When we begin to focus on getting nursing accomplished, we must see nursing as a whole thing, as a system of action directed toward (1) the achievement of a patient's required therapeutic self-care and (2) the overcoming of his limitations to act for himself in therapeutic self-care. Goals of nursing action may be phrased in these terms as illustrated in Figure 7.1.
A system is a collection of interrelated elements characterized by a boundary and a functional unity. It is a set of objects together with relationships between the objects and between their attributes. Objects are the parts or components of the system; attributes are the properties of the objects; relationships are the connections among the objects that tie the system together. We may properly speak of a system of nursing assistance. The elements would be as illustrated in Figure 7.2. But we see a system of nursing action (labeled I) as distinct from a system of medical care (labeled II) and the patient's system of family life (labeled III).
The actions of nurse and patient that produce intra-relations are essential to the system. We want to focus on what the nurse does deliberately to bring about and maintain an effective system of nursing for the patient. This we refer to as the nursing process. Every human action deliberately performed, and nursing, in which not one act but a series of actions is performed over time, is conceptualized as having three phases: (1) the phase of planning, (2) the phase of doing, and (3) the phase of seeing or checking.
This paper was first presented at a workshop sponsored by the Catholic University of America,
Washington, DC, on July 22, 1969.