nurses to make the best decisions possible.

Today, Orlando’s theory is used to ensure that patients receive the specific type of nursing care indicated by their unique situations. By implementing the theory, nurses can better recognize and react to patients’ needs with greater effectiveness and efficiency. This can potentially improve a health care facility’s ability to reach the goal of providing care that can improve patient outcomes.

The Nursing Process Steps

The key to understanding the nursing process is to examine its individual steps and identify what each brings to the table. Each step can help nurses better gauge how they can apply their knowledge and skills situationally based on patient behaviors, which are often tied to patient needs. This can potentially be beneficial to patients in the short and long term.

Step 1: Assessment

In the assessment stage, nurses gather as much information about the patient as possible. This allows nurses to establish a baseline that supports the initial care delivery strategy and affords enough flexibility to allow nurses to use their critical-thinking skills to make adjustments based on patient needs.

Nurses can use several sources and methods to gather assessment data. These sources are typically separated into three tiers.

Primary sources
Secondary sources
Tertiary sources

The primary source in the assessment phase is the actual patient. They can provide the nurse with subjective, detailed information on what they feel is wrong with them and how it is impacting their daily functionality. The typical data-gathering methods here include patient interviews, physical examinations, and patient observation.

The secondary sources stem from people and information connected to the patient’s sphere of influence. This can be a patient’s family, friends, or guardians. This type of data can also come from professional resources. These can include a patient’s primary care physician or their electronic health record (EHR).

Tertiary sources extend beyond a patient’s sphere of influence. These sources can range from medical journals and textbooks to in-house procedural manuals. These can help nurses establish further context regarding specific patient conditions.

These sources collectively provide the pieces a nurse needs to carry out the rest of the nursing process. Nurses must be aware that these pieces are subject to change due to elements such as the development of a new symptom. As such, nurses must be prepared to reassess a patient’s situation should a change occur.

Step 2: Diagnosis

After assessment data is collected, the nurse examines that information in the nursing diagnosis phase. This essentially allows nurses to identify the disease, condition, or problem that is causing the health issue. Analyzing the data gathered from the nursing assessment stage is a critical component of diagnosis, but other factors are also in play, including identifying health problems, detecting potential patient strengths and vulnerabilities, and developing diagnostic statements based on medical findings.

Nursing diagnoses are designed to treat the patient in a way that mirrors Maslow’s Hierarchy of Needs. Developed by psychologist Abraham Maslow, this hierarchy allows nurses to prioritize the structure of their diagnosis so the most critical patient needs are met.

The priority of diagnosis based on Maslow’s Hierarchy of Needs is as follows:

Basic physiological needs. This includes a patient’s fundamental functions like breathing, circulation, sleep, and nutrition. They can also include other elements that can alleviate psychological stress, such as shelter.
Safety and security. This includes incorporating measures that minimize the risk of injury, such as putting fall precautions in place. This also encourages the development of a therapeutic relationship within the patient/nurse dynamic to generate trust.
Love and belonging. This includes taking the steps to preserve supportive relationships and create environments that minimize the possibilities of social isolation.
Self-Esteem. This includes a patient’s acceptance of who they are, which can include self-acceptance.
Self-Actualization. This includes a patient’s ability to connect to an empowering environment that allows them to obtain personal growth.

From a care delivery perspective, nursing diagnosis primarily concentrates on addressing and ensuring a patient’s core physiological and safety needs. However, nurses should be mindful of the other three tiers as the nursing process progresses into other stages.

Step 3: Planning

The planning stage of the nursing process is where nurses develop a treatment strategy. The nursing care plan stemming from this is commonly a collaborative process that involves input from the nurse, their supervising medical personnel, and the patient. This input must reflect agreement on the information determined in the diagnostic stage. The strategy here typically strives to meet both short- and long-term health goals, shaped through the principles of evidence-based practice, (i.e., holistic care based on current medical knowledge and research).

Nurses implement three types of planning: initial, ongoing, and discharge.

In the initial planning stage, the nurse who conducted the initial patient assessment develops the framework for the plan care strategy.

In the ongoing planning stage, all nurses involved in the patient’s care collaborate to develop the initial framework into a complex strategy. Ongoing planning must contain enough flexibility to shift strategic elements in the event of changing health status, patient care priorities, or new issues that emerge during care delivery.

The final stage, discharge planning, concentrates on a patient’s exit strategy. As the name implies, this prepares for a patient’s discharge, but it also involves developing strategies for continuity of care, making sure a patient’s needs are met in a way that addresses long-term health goals.

Step 4: Implementation

Implementation in the nursing process brings strategies into action. This phase typically starts by conducting patient-specific interventions that aim to achieve desired outcomes. These interventions are usually collaborative efforts involving nurses and other appropriate medical staff.

During the implementation phase, nurses monitor patients to detect signs of health improvement or decline. They may also take on an active role in patient care through duties such as administering medication or providing the patient with health management education. Additionally, they may need to conduct assessments and diagnoses based on patient progress.

Nurses can develop these implementation strategies around various interventions. There are hundreds of interventions nurses can consider, and they fall under the Nursing Interventions Classification (NIC) System, a taxonomy devised to allow nurses to refine their care strategies to meet patient needs as much as possible. The taxonomy breaks up these interventions into six distinctive categories:

Behavioral Nursing Interventions. These focus on encouraging patients to modify their behaviors to improve their health. Examples include providing patients with the tools to quit smoking or encouraging them to engage in physical activities such as walking.
Community Nursing Interventions. These concentrate on creating peripheral factors that can encourage patients to make smart, health-oriented decisions. This includes promoting healthy eating habits or implementing proactive health education programs.
Family Nursing Interventions. These focus on extending health strategies beyond the individual patient and toward the health of family members and loved ones. Examples of this intervention in action include educating a patient’s family about slowing the spread of a communicable disease or how to care for a patient after they’ve been released from the hospital.
Health Systems Nursing Interventions. These home in on ways to keep a facility safe for patients and staff alike. These include following procedures designed to lower the risk of patient infection and making sure patients remain comfortable in their hospital rooms.
Physiological Nursing Interventions. These ensure a patient’s physical needs are met in a way that optimizes their health. These can include basic procedures such as assisting with hygiene or feeding or conducting complex procedures like handling patient IV lines.
Safety Nursing Interventions. These concentrate on maintaining a healthy patient environment that promotes safety and proactively prevents injuries. This can include educating patients on the best ways to use assistive devices or making sure a patient’s call button functions properly.

Nurses can execute interventions either independently, with assistance or supervision from health care professionals, or as part of a collaborative effort across multiple health care disciplines.

Successful implementation of the nursing process requires nurses to rely on their cognitive skills. Critical thinking, problem-solving, and decision-making competencies allow nurses to apply their clinical knowledge to actionable skills. Interpersonal skills are also important during the implementation stage, as they help nurses build trust and rapport with patients. Additionally, health care-specific technical skills, such as injection administration, medical equipment utilization, and bandaging, are also key components of the implementation process.

Step 5: Evaluation

The evaluation phase of the nursing process concludes the clinical approach that nurses take to review, refine, and update a patient’s care. By determining what worked well and what fell short, nurses can gain a clearer picture of whether or not a care delivery strategy achieved the desired outcome. It can also give nurses the information they need to potentially adjust future care strategies.

Evaluation includes six components:

Collecting outcome data
Comparing data with goal-oriented outcomes
Analyzing the patient’s response to a nurse’s activities
Pinpointing factors that led to attaining a goal or falling short
Making adjustments to the nursing care plan
Transitioning the patient from one phase of care to another

The final component is particularly important, as it prepares patients for life after discharge. It involves educating patients on dietary restrictions, at-home medication usage, and emergency contact numbers. It also includes paying close attention to the patient’s post-treatment goals and honoring their post-care preferences.

The Nursing Process in Action

The nursing process outlined by Ida Jean Orlando is a fundamental component and industry standard of nursing practice across the world. While each patient presents differently, walking through the steps in a hypothetical scenario can provide insight into the skills that nurses must balance to provide quality care.

Consider this example: A patient visits urgent care complaining of extreme fatigue. She is an established patient with a health history on file.

Step 1: Assessment

The nurse reviews the patient’s medical history and begins a head-to-toe assessment, including vital signs such as blood pressure, oxygen saturation, and respiration rate. While reviewing her medical history, the nurse notices the patient’s intake of iron, vitamin D, and B12 supplements.

At this stage, the nurse also documents the patient’s emotional stability, mental awareness, and lifestyle changes. This crucial step may provide clues on how to navigate the rest of the nursing process.

Step 2: Diagnosis

Using the information gathered during assessment, the nurse identifies potential links to the patient’s fatigue. The patient’s medical history shows that she was treated for an iron, vitamin D, and B12 deficiency eight months previously. The nurse uses their assessment findings to identify a link between extreme fatigue and a nutrient deficiency. She may not have been taking her supplements as prescribed.

Step 3: Planning

The nurse shares that diagnosis with the health care team and collaborates to establish a care plan to determine the cause of the patient’s fatigue. The plan includes an immediate laboratory order for a complete blood count (CBC) and a vitamin D, B12, and iron panel. The planning stage also includes setting measurable goals to help the patient feel more alert so she can resume her daily activities.

Step 4: Implementation

The patient completes the ordered laboratory testing for immediate evaluation and waits in the doctor’s office for the results. While waiting, the nurse continues to monitor the patient’s condition. When the lab result is available, the nurse reviews the findings in the electronic health record and communicates the results with the care team.

Step 5: Evaluation

The patient’s bloodwork shows iron, vitamin D, and B12 levels that support the patient’s initial complaint of extreme fatigue. The nurse explains the results and evaluates the patient’s response to the care plan to determine if additional treatments are needed. The nurse educates the patient about eating a balanced diet and incorporating supplements as needed, and schedules a follow-up appointment in six months to reassess the patient’s vitamin levels.

The Principles of the Nursing Process

The primary goal of the nursing process is to streamline quality care to achieve optimal results. This requires nurses to follow certain guidelines.

For instance, the process must focus on the patient. This means honoring the patient’s needs, but also adhering to their values and preferences. This requires the nurse to advocate for the patient to other health care professionals to ensure patient desires are respected.

The nursing process must also be collaborative. Nursing care depends on interactions between a nurse and other health care professionals, including physicians. As such, nurses need to foster an environment of collaboration driven by mutual respect, clear communication, and shared decision-making that aims to optimize care.

In addition, the process must be adaptable so nurses can pivot based on changing circumstances. This requires nurses to use critical thinking to efficiently shift care strategies to meet a patient’s needs as they evolve.

Finally, the process must be interpersonal. Nurses and patients should develop a rapport to ensure the open communication and mutual trust that can lead to optimal care.

Why the Nursing Process Matters

The framework of the nursing process is crucial to modern health care. It provides nurses with a consistent framework, even as care concepts evolve. As technical innovations such as EHRs and artificial intelligence (AI) move into the health care space, nursing process guidelines help nurses identify where they can implement innovations.

The nursing process also helps nurses to pay closer attention to a patient’s needs based on Maslow’s theory. This can improve patient satisfaction and lead to better outcomes, and it allows nurses to integrate cultural competency into their care.

By focusing on patient needs, nurses can respect different cultural beliefs and philosophies, which can lead to a deeper sense of trust within the patient/nurse dynamic.

Guide Others Through the Process

The nursing process provides guidelines that can streamline nursing strategies and make them more efficient. However, high-quality care still relies on talented nurses who can apply the framework in ways that lead to optimal outcomes.

The University of Tulsa’s online Accelerated Bachelor of Science in Nursing (ABSN) program prepares nurses to have a real impact. Our program is designed to help you build the foundational knowledge and skills to develop strong process strategies that lead to targeted care that can make a true difference in the lives of patients.

Learn how we can jumpstart your success.

Recommended Readings

Nursing Manager: Salary and Job Description

9 BSN Careers for Graduates to Consider

Associate vs. Bachelor’s in Nursing Degrees: What Is the Difference?

Sources:

American Home Health, “Nursing Process”

American Nursing Association, “The Nursing Process”

American Nursing Association, “What Is Evidence-Based Practice in Nursing?”

American Nursing Association, “What Is Nursing?”

Credenza, “Nursing Process Steps: What They Are and Why They Matter”

Credenza, “Sample Nursing Care Plan for Patient With Anemia”