00:01
Now, once we've
considered priorities,
and of course,
including our patient,
we have reevaluated
our nursing diagnosis
to make sure,
it's still appropriate at this time.
00:11
Now, once we've done this,
we can set goals.
00:14
Now, this is a great little acronym
that we like to use to create
Specific, Measurable, Attainable,
Realistic, and Timely goals.
00:24
Now, this is a really
important acronym
for us as nursing students
or nurses.
00:29
I know this may seem a little silly,
but it's actually really helpful.
00:32
Reason being here
is a great example.
00:34
When we're setting goals,
we need to make sure
we can measure it ,right?
And to see if it's working,
and to evaluate it later.
00:41
So if I say something
for a goal like,
"I hope the patient gets better."
Well, that's true, right?
That's a true statement.
00:48
But how do we measure that?
What does better mean?
So make sure
you follow this acronym,
and this will be really helpful
in the evaluation piece.
00:56
So here's another example of this.
00:59
So our scenario, is Mrs. Smith is
having severe pain in her right leg
that is limiting her mobility.
01:05
Now, our goal
using the SMART acronym
is Mrs. Smith pain
will be controlled
to a reported score of five or less
by the end of the shift.
01:16
Now, look at the difference here.
01:18
When you see a reported score,
that's pretty specific,
I can measure five or less, right?
We've got to also see for
this particular patient,
is that attainable?
Is that a realistic goal?
Now, you've got to take your
clinical judgment and decide,
if this is appropriate
for your patient.
01:36
And of course, timely.
01:38
So I don't want
Mrs. Smith pain to be less
by maybe three days, right?
That's not timely.
01:45
It needs to be appropriate
for your patient.
01:47
So in this goal, we're saying
by the end of the shift.
01:50
So make sure you keep this in mind,
and use that SMART acronym
when you're creating goals
for your patient.
01:57
So when we're talking about
goals of care,
of course,
they've got to be patient centered.
02:01
So this needs
to reflect the patient's
highest level of
wellness and function.
02:06
So we want the patient to do
as much for themselves as possible.
02:10
Now, again,
when we're talking about goals,
many times we're going to create
a short-term, and long-term goal.
02:18
So we're talking about
short-term goals.
02:20
We're talking about hours,
maybe a week.
02:23
Usually, when we're talking about
short-term, it's pretty quick.
02:26
It's usually within that shift.
02:28
A great example of the short-term,
maybe the patient
Oh, is able to get up to the
or transfers to the chair
before lunch today.
02:36
That's a pretty short-term goal.
02:39
We also got to remember
to use our SMART acronym.
02:43
Also, we've got to create
a long-term goal for a patient.
02:46
Is this attainable?
Is this realistic?
Something we can evaluate.
02:50
So maybe our long-term goal
would be the patient
ambulates
to the end of the hall, once
by the time of discharge.
02:58
So you can kind of see
the difference between
short-term and long-term goal.
03:02
Now, the trick here,
when we're talking about goals,
it's all individual to your patient.
03:08
And as a nurse,
you have to assess,
you have to make a
informed diagnosis, and decide,
is this achievable
for our patients?
We don't want to make goals
that are so unattainable,
that we're not creating a
good appropriate plan of care.
03:25
So again, when we're
talking about plan of care,
we always want to partner
with our patient.
03:30
And of course,
go back to make sure
it's individualized for them.
03:34
Now, with the patient,
you may be able
to have them participate
in their ADLs, for example.
03:39
Like brushing their teeth,
maybe getting dressed,
helping to feed themselves,
for example.
03:45
They also need to be able
to participate
in the problem solving,
and also the decision making
of their care.
03:50
That gives them
a little bit of autonomy,
and also self-esteem, and
confidence with their treatment.
03:56
Also, the patient
needs to understand
the value of the therapies
that we're giving.
04:01
If they don't understand
why we're doing an intervention
or providing a goal,
probably going to be
less compliant here, right?
Also, they're not going
to understand
where we're going
with their goal for that day.
04:15
Don't forget about
those expected outcomes.
04:18
So, we've talked a lot about goals.
04:20
But goals aren't going to help you,
unless we know,
where we want to be, right?
So, each goal will have at least
one expected outcome
that defines
if we met the goal, or we didn't.
04:31
Now, let's take a look
at an example.
04:33
So in this scenario,
we've talked about this before
Mrs. Smith having severe pain
in her right leg
that's limiting her mobility.
04:42
So, our goal, is maybe
to reduce that pain again
by the end of the shift.
04:47
Now, due to this scenario, we're
wanting to see an expected outcome
is if we reduce that pain
by using that goal?
We're going to help her mobility
to be able to transfer
from bed to chair.
05:01
So with our
expected outcomes,
remember, they must be
specific and measurable
much like our goals.
05:07
Now, the help support
our nursing practice,
we have the
Nursing Outcomes Classification,
otherwise known as
NOC.
05:14
Now, these were developed
to help accompany each NANDA goal.
05:18
So what that's going to look like
is you're going to have
your nursing diagnosis,
otherwise known as NANDA.
05:23
And if you remember,
these are specific common language
that's going to help us communicate
between
healthcare professionals.
05:30
Then we have our goal
that's client centered.
05:33
And also our expected outcome
to accompany that NANDA goal.