No more NANDA diagnoses? - page 4
One of the chief nurses on my med surge floor told us yesterday that they are doing away with the NANDA diagnoses. This is taking away from our profession, yet again. Correct? Why are they... Read More
Dec 10, '06Quote from gauge14ivBut billing wouldnt be done on NANDA anything - ever.
It is done in ICD-9 or 10 language which is wirtten by the AMA. And there is no E code for altered energy field! LOL
(Nor, I suspect, will there ever be)
Bingo. Has nothing to do with the merits or lack of ... of altered energy field or any other nursing dx that NANDA or anyone else dreams up. It is simply reality that medical billing (and, you could argue, therefore medical practice) runs on a standardized code of medical diagnosis & treatment. Nurses can use whatever language they want to develop plans of care -- language currently used in NANDA dx, binary code, or ancient Sanskrit -- it doesn't matter to anyone outside of nursing academia. And this is the problem with the time & energy devoted to nursing diagnoses - they are separate from the patient care from the rest of the treatment team including medicine, physical therapy, occupational therapy, etc. etc. etc.
Dec 10, '06Quote from gauge14ivand, you're never going to find one. icd-9-cm and icd-10-cm codes are medical diagnosis codes. fyi. . .e-codes are used to describe the external causes of injury or poisoning. they are meant to be used in addition to the medical diagnosis codes. therapeutic touch would be classified as a treatment, not as a condition, injury or poisoning. when i had to leave clinical nursing i trained and worked as a medical coder and am currently studying to get an rhit in health information management which includes knowledge of medical coding.and there is no e-code for altered energy field!
Dec 10, '06Great - then Therapeutic touch can be billed for by TT providers just as chiro is billed by chiro and that way it can be left out of nursing
Semantics aside - the point I was making is - why are we as nurses including things in nursing that can't be included in medicine? That HINDERS communication, it does not foster it. It alienates "us" from "them" thereby creating a great divide. What is the purpose in that?Last edit by gauge14iv on Dec 10, '06
Dec 10, '06My last day of med surg clinical which was yesterday, I asked my clinical professor about NANDA. I asked her why she didn't focus on care maps and nursing diagnoses like we are learning in school. Her reply to me was pretty close to this. It seems as though there is a trend in your universities teachings. What I mean by that is you are not being taught to think critically. Ie. Why is this happening in the body and so on. In reality, you are not going to utilize the nursing diagnoses when you begin working in the real world. However, some hospitals MAY require you too. But in my experience, not many hospitals are using them anymore. As long as you know in your head that this patient is at risk for infection or risk for altered bowel, you will know what step to take next. It's the critical thinking that needs to become second nature to you as an RN. Nursing is critically based and in time, you will be come a master at it.
Dec 10, '06Quote from DaytoniteI completely disagree on one point. We can make computers do practically anything we want with langauge. And, we have.With regard to using pig latin. . .NANDA is trying to satisfy two groups: the nurses and the computer programmers. They are held back by what computers are able to accomplish in working with contextualized English as well as what is going to satisfy the needs of the nursing profession. Until this context problem can be solved by programmers, then users of NANDA are, unfortunately, stuck with using the words available in the program. Nursing schools and organizations that don't computer code theirare free to use other methods of constructing and wording of their care plans. Why they would continue to insist on using NANDA I have no answer for. You'd have to ask them.
The obtuse-ness of NANDA was created, as many of its believers attest, to create a 'nursing language'. The semantics of this has to do with creating our own 'body of knowledge' and has nothing to do with ineffective programming.
Dec 10, '06And then the question becomes - do we need a nursing language? Bottom line from a billing perspective is that if its not billable, ???? NANDA has outlived its usefulness, as has NIC/NOC (I thought this was some kind of joke before I went back for my BSN - lol). As nurses, we must use the language of medicine because that is what we do!