A question for those who teach (school setting).

[eriksoln, BSN, RN]

I'm returning to school. I want to obtain my Master's in Informatics. Step #1 is getting my BSN. I will be starting towards completing that goal this fall semester.

My fear is: My beliefs and attitudes about nursing do not mirror what is being taught in schools. I think Nursing Diagnosis and Care Plans are garbage. I believe nursing could be a profession, but has done a very poor job in defining its "unique body of knowledge" and hence is often not viewed/treated as one. I feel a great many of nursing's leaders, past and present, are failing the profession and allowing it to be shaped by businesses rather than nurses. I also feel more than a few of nursing's theorists, again.....past and present, don't cut the mustard and are off the mark.

Now, should I stay under the radar and just be quiet during class discussion, write papers that reflect the classic/accepted views or show my true colors?

I truly fear being tared and feathered if I speak my mind.

[showbizrn]

[color=slategray]any professor worth

their "salt" in education

would encourage you

to speak, document, and

present your views, ideas, and opinions

within the proper "scholarly" channels.

(papers, debates, presentations, etc)

you sound like a future

nurse leader, theorist, professor

yourself.

much success to you!;);););):)

[Whispera, MSN, RN]

I agree with showbizrn. I think you might even find a nursing theorist or two you can identify with. I think some of them are full of unicorns and rainbows but some of them state things as I think they truly are.

An open mind, that questions the information to get to the true meaning as well as to get rid of the fluff and nonsense is something a nurse needs.

Yay for you on your goals!

[VickyRN, MSN, DNP, RN]

We need you in nursing academia, Erik, with your youth, energy, and fresh, relevant ideas. Continue to question the status quo and ask, "Why can't this be done in a better way?"

Perhaps you could come up with a better framework to define what nurses do than nursing diagnoses, the corresponding nursing interventions, and desired nursing outcomes. It would need to be evidence-based. I notice registered dieticians use their own version of "diagnoses." Maybe we could create an interdisciplinary-allied health version of healthcare "problems" or "diagnoses," similar to what is used in the clinical care paths.

I believe nursing as a discipline is far too isolated. The future of healthcare rests with an interdisciplinary or team approach. We need to better define where we stand on the "team." We also don't hold the trademark on caring or on being holistic. Other healthcare professionals "care" too. And I know many physicians and physicians assistants who are very holistic.

The new Institute of Medicine report on the Future of Nursing may be of interest to you. Some of the things the IOM suggests:

* Greater autonomy for nurses

* Greater leadership role for nurses in the HC sytem

* End interprofessional turf battles and focus instead on what is best for the PATIENT

http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx%20

[vbwise2]

I am a nurse educator and I applaude your enthusiasm and desire to obtain a graduate degree in nursing. I agree with your analysis of nursing diagnoses. I teach the use of nursing diagnoses in my classroom but the application in the clinical setting leaves much to be desired. However, I do not agree with your statement regarding care plans and here is the reason: I require care plans because it requires my students to critically think about a medical issue (at least the way I teach care plans). I feel that care plans break down the intricacies of a medical diagnosis into nursing terms that require students to not only analyze a medical diagnosis, but also to indicate nursing interventions and outcomes of their nursing actions. Also, when I examine these care plans, I am able to see how (or if) my students can critically think and problem solve. I know that they can get care plans off of the web or other books, however, they are required to explain their interventions (with rationales) to me.

Also...never be afraid to speak your thoughts. However, if you disagree with instruction or instructors...do so with respect and tact.

[Whispera, MSN, RN]

I think nursing diagnoses/careplans have their use. They help a student focus on what needs to be done, and individualize things for specific patients. Remember back when you started nursing school, how complicated everything seemed? Careplans/diagnoses help narrow things down and prioritize interventions. Soon they become automatic.

I don't think they are useful on the job after awhile, because we are doing them in our heads anyway. Writing them is just another bunch of paperwork.