Nurse’s Guide to Stages of Growth and Development

Growth And Development

Throughout your nursing training and career, you will care for patients and family members of all ages. It is important to have an understanding of where they are from both a developmental and a cognitive perspective. This will enhance your interactions and decrease frustration on both sides.

Many believe that they are just memorizing this for a NCLEX-RN test, but I assure you that this is knowledge that you will use every shift.

Think about the following examples for a moment:

  • Administering an immunization to a 1 month old versus a 10 year old
  • Preparing a 4 year old for an appendectomy versus an 18 year old
  • Discussing life goals with a 5 year old versus a 20 year old versus a 70 year old
  • Using the same approach with each patient would not successful, you must stop and think about where the individual is at and meet them on that same level. Review the Charts below for examples of where you would expect the individual to be.

    Erickson’s Psychosocial Theory

    StageNameAgePsychosocial CrisisPositive OutcomeNegative Outcome
    1InfancyDay 1 to 1.5 yearsTrust vs. MistrustFeelings of TrustFear or mistrust
    2Early Childhood1.5 to 3 yearsAutonomy vs. Shame and DoubtSelf SufficiencyLack of independence
    3Play Age3 to 5 yearsInitiative vs GuiltDiscovers ways to initiate actionsGuilt from actions or thoughts
    4School Age5 to 12 yearsIndustry vs InferiorityDevelopment of sense of competenceNo sense of mastery
    5Adolescence12 to 18 yearsIdentity vs Role ConfusionAwareness of uniqueness of selfInability to identify the appropriate roles of life
    6Young Adult12 to 18 yearsIntimacy vs IsolationDevelopment of loving, sexual relationshipsFear of relationships with others
    7Middle Adult25 to 65 yearsGenerative vs StagnationSense of contribution to continuity of lifeFeeling one's activities are trivial
    8Late Adult65+ YearsEgo Integrity vs DespairSense of unity in life's achievementsRegret over lost opportunities of life

    Mastering these tasks plays a huge role in the development of an individual. Failure to master a task can lead to issues at later stages in life. During stressful time, such as a serious illness or loss, an individual may regress, and as caregivers we should be aware of this and aid them in proceeding forward as they are able.


    Thinking of some of the earlier examples, a one month old requires no explanation of the immunization but does require nurturing during and immediately after wards to ensure the development of trust. The ten year old, on the other hand, should be provided with basic and honest information before the procedure and perhaps simple options of which arm should be used and if he or she wishes to hold a parent’s hand.

    When discussing life goals, expect very different responses. For example, a four year old may desire to be a princess, a 20 year old may be struggling with all the potential options and obstacles, and the 70 year old may be focused on enjoying his remaining years by traveling.

    Piaget’s Four Stages of Cognitive Developmentally

    StageAge RangeCharacteristics
    SensorimotorBirth to 2 yearsBegins to differentiate self from objects

    Interacts with the environment

    Object permanence and separation anxiety develop
    Pre-Operational2 to 7 yearsLearns to use symbols (words and images)

    Thinking is egocentric - cannot see viewpoint of others

    Can pretend
    Concrete Operational7 to 11 yearsCan think logically about objects and events

    Classifies objects according to several features

    Learns rules
    Formal Operational11 years and upCan think logically about abstract propositions and test hypotheses systematically

    Becomes concerned with the hypothetical, future, and ideological problems

    Every child develops at their own pace, but having a basic understanding of where he or she is helps the provider develop a strong therapeutic relationship with the patient. The stronger the bond, the more open and honest the patient will be. This will allow you to discuss their fears and concerns which in the end will allow you to provide them with the highest level of care.