What Are the 3 P’s in Nursing?

Written by: University of Tulsa • Mar 9, 2026

Two nurses wearing scrubs talk in a hallway.

Nursing students must possess core clinical 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 P’s. At all levels of nursing, the 3 P’s help nurses effectively care for patients.

During nursing school, students learn what the 3 P’s in nursing are and build foundational competencies in them. They further develop those competencies with clinical experience or an advanced nurse education program. Mastering the 3 P’s helps nurses advance their careers and improve patient care.

Unpacking the 3 P’s

The 3 P’s 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 P’s. 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. Because nurses spend more time interacting with patients than many other health care providers do, nurses are uniquely positioned to provide health education. Nurses following a patient-centered approach work closely with patients to educate them about disease prevention, health, and overall well-being.

According to AACN, nurses who hold a Bachelor of Science in Nursing (BSN) are highly regarded for their skills in leadership, case management, critical thinking, and health promotion. BSN nurses not only treat the issue that originally brought the patient in but also advise them on how to make more health-conscious decisions in the future.

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:

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 to public health and environmental nursing. Critical health promotion skills, which nurses develop during their education and career, include:

Health assessment: Conducting health assessments to determine each patient’s physical health and medical needs
Patient care planning: Developing patient care plans that incorporate health education and take the patient’s needs and wants into account
Health education needs assessment: Conducting a needs assessment to determine a community’s health education needs
Communication: Educating patients and the public about health promotion, using strong communication skills, including empathy
Cultural diversity awareness: Incorporating cultural values into health education plans and integrating cultural diversity training into health promotion courses, further developing this skill in clinical practice

Pathophysiology

Pathophysiology combines 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.

By mastering physiology, nurses can apply their understanding of pathology in nursing practice. If a patient has elevated 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 outcomes.

Pathophysiology Classes

Nursing students begin developing their anatomy and physiology expertise in their earliest nursing classes, and advanced courses further strengthen their pathophysiology skills. Common courses in this area include:

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 develop during nursing school and continue to hone throughout their careers. Critical pathophysiology skills for nurses include:

Clinical knowledge: Applying theoretical knowledge of pathophysiology in practice
Concept mapping: Analyzing a patient’s symptoms to identify underlying physiological changes and the root cause of these changes
Critical thinking: Using critical thinking skills to identify connections between a patient’s symptoms and underlying pathologies
Patient education: Understanding how diseases affect patients
Disease management: Educating patients with chronic diseases about managing their symptoms and self-care

Pharmacology

Nurses must safely administer medications to patients, requiring an understanding of physiology and pathophysiology. Insufficient knowledge of pharmacology can put patient safety at risk.

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), including nurse practitioners (NPs), continue their pharmacology education, so they can prescribe appropriate medications while factoring in the patient’s unique needs.

Pharmacology Classes

Students develop their pharmacology knowledge in stand-alone pharmacology courses or through integrated pharmacology units in other courses, such as medical-surgical nursing. Common pharmacology courses include:

Pharmacology
Critical Care Pharmacology
Advanced Pharmacology
Pharmacotherapeutics
Pediatric Pharmacology

Pharmacology Competencies

Nurses use their pharmacology skills to help patients manage medications, to address adverse reactions, and to safely administer drugs. These skills play a critical role in patient safety and health outcomes. Important pharmacology skills include:

Clinical judgment: Administering medications using strong clinical judgment along with an understanding of pharmacology
Patient observation: Conducting health assessments and observing patients to make clinical decisions about medications and identify potential side effects that can complicate their health
Patient education: Educating patients on how to safely take their medications and modifying instructions based on the patient’s unique circumstances
Individualized care: Putting patient safety at the center of individualized care
Advocacy: Considering and communicating patient concerns about medication to ensure quality care

Why Are the 3 P’s Critical in Nursing Education?

The 3 P’s are important for improving the quality of nursing education and practice standards. Below are some of the main reasons nursing students should seek out programs that emphasize the 3 P’s.

Improve Patient Outcomes

Advanced knowledge of the 3 P’s enhances 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, nurses with health promotion and education skills can help decrease preventable diseases.

Core competencies in health promotion, pathophysiology, and pharmacology also require well-developed soft skills. Communication and empathy help nurses create trusting relationships with patients, advocate for their needs, and provide quality care.

Develop Critical Thinking Skills

Building core competencies in the 3 P’s helps nurses develop their critical thinking skills. They can apply these skills to adjust care plans based on their clinical judgment or take 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, all of which require an understanding of health promotion, pathophysiology, and pharmacology.

APRN programs that prepare NPs, clinical nurse specialists (CNSs), certified registered nurse anesthetists (CRNAs), and certified nurse midwives (CNMs) must incorporate separate, graduate-level courses in each of the 3 P’s to meet AACN’s standards. The 3 P’s provide a framework for nursing science for all nurses who provide patient care, according to AACN.

Prepare for Career Advancement

Graduate programs prepare nurses for advanced roles, such as NP, nurse educator, and nurse leader. At the graduate level, nursing schools incorporate focused training in the 3 P’s 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. Nurses who want to advance their careers often need competency in the 3 P’s.

Nursing Roles and the 3 P’s

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 (ERs), and other critical care units.

During a typical shift, these nurses apply 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.

According to the U.S. Bureau of Labor Statistics (BLS), nurses who worked in ambulatory health care services made a median annual salary of $83,780 in 2024.

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 use the 3 P’s to discuss end-of-life options with patients and their families and to manage pain.

Hospice nurses need competencies in disease management, health assessment, and patient advocacy — , core aspects of the 3 P’s.

According to Payscale’s 2025 data, the median annual salary for hospice nurses is approximately $77,310; top-earning hospice nurses make as much as $94,000.

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.

As key members of the nursing community, nurse educators stress the importance of the 3 P’s when educating prospective and current nurses. They incorporate health education, pathology, physiology, and pharmacology into their lesson plans.

According to Payscale’s 2025 data, nurse educators make a median annual salary of $88,630, with top earners making closer to $120,000.

Nurse Practitioners

NPs provide primary and specialty care, which includes the diagnosis and treatment of medical conditions. Nursing students preparing for NP roles must complete graduate-level coursework focused on the 3 P’s to meet AACN’s competency guidelines.

NPs conducting health assessments must correlate physical symptoms with possible pathologies to create effective treatment plans.

According to the BLS, NPs earned a median annual salary of $129,210 in 2024.

Public Health Nurse

Public health nurses focus on disease prevention and health promotion across entire populations. These nurses draw on their knowledge of the 3 P’s to engage with the public and improve population health.

Public health nurses apply their knowledge of health education, pathology, and public health to promote healthy communities and prevent illness.

According to Payscale, public health nurses make a median annual salary of $74,430. Top-earning public health nurses make upwards of $116,000.

Master the 3 P’s at The University of Tulsa

The 3 P’s in nursing are integral for nurses providing quality care. The online nursing programs at The University of Tulsa can help you develop these competencies for nursing practice.

TU’s online Accelerated Bachelor of Science in Nursing (ABSN) program incorporates coursework in pharmacology, health assessment, population health, and nursing interventions, all designed to integrate the 3 P’s into the curriculum. The online Master of Science in Nursing (MSN) program also helps develop clinical competence through instruction in the 3 P’s.

Contact TU today to learn how an online nursing program can advance your clinical competencies.

Recommended Readings

Everything You Need to Know About the Oklahoma Board of Nursing

How an MSN Can Improve Nurse Retention

NCLEX Tips for ABSN Graduates

Sources:

American Association of Colleges of Nursing, The Impact of Education on Nursing Practice

American Nurses Association, Advanced Practice Registered Nurse (APRN)

Britannica, Pharmacology

EBSCO, Pathophysiology

ExploreHealthCareers.org, Nurse Educator

Heart to Heart Hospice, What’s the Role of a Hospice Nurse?