[jjjoy]

I can sort of see what people are trying to say in differentiating nursing practice from medical practice. I agree with the model that nurses help people maintain the highest level of health and well-being. In a hospital, that usually means carrying out doctor's orders and assisting with comfort and hygiene.

I don't see the use of nursing diagnoses in most cases, however. I can see the idea behind their development but they just aren't useful in most settings. We can learn how and when to apply various nursing measures without having to apply a specific nursing diagnosis to do so, and without diagnosing (and practicing medicine) either. If a diagnosis has already been made, then the nursing interventions are based around the appropriate supportive care. If a diagnosis hasn't been made, then the nursing interventions relate to the presenting symptoms.

[Daytonite]

Originally Posted by amanda sue

When reading about the differences between nurses and doctors/physician assistants, I always hear the claim made that nurses operate via a nursing model and make nursing diagnoses, whereas doctors and physician assitants operate via a medical model.

What does this mean?? What are the differences between a nursing model and a medical model??

Thanks so much!

You ask a very interesting question that goes to the heart of the definition of what a model is to begin with. I think one needs to start by defining what is meant by the word "model". A model is basically a pattern, a standard, to be copied and/or imitated. You will find it defined this way in a collegiate dictionary. So, when talking about a "nursing model" or a "medical model" you are talking about the professional behavior being practiced by a nurse or medical doctor. And, that is pretty much what each (nurses and doctors) are taught when they go to their respective schools. Nurses are taught according to a nursing model and physicians are taught according to a medical model. Each profession has developed standards of care for it's members to adhere to and follow. Their licensing laws reflect those standards. Based on those, there are certain things that doctors can do that nurses cannot; vice versa, there are certain things that nurses can do that doctors cannot. If you want to know what those specific things are it would help to (1) read state law for nursing and medical practice and (2) the job descriptions for nurses and doctors.

Making nursing diagnoses or medical diagnoses are merely tasks that each group does within their job descriptions. In it's strictest sense a diagnosis is a decision or opinion resulting from the examination and observation of facts. A car mechanic can also make a diagnosis about what is wrong your car. The difference between a nursing diagnosis and medical diagnosis is based upon the standards of care each profession uses and applies in arriving at their decision (or opinion, or diagnosis). Medical diagnoses are the most widely known. We recognize them when we hear them: pneumonia, influenza, polio, heart attack. We recognize some automotive diagnoses as well: blown head gasket, flat tire, cracked engine block. Nursing diagnoses are not as well known and so a puzzlement to most when we first hear about them: impaired skin integrity, total urinary incontinence, ineffective tissue perfusion. Keep in mind that we are talking about different standards of care, different facts being observed, different decisions being made and this all results in different treatments being rendered to address the problems. Doctors are taught to look for certain types of things in making their diagnoses; nurses are taught to look at certain types of things in making their diagnoses (some may be similar to the same ones the doctors are also looking for); car mechanics are taught to look for certain types of things in making their diagnoses. The thinking processes they are using are the same, but the set of facts each profession deals with are different. Don't get too hung up on diagnosing. It is only one of many things done by both doctors and nurses that is part of something called the "scientific process".