idea for teaching students nsg dx statements

Nursing Students General Students

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I just had this idea. We are forever seeing nursing students trying to come up with nursing diagnoses based off the M.D. diagnoses. I was guilty of it 3 years ago. Example " I need help for a patient with this dx and that dx."

I think it might be a good idea to teach the nursing process in class, then on just 1 clinical day, have the students come to clinical, be assigned 1 patient, bring their NSG dx books but they are not yet allowed to know the pt's dx at first. First the student looks at lab results and the v/s for their patients. Have them view their trends.

Then they must go in their patient's room (not knowing the M.D. dx .) They must then perform a complete head to toe assessment with v/s. Then come out, go to a conference room, and come up with a couple NSG dx based off their assessments. The NSG dx books are there only to guide them to a NANDA approved NSG dx.

Sounds pretty basic, I know. But I think it would help students to not rely on M.D.s diagnoses (or NP) and cause them to do a more thorough assessment knowing that when they come out, they have to tell their instructor a problem and an idea (plan) for their patient. Because nursing students just aren't really GETTING it. I didn't really get it either til about the end of my 2nd second semester. To nursing students who realize that the NSG dx is YOURS and comes from YOUR assessment....Excellent!!! But we've gotta do SOMETHING for those who aren't getting it. What is going wrong in the classrooms and books that makes students continue to try to find out a NSG dx for "diabetes" for example. They don't seem to understand that you can have 2+ patients with the exact same medical diagnoses and completely different nursing diagnoses.

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I dunno-- I think if faculty did a better job of explaining that right out of the gate it would nip that "My patient has CHF, what are his nursing diagnoses?" thang in the bud. I see a depressingly high number of students here who appear to be getting assignments for hypothetical patients where the data given is almost exclusively medical diagnosis-related; that just reinforces the idea that nursing diagnosis is subordinate to and dependent on medical diagnosis.

Question: What is your nursing plan of care for a patient admitted with an unknown medical diagnosis? Do we just sit and do nothing and twiddle our thumbs waiting for the physician to enlighten us? Of course not. What would you base your nursing plan of care on if you had no medical diagnosis?

That's related to your plan, might make a good thought experiment early on in first semester.

Most people here already know that I am the NANDA-I 2012-2014's biggest fan. I'd like to see every nursing student have a copy and be assigned a chapter or two or three every week, just to get the idea of how to think like a nurse. (In case you all have forgotten: Free 2-day shipping for students from Amazon! Get it NOW whether your faculty remembered to put it on the bookstore list or not! Fake them out with your mastery of nursing right away!) :flwrhrts:

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Specializes in Complex pedi to LTC/SA & now a manager.

When I went through my "nursing process" class, we were given a patient demographics, background, assessment (including labs, vitals, signs & symptoms (subjective & objective assessment data), past medical history, and primary complaint/history of present illness/complaint. Then were given a blank care plan matrix and told to use our nursing diagnosis book as well as critical thinking skills to determine possible nursing care plan while prioritizing the possible nursing diagnosis, then goals.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I agree with Grntea, as the resident helper.....I think that a better explanation of what the nursing diagnosis is......it is all about the assessment of what the patient NEEDS not what they HAVE.

You want to have fresh baked bread.....but you need to assemble the ingredients first.

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Ah this topic brings back fond memories from nursing clinicals a little over 7 years ago. OMG I had the Yes Sarge" nursing instructor my 2nd semester. Tough as nails she was. She made me so darn nervous I would screw up at bedside while she was observing me. (got 1 unsafe from her) that's beside the point. LOL But when it came time to do our BIG nursing care plan with all of our dx's and plans, implementations etc. etc. I blew her mind because i had a natural knack for it she said. She gave me high praise! Even had some of the other students that didn't do so well look at mine to "see how it's done." After that my confidence was way up and she no longer made me nervous. Turned out to be an ok semester. To this day I know to trust my nursing judgement, critical thinking along with my gut feeling about patients and circumstances. NANDA and, those tedious care plans will serve you well, trust me.

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I dunno-- I think if faculty did a better job of explaining that right out of the gate it would nip that "My patient has CHF, what are his nursing diagnoses?" thang in the bud. I see a depressingly high number of students here who appear to be getting assignments for hypothetical patients where the data given is almost exclusively medical diagnosis-related; that just reinforces the idea that nursing diagnosis is subordinate to and dependent on medical diagnosis.

Question: What is your nursing plan of care for a patient admitted with an unknown medical diagnosis? Do we just sit and do nothing and twiddle our thumbs waiting for the physician to enlighten us? Of course not. What would you base your nursing plan of care on if you had no medical diagnosis?

That's related to your plan, might make a good thought experiment early on in first semester.

Most people here already know that I am the NANDA-I 2012-2014's biggest fan. I'd like to see every nursing student have a copy and be assigned a chapter or two or three every week, just to get the idea of how to think like a nurse. (In case you all have forgotten: Free 2-day shipping for students from Amazon! Get it NOW whether your faculty remembered to put it on the bookstore list or not! Fake them out with your mastery of nursing right away!) :flwrhrts:

SOMETHING'S gotta give with how they are taught. And, yes, the idea would be only for the very beginning of clinical. And like I said, just 1 day, but not take up the whole clinical. Something quick so that the point is made.

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