Does anyone think nursing diagnoses are just plain silly? - page 3

Does anyone think nursing diagnoses are just plain silly - overly literal and laughably complex? (please see examples at end of this post) Are we trying so hard to legitimize nursing as a... Read More

  1. by   pagandeva2000
    I think that nursing diagnoses as well as care plans are the dumbest inventions of the planet earth. How and why do you have to make a plan for how to nurse a person? Nobody reads them except other nurses that are higher than we are, such as nursing supervisors, or regulatory agencies. Doctors don't read them, dietiticans, social workers, no one else on the interdiscipilinary team is even remotely concerned about them. As an LPN, I don't deal with them, really (thank GOD) in my current position. But, if I ever had to, I would probably go competely insane!
  2. by   Daytonite
    Quote from marie-francoise
    I posted this to the general forum since I want to know how real nurses feel about nursing dx's
    Well, I'm a real nurse (licensed for 32 years) and I'm telling you how I feel about nursing diagnoses and I disagree with your student opinion!
    And, yes, I independently purchased the Nursing Diagnoses text, and still hold to my opinion - about the dx language itself. The book's descriptions of the INTERVENTIONS, though, were genuinely useful. The book itself is a useful read. Forcing nurses to use the dx language in real life, though... different story. The language is way out in academic left field (not politically, but figuratively).
    The NANDA taxonomy DOES NOT include nursing interventions. I don't know what book you purchased, but it was not a NANDA publication. Who's forcing you to use nursing diagnoses? Your instructors? If your grade depends on it, well. . . An employer? If your paycheck depends on it, then. . . Otherwise, don't use them.

    Please! The NANDA language is "out in academic left field"? I say tomato; you say to-mah-to. That's all it is. That's what academia is, using a different word to express the same thing. Only fascists want things their way.
    And I hear what you're saying, but still think that Nursing Diagnoses need to be seriously revisited, esp in this day and age where nurses are being asked to do WAY too many things in a limited about of time, as it is.
    How would you know if nurses are being asked to do way too many things in a limited amount of time? You're a student. You've never worked as a licensed RN!
    Docs don't have to recite and chart each and every bodily process underlying/associated with a medical problem. Forcing already time-strapped nurses to do that, and using such hyper-literal language while they're at it, just adds more time away from patients. And the hyper-literal descriptions required in the ND's are just ridiculous.
    And, what medical school and residency did you go to that you know this? There are two doctors in my family. Believe me, they get raked over the coals about what is in the charts and about the medical background and physical exams of the patients they are caring for when they are medical students and in their residencies.

    Please give me examples of this hyper-literal language and hyper-literal descriptions in the nursing diagnoses that you are referring to. I don't know what you mean by this term and I'm wondering if you even know what it means, so please define it for me.
    And some of the language DOES appear to be the product of 1970s ethos - e.g., "Readiness for enhanced family processes". Sorry, but it just doesn't ring right. We need to get real.
    FYI. . .Readiness for Enhanced Family Processes is a nursing diagnosis that was added to the taxonomy in 2002 which, if you had taken the time to check, you would have not made the mistake of equating with the 1970s. It is a diagnosis that is primarily used by advanced practice nurses who perform counseling services and need to bill for those services.

    Dear student. . .the nursing process is
    1. Assessment
    2. Problem identification
    3. Planning
    4. Implementation
    5. Evaluation
    It is an ongoing, never ending cycle. It is a problem solving process. I can cite several sources that tell you that. It is a mental process. The physical process is the written care plan. An advanced degree in health care doesn't make you a nurse. Passing the NCLEX and getting your RN license will legally make you a nurse. You have a lot to learn about this profession. And, you are blindly trashing nursing diagnoses without having done your homework about them. I sincerely hope you don't approach your clinical performance with the same recklessness.
    Last edit by Daytonite on Nov 30, '07
  3. by   Daytonite
    Quote from Shantas
    I think these laws are created by those people who left bedside nursing and ultimately forgot what it is like to do bed side nursing with the fear that their finger nails may get dirty!!
    Just like anything else in nursing, just put up with all the grabage that the management and the feds tell us to do after all they are giving us money....
    Then, get into politics and get it changed.
  4. by   ERRNTraveler
    all I have to say is......


    I am SO glad I work in ER- we're not required to do care plans or nursing diagnoses, and I am SO glad I'm not a student, so I don't have to deal with holier-than-thou instructors....
  5. by   gerry79
    I have yet to do a care plan or use a nursing diagnoses. Just tolerate it until school is over and then happily watch nursing diagnoses go the way of the Woolly Mammoth......
  6. by   birdgardner
    Ah, Daytonite, you and I have gone a round on NANDAs before. Your suggestion that if we don't llike them, we go into politics and change them just backs up my belief that NANDAs are more about politics than patient care. I would rather deal with poop than politics.

    Since the interventions for say, anaphylactic shock are rather different than those for pneumonia, why call them both Impaired Gas Exchange differentiated by a really long "related to...secondary to...?" Why not plan nursing interventions off the medical diagnosis while keeping in mind that we do more than following doctors' orders?

    And yes, I agree that there are some things the physicians may not address that we have to address and it would help for us to be able to name them, but why do it with such an assault on the English language as "Readiness for enhanced family processes?" I think a phrase that long should be self-explanatory.

    I'm sure you'll be pleased to know that your concern that I was getting bad grades on my care plans was unfounded. I'm learning a lot from the care plans - but I still hate having to use NANDAs.

    I'm curious - do you teach full time, or do you still work clinically as well? You invest a lot of time teaching about NANDAs on the forum, and I appreciate NANDAs a bit more because of it - I see now how you can make them the basis of a really good patient care plan. But it still seems to me that you can make a patient care plan just as good in real terms (not school terms) without having to resort to the jargon and politics of NANDAs.
  7. by   ERRN92
    It probably has more to do with the AMA...they get really anal about nurses "diagnosing" pts. God forbid we should cross the line and come to an actual educated theory as to what is wrong with our pt.!!
  8. by   SuesquatchRN
    Quote from birdgardner
    Since the interventions for say, anaphylactic shock are rather different than those for pneumonia, why call them both Impaired Gas Exchange differentiated by a really long "related to...secondary to...?" Why not plan nursing interventions off the medical diagnosis while keeping in mind that we do more than following doctors' orders?
    Thank you, thank you, thank you.

    Of curse we don't diagnose. But we know what the patient has, and that's what we're treating! This round the mulberry bush nonsense taxonomy is so awkward and useless.
  9. by   leslie :-D
    Quote from ERRNTraveler
    and I am SO glad I'm not a student, so I don't have to deal with holier-than-thou instructors....
    why the disrespect?
    daytonite feels just as strongly in defense of nanda, as do those who find it senseless and annoying.
    if one wants to be recognized professionally, one needs to act/respond in same.

    leslie
  10. by   SuesquatchRN
    Quote from earle58
    why the disrespect?
    daytonite feels just as strongly in defense of nanda, as do those who find it senseless and annoying.
    if one wants to be recognized professionally, one needs to act/respond in same.

    leslie
    Ah, I would say the disrespect has primarily gone in one direction.
  11. by   FireStarterRN
    I always thought they were silly, but I haven't dealt with them since nursing school. Yes, I think they are silly and make us look foolish.
  12. by   FireStarterRN
    Addendum: they do have a use in nursing school to orienting nurses to be to the nursing process...
  13. by   FireStarterRN
    P.s. I only read the opening post and no others. Need to run to the Post Office... We're going to see 'A Christmas Carole' tonight at the University...

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