What Are the 3 Ps in Nursing?
Written by:
University of Tulsa
• Jul 29, 2024
Nursing students need core competencies to earn a license, enter the workforce, and care for patients. In its guidelines on professional nursing education, the American Association of Colleges of Nursing (AACN) requires that advanced nursing education programs include separate courses for each of the 3 Ps. At all levels of nursing, the 3 Ps help nurses effectively care for patients.
During nursing school , students learn what the 3 Ps in nursing are and build foundational competencies in them, which they strengthen with clinical experience or an advanced nurse education program. Mastering the 3 Ps helps nurses advance their careers and improve patient care.
Unpacking the 3 Ps in Nursing
The 3 Ps are health promotion, pathophysiology, and pharmacology. Nurses draw on these three critical competencies to provide evidence-based, effective patient care.
The nursing process — assessment, diagnosis, planning, implementation, and evaluation — requires foundational skills in the 3 Ps. For example, nurses can’t make clinical judgments about a patient’s health without understanding pathophysiology or how diseases affect bodily systems. Planning and implementing a treatment plan requires a strong understanding of pharmacology, and throughout their patient interactions, nurses promote health.
Health Promotion
Health promotion is the first P in nursing. What is health promotion? Because nurses spend more time interacting with patients than many other health care providers do, nurses play a critical role in health education. Nurses following a patient-centered approach work closely with patients to educate them about disease prevention, health, and overall well-being.
Throughout nursing school, nursing students explore strategies to educate patients, including centering the patient in the learning process. In addition to individual-focused health promotion, nursing students develop health promotion knowledge at the population level with a focus on health inequities.
Nurses with stronger health promotion knowledge are more likely to educate patients about healthy lifestyles and best practices in public health, according to a 2022 study in the Journal of Preventive Medicine and Hygiene. That makes health promotion a vital skill for nursing practice.
Health Promotion Classes
Nurses begin to develop their skills as health educators in their registered nurse (RN) courses. Graduate-level nursing courses build on this foundation to strengthen health promotion skills. Common course titles include the following:
- Health Promotion
- Health Assessment
- Patient Health Care Education
- Advanced Health Assessment
- Community Nursing
Health Promotion Competencies
Nurses use their health promotion skills in diverse nursing specialties, from bedside care roles to public health and environmental nursing roles. Critical health promotion skills, which nurses develop during their education and career, include the following:
- Health Assessment: Nurses conduct a health assessment to determine each patient’s physical health and medical needs. This assessment informs the nurse’s plan to encourage health and wellness.
- Patient Care Planning: Building on their health assessment, nurses develop a patient care plan that incorporates health education and takes the patient’s needs and wants into account. Patient care planning requires a strong understanding of health promotion.
- Health Education Needs Assessment: Nurses conduct a needs assessment to determine a community’s health education needs. They draw on this assessment to craft health education programs.
- Communication: The ability to educate patients and the public about health promotion requires strong communication skills, including empathy. Nurses can’t effectively promote health, prevent diseases, and educate the public without exceptional communication skills.
- Cultural Diversity Awareness: Nurses incorporate cultural values into their health education plans; this requires strong cultural awareness. Nursing schools integrate cultural diversity training into courses on health promotion, and nurses further develop this skill in clinical practice.
Pathophysiology
Pathophysiology is the second P in nursing. Pathophysiology brings together the study of bodily systems (physiology) with the study of disease (pathology). This focus area emphasizes the impact of disease on bodily systems and the physiological changes that impact patients.
RN students examine typical physiological changes across the lifespan and common diseases that impact overall health and specific organ systems. They explore the clinical features of different diseases and how they manifest. For example, nursing students learn about diseases of the cardiovascular system and indicators of heart disease.
By mastering physiology, nurses can apply their understanding of pathology in nursing practice. If a patient presents with high blood pressure, for example, nurses can incorporate that knowledge into their treatment plan. Nurses who combine health promotion and pathophysiology expertise can build a trusting relationship with patients and improve patient outcomes.
Pathophysiology Classes
Nursing students begin developing their anatomy and physiology expertise in their earliest nursing classes. Advanced courses strengthen pathophysiology skills. Common courses in this area include the following:
- Anatomy and Physiology
- Human Disease and Pathology
- Forensic Pathology
- Advanced Pathophysiology
Pathophysiology Competencies
Understanding the complex interplay between systems and diseases requires advanced nursing skills, which nurses begin to develop during nursing school and continue to hone throughout their careers. Critical pathophysiology skills for nurses include the following:
- Clinical Knowledge: Clinical knowledge allows nurses to apply their theoretical knowledge of pathophysiology in practice. Nurses draw on their clinical skills to conduct advanced health assessments and create treatment plans.
- Concept Mapping: Concept mapping helps nurses visually analyze a patient’s symptoms to identify underlying physiological changes and the root cause of these changes. The ability to create concept maps gives nurses a comprehensive view of a patient’s health.
- Critical Thinking: Nurses draw on their critical thinking skills to connect the dots between a patient’s symptoms and underlying pathologies. The ability to think critically in clinical settings allows nurses to implement care plans and intervene in complex situations.
- Patient Education: Clinical skills help nurses detect pathologies, but patient education skills allow nurses to understand how diseases affect patients. Developing communication and compassion makes nurses more effective patient educators who encourage patients and their families to follow treatment plans.
- Disease Management: For patients with chronic diseases, strong disease management skills help nurses educate them about managing their symptoms and self-care. Nurses also leverage their understanding of pharmacology to help patients manage medications.
Pharmacology
Pharmacology is the third P in nursing. Nurses need to understand how to safely administer medications; this requires an understanding of physiology and pathophysiology. Insufficient knowledge of pharmacology can put patient safety at risk.
In pharmacology courses, nursing students explore medication classes and their mechanisms. They learn about contraindications that may make particular medications unsafe. These courses also cover side effects and adverse reactions, which nurses need to know how to manage.
The National Council Licensure Examination for Registered Nurses (NCLEX-RN) tests prospective RNs on dosage calculations; medical administration; and diverse medications, such as antibiotics, cardiovascular medications, and psychiatric medications. Advanced practice registered nurses (APRNs), such as nurse practitioners, continue their pharmacology education, so they can prescribe appropriate medications while factoring in the patient’s unique needs.
Pharmacology Classes
RN students develop their pharmacology knowledge in stand-alone pharmacology courses or through integrated pharmacology units in other courses, such as medical-surgical nursing. Specialized coursework in critical care, acute care, or pediatric pharmacology prepares nurses for advanced roles. Common pharmacology courses include the following:
- Pharmacology
- Critical Care Pharmacology
- Advanced Pharmacology
- Pharmacotherapeutics
- Pediatric Pharmacology
Pharmacology Competencies
Nurses use their pharmacology skills to help patients manage medications, address adverse reactions, and safely administer drugs. These skills play a critical role in patient safety and health outcomes. Important pharmacology skills include the following:
- Clinical Judgment: Administering medications requires strong clinical judgment along with an understanding of pharmacology. Rather than administering scheduled medications, nurses must assess the patient’s condition and at times withhold a dose.
- Patient Observation: Nurses conduct health assessments and observe patients to make clinical decisions about medications and identify potential side effects that can complicate their health.
- Patient Education: Patients often manage their medications at home, so strong patient education skills allow patients to safely take their medications. Nurses modify their instructions based on the patient’s unique circumstances.
- Individualized Care: When designing or implementing care plans, nurses must take into account medical history, age, medical conditions, and other factors. Pharmacology knowledge puts patient safety at the center of individualized care.
- Advocacy: In patient care roles, nurses communicate the patient’s concerns to other health care providers, advocating for the patient’s interests. In particular, nurses must take into consideration the patient’s concerns about medication to ensure quality care.
Why Are the 3 Ps Critical in Nursing Education?
Professional nursing education guidelines and nursing licensure exams incorporate the 3 Ps. Why exactly are the 3 Ps in nursing so important for nursing students and practicing nurses?
By emphasizing the 3 Ps during nursing programs, nursing schools prepare graduates to apply their clinical judgment and effectively treat patients. In particular, prioritizing competencies in the 3 Ps trains nurses to improve patient outcomes, apply critical thinking skills, meet professional standards, and advance in their careers.
Improve Patient Outcomes
The health care system relies on nurses and their direct interaction with patients to improve patient outcomes. Advanced knowledge of the 3 Ps boosts the quality of nursing care. For example, nurses with a strong pharmacology foundation can prevent medical errors and improve patient safety. Similarly, at the population level, the strong health promotion and education skills of nurses can decrease preventable diseases.
In addition to clinical knowledge and judgment, core competencies in health promotion, pathophysiology, and pharmacology require strong soft skills . Abilities such as communication and empathy help nurses create trusting relationships with patients, advocate for patient needs, and provide quality patient care.
Develop Critical Thinking Skills
Building core competencies in the 3 Ps helps nurses develop their critical thinking skills . Nurses apply their critical thinking abilities when adjusting care plans based on their clinical judgment or taking steps to prevent harm during critical care situations.
During nursing school, nursing students learn how to identify problems, evaluate treatment approaches, and implement the most effective solution. Courses in pathophysiology strengthen clinical decision-making skills, while coursework in health promotion and pharmacology encourages nurses to make evidence-based decisions.
Meet Core Competency Standards
RNs must pass the NCLEX-RN exam to qualify for licensure. The exam’s content areas include health promotion and maintenance, physiological integrity, and pharmacological and parenteral therapies. Test takers need a strong understanding of health promotion, pathophysiology, and pharmacology to pass the exam.
APRN programs that prepare nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives must incorporate separate, graduate-level courses in each of the 3 Ps to meet AACN’s standards. “The 3 Ps operationalize the science of the discipline” for all nurses who provide patient care, as AACN explains.
Prepare for Career Advancement
Graduate programs prepare nurses for advanced roles, such as nurse practitioner, nurse educator, and nurse leader. At the graduate level, nursing schools incorporate focused training in the 3 Ps to strengthen the knowledge and skills necessary for career advancement.
Nurse educators, for example, need exceptional health education skills to emphasize and integrate health promotion skills when training nurses. Similarly, when nurse practitioners prescribe medications, they use their extensive pharmacological expertise. Career advancement in nursing often requires competency in the 3 Ps.
Nursing Roles and the 3 Ps
How do nurses in different roles apply the 3 Ps in health care settings? Across diverse specialties, nurses rely on their competencies in health promotion, pathophysiology, and pharmacology to provide effective patient care.
Critical Care Nurse
Critical care nurses care for patients with life-threatening illnesses and injuries. They work in intensive care units (ICUs), emergency rooms, and other critical care units.
In the high-stakes specialty of critical care, nurses make clinical judgments that save lives. These nurses draw on their assessment and communication skills to evaluate patients, start treatments, and order diagnostic tests. They also play an important role as patient advocates, because they provide bedside care to patients in critical condition. Critical care nurses educate patients during discharge about maintaining their health and communicate pharmacological information to patients, family members, and health care providers.
Hospice Nurse
Nurses who specialize in palliative and hospice care provide end-of-life care to patients. These roles require compassion, empathy, and communication skills.
Hospice nurses draw on the 3 Ps to discuss end-of-life options with patients and their families and manage pain. Using their clinical judgment, they administer medications and advise patients on treatment options. They weigh factors such as quality of life when offering guidance to patients and families. Disease management, health assessment, and patient advocacy skills are critical for palliative and hospice nurses.
Nurse Educator
Nurse educators train nurses in patient care, evidence-based practice, and clinical skills. In hospitals, nursing schools, and other health care settings, nurse educators ensure that nurses follow tested methods for nursing practice.
To become a nurse educator, students explore effective instructional methods, teaching strategies, and nursing research. They also learn how to design and evaluate educational programs.
As key members of the nursing community, nurse educators stress the importance of the 3 Ps when educating prospective and current nurses. They incorporate health education, pathology, physiology, and pharmacology into their lesson plans.
Advanced Practice Registered Nurse
APRNs such as nurse practitioners provide primary and specialty care, including the diagnosis and treatment of medical conditions. Nursing students preparing for APRN roles must complete extensive graduate-level coursework focused on the 3 Ps to meet AACN’s competency guidelines.
How do APRNs use the 3 Ps in nursing practice? Nurse practitioners conducting health assessments must connect physical symptoms with possible pathologies to create effective treatment plans. Certified nurse midwives educate pregnant patients about the best ways to promote health. Clinical nurse specialists develop medication plans for patients managing chronic illnesses.
Public Health Nurse
Public health nurses focus on the health of entire populations, particularly disease prevention and health promotion. These nurses draw on their knowledge of the 3 Ps to engage with the public and improve population health.
To develop health education programs for the public, public health nurses must evaluate population health and conduct a health needs assessment. They research health inequities to identify vulnerable populations. Public health nurses apply their knowledge of health education, pathology, and public health to promote healthy communities and prevent illness.
Master the 3 Ps at The University of Tulsa
Effective nurses use their knowledge of health promotion, pathophysiology, and pharmacology when caring for patients. The online nursing programs at The University of Tulsa can help you develop these competencies for nursing practice.
TU’s online RN to Bachelor of Science in Nursing (RN to BSN) and accelerated BSN programs incorporate coursework in pharmacology, health assessment, population health, and nursing interventions, which integrate the 3 Ps into the curriculum. The online Master of Science in Nursing (MSN) and RN to MSN Pathway programs emphasize the 3 Ps to develop clinical competence. Whether specializing in nurse education, public health, or adult gerontology acute care, graduate nursing students complete focused courses in each 3 P competency area.
Contact TU today to learn how an online nursing program can advance your clinical competencies.
Recommended Readings
Nurse Advancement Opportunities for RNs
The Nurse Practitioner Job Outlook: Why NPs Are in Demand
Why Critical Thinking Skills in Nursing Are Essential
Sources:
American Association of Colleges of Nursing, Frequently Asked Questions
American Nurses Association, Critical Thinking in Nursing: Tips to Develop the Skill
American Nurses Association, What Is Nursing Theory?
Indeed, Public Health Nurse Skills: A Guide for Job Seekers
Indeed, What Does a Hospice Nurse Do? (Plus Skills and Salary)
National Council of State Boards of Nursing, 2023 NCLEX-RN Test Plan
Nursing Times, “Essential Critical Care Skills 1: What Is Critical Care Nursing?”
Relias, “Enhancing Patient Safety in Nursing: Strategies and Practices”
World Health Organization, “Nurse Educator Core Competencies”
