Hi I was needing some help on nursing diagnosis....how do you make one and when....what is the rationale for a nursing diagnosis when a medical one is the one that matters?
Goal of care-Is this the 'planning' part of the nursing process and what is an example of one? Goal for nurse or patient's goals?
Planned strategies (nursing interventions)-Is this the same as nursing implementation or 'plan in action'?
HELP PLEASE....have clinicals tuesday and things I thought I was sure about....Im not.
Could u guys set up some personal experiences in your hospital setting? please?
While I still despise care plans, I have come to terms with them. For nursing students, they are helpful to organize our thinking. I mean, we walk into a patient's room for the first time, and we can tick off everything we see wrong patho-wise, but then it's "Now what?" The painful care planning we do in school gives us the answers to that.
That's really what it's all about. Nursing diagnosis and care planning is a strategy whose purpose is to help nurses (particularly, help new nurses) organize their thoughts. The diagnosis provide an official label for the problems that the patient will have as a result of his medical diagnosis. By using the same labels for those problems, the nursing profession can organize all of our knowledge about that problem under one category heading.
The rationale/purpose for planning is similarly to help organize nurse thinking and care. With a set plan, we are less likely to miss important details. The plan keeps on pointed in the right direction and on track.
I'm happy that you have figured this out for yourself. That insight will get you far in life.
Can someone post a link to an article regarding The Joint Commission and views on nursing diagnoses? I'd've love to read it.
This was anecdotal information from my NM from the surveyors that were at my facility about 3 months ago. I don't know if they have an "official" position about nursing dx, but they are heavily pushing the interdisciplinary care plan business (I am pretty sure they have written documentation on that if you go to the site) and the surveyors in my area did not consider the nursing dx language "interdisciplinary".
Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.
Can someone post a link to an article regarding The Joint Commission and views on nursing diagnoses? I'd've love to read it.
We also had to pull out any NANDA terminology during out last Joint Commission survey. The requirement for this was in their "compliance binders", which you have to pay for. I don't remember an extensive explanation, just something to the effect of preferring universally understood terminology when planning overall patient care, particularly proprietary terminology.
The best description of why Nursing Diagnoses are harmful to nursing education, research, practice, etc. is Patricia Benner's new book: "Educating Nurses; A Call for Radical Transformation".
The best description of why Nursing Diagnoses are harmful to nursing education, research, practice, etc. is Patricia Benner's new book: "Educating Nurses; A Call for Radical Transformation".
Thanks for posting that reference. I would like to read it to see what she has in mind to replace care planning in nursing education. I'm not sure it's wise to get rid of a way of thinking about nursing education without have a something else ready to take its place.
Specializes in Nurse Leader specializing in Labor & Delivery.
I like you, Frazzled. You are already thinking like one of us.
The rationale is that it's required academic paperwork and you need to do it to get through your program.
I remember being told in first semester nursing school, when I asked the benefit of the nursing care plan, that I would use nursing diagnoses ALL THE TIME as an RN.
Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.
Thanks for posting that reference. I would like to read it to see what she has in mind to replace care planning in nursing education. I'm not sure it's wise to get rid of a way of thinking about nursing education without have a something else ready to take its place.
I don't think there is any push to totally do away with care planning, just the use of NANDA terminology, and NIC/NOC is still used frequently.
One of the strengths of Nursing is that we see patients as a complex mix of problems, goals, circumstances, etc, as opposed to Medical diagnoses. NANDA Nursing diagnoses paint patients using an even wider brush than medical diagnoses, losing the individuality of each patient in vague, generic descriptions of very individualized overall problems.
In education, a pedagogical system such as NANDA teaches students to think in a way that is not conducive to true "critical" thinking and creates habits that have to be unlearned after graduation.
Where I work, we have replaced NANDA terminology with a comprehensive narrative description of the patient's story, from root causes to medical diagnoses, to goals, to complicating factors, to barriers, etc that basically comprises the plan of care. The structure of each component is "PPM" or Predict, Prevent, Manage" with the nursing process used as the overall structure.
From my very limited perspective it seems more difficult to actually develop a written care plan compared to assessing the patient followed by figuring out the problems and addressing them. At any rate, I don't find them helpful. Maybe I'm just used to multitasking and thinking through contingencies. I could see how they might help others.
I'm also perplexed at why one needs to have a "nursing diagnosis." To me it's illogical. Since nurses don't practice medicine that's why we're told we can't utilize the pre-existing medical diagnosis. We've been taught to utilize the nursing diagnosis RELATED TO the medical diagnosis AS EVIDENCED BY _______. To me this screams that the medical diagnosis is already present and provided by a medical practitioner. The nurse isn't labeling the patient with that diagnosis but merely utilizing that provided by a "superior" clinical and diagnostician. I don't understand why a nurse would use something like "impaired gas exchange" when a medical diagnosis is already present that identifies a problem that the nurse should know enough about (the pathophysiology) to inherently understand that gas exchange is impaired. I keep thinking "why not call it like it is?"
Anyway, these are just my rambling thoughts which are worth nothing to anyone but me.
ImThat Guy, I totally agree with you!!!!! Every other Allied Health Discipline uses the medical diagnosis as a basis and nursing should as well. I don't understand why nurses need to diagnose at all...I thought that was the physicians job.
]hi i was needing some help on nursing diagnosis....how do you make one and when....what is the rationale for a nursing diagnosis when a medical one is the one that matters?[/b]
goal of care-is this the 'planning' part of the nursing process and what is an example of one? goal for nurse or patient's goals?
planned strategies (nursing interventions)-is this the same as nursing implementation or 'plan in action'?
help please....have clinicals tuesday and things i thought i was sure about....im not.
could u guys set up some personal experiences in your hospital setting? please?
there is a sticky note above to help with care plans. you may want to review the sticky note found at
ImThatGuy, BSN, RN
2,139 Posts
Can someone post a link to an article regarding The Joint Commission and views on nursing diagnoses? I'd've love to read it.