[Tony35NYC]

Perhaps not as ridiculous as you think.

1. Denial, as a coping mechanism, is never effective.

2. Disturbed energy field is valid as a nursing diagnosis because parts of it highlight the importance of the relationship between a healthy body and a healthy mind. In psych nursing we learn that if (even a non-physical) stressor were to relentlessly disturb a person's mental health balance, that person will eventually begin to experience physical symptoms.

3. Why is Impaired Environmental Interpretation Syndrome ridiculous? Have you ever worked with patients who were experiencing early onset dementia, or newly diagnosed schitzophrenics, or chronic addictive substance abusers? Most of these people have diminished cognitive abilities, and they sometimes have to be put in a home or in some type of assisted living facility for their own protection.

4. Why not Health Seeking Behaviors? This is always a great nursing diagnosis for community health nursing. People don't always seek healthcare just because they are sick. Sometimes its for a routine physical, or because they have questions or concerns about things like how to better manage their diabetes, or to test for a sexually transmitted disease, or to get free contraceptives.

5. I can't believe you don't see the value of Impaired Home Maintenance Management. This one is not only about having an untidy house. Its more about not having the resources necessary to support the household. This is a critical nursing diagnosis, especially when planning for the discharge of indigent patients. If people don't have the money to pay the rent, buy food, and keep their home clean they won't be too concerned about compliance with medical care. And, soon after discharge they will probably be back in the hospital again.

6. You don't like Altered Protection??? Remember that everything about nursing care is based on Maslow's pyramid. And, in that pyramid, the safety needs are the second most important needs. When a person feels threatened the resulting stress causes psychological as well as physiological alternations in that person. If the nurse ignores the patient's altered mental health status then the whole point of the nursing process is lost.

7. I agree with RNinMay about Noncompliance. That is a HUGELY important nursing diagnosis. It happens all the time and for many different reasons.

8. I don't know about Wandering, but I can see how a nurse could use this for confused and neurotic patients. It could identify the need for 1:1 care and observation, or physical restraints if the patient is a jaywalker who tends to arbitrarily take off and disappear somewhere down the street.

I had an instructor who encouraged us to make up our own nursing diagnoses. I love to have fun with these diagnoses, but this is a nursing school thing. In the critical care unit where I work, the nurses have no time to mess around with drawn out nursing diagnoses, they just get straight to the point!

[mariedoreen]

Originally Posted by suemom2kay

Can't see myself using the energy field one, but I should try it on one of my careplans...

Oh, that's hilarious! I'm going to throw it on to one of mine and see what my instructor says!!!! How in the heck are they going to argue against it? "I went and checked their energy field and it was just fine for me..." ?? Heck maybe I'll start putting it on everyone's care plan

[heron]

Ackshully...disturbed energy field refers to a nursing technique developed by Dolores Krieger in the early 70's, out of research she did on psychic healers. They have actually been able to measure significant changes in hematocrit and wound healing. It's called Therapeutic Touch ... there are quite a few practitioners ... might be worth googling.

[mariedoreen]

Originally Posted by klone

Yes, I realize that ALL of them are legitimate when you actually look beneath the surface (okay, maybe not energy field). I figured someone would pick apart my post and say why I'm wrong. I was slappy, sleep deprived, and working on a 10-page clinical worksheet as I posted that last night. Just trying to bring a little levity to the board. Sorry, won't happen again.

Lol, don't worry about it, those of us still in school knew where you were coming from. It's kind of like when your teenagers come in and blow off some steam, they just want you to listen for a moment, not give them a three hour lecture on the topic at hand. So, thanks for the levity, but no thanks on the lectures that were posted. We can read the nursing dx book for ourselves. It was a joke people!

[klone]

Originally Posted by heron

Ackshully...disturbed energy field refers to a nursing technique developed by Dolores Krieger in the early 70's, out of research she did on psychic healers. They have actually been able to measure significant changes in hematocrit and wound healing. It's called Therapeutic Touch ... there are quite a few practitioners ... might be worth googling.

There's also something similar called Reiki.

I know it's legit, but that doesn't mean that I don't snicker and think it's funny when I see it as a nsg dx.

Thanks, Mariedoreen! I hate when my humor falls flat.

[medsurgnurse]

Originally Posted by klone

Ineffective denial...as opposed to EFFECTIVE denial?
Disturbed energy field
Impaired environmental interpretation syndrome
Health-seeking behaviors (the horror!)
Impaired home maintenance (I'm guilty of that one! If only I could do a collaborative intervention with Merry Maids)
Ineffective protection
Noncompliance
Wandering

Some of these just made me chuckle, and made me wonder about the people who come up with them.

Don't worry, Klone, sometimes nursing diagnosis can seem ridiculous. I made up my own like: impaired transportation as evidenced by a car that will not start.

[klone]

Risk for constipation d/t fear of self-flushing toilets (my 4-year-old)

Impaired verbal communication as evidenced by door-slamming and temper-tantruming (my 7-year-old)

Impaired orientation d/t wine volume excess (me, after my kids go to bed)

Readiness for enhanced sleep as evidenced by the the hallucinations of small animals scurrying across my field of vision when I've been up too late.

Uh oh, I'm starting to get punchy again.

[SMK1]

Originally Posted by klone

Risk for constipation d/t fear of self-flushing toilets (my 4-year-old)

Impaired verbal communication as evidenced by door-slamming and temper-tantruming (my 7-year-old)

Impaired orientation d/t wine volume excess (me, after my kids go to bed)

Readiness for enhanced sleep as evidenced by the the hallucinations of small animals scurrying across my field of vision when I've been up too late.

Uh oh, I'm starting to get punchy again.

[studentnurse74]

We aren't even allowed to use the word non-compliant. It's too negative. That bothers me, just like the word client instead of patient! They will always be my patients! I'm taking care of them, not cutting their hair!

[paraloco]

I've come up with a diagnosis for my kids: Motivational Deficit Disorder.

Originally Posted by studentnurse74

We aren't even allowed to use the word non-compliant. It's too negative. That bothers me, just like the word client instead of patient! They will always be my patients! I'm taking care of them, not cutting their hair!