I'm sorry, but some nursing diagnoses are just ridiculous!

gwenith, BSN, RN · Feb 27, 2005

One of the funniest spoofs of Nursing diagnosis I ever read was the "Holistic Nursing" where the patient was seen as a collection of holes into which nurses placed tubes such as catheters, N-G tubes...............:rotfl:

We can and should every so often hop on that white horse and charge the sacred windmills that dot the academia of our profession. We need to do this sometimes to bring a sense of reality to what can become a exercise in jargon.

jnette, ASN, EMT-I · Feb 27, 2005

One of the funniest spoofs of Nursing diagnosis I ever read was the "Holistic Nursing" where the patient was seen as a collection of holes into which nurses placed tubes such as catheters, N-G tubes...............:rotfl:
We can and should every so often hop on that white horse and charge the sacred windmills that dot the academia of our profession. We need to do this sometimes to bring a sense of reality to what can become an exercise in jargon.

True enough... I wholeheartedly agree. :)

BETSRN · Feb 27, 2005

Ineffective denial...as opposed to EFFECTIVE denial?
Disturbed energy field
Impaired environmental interpretation syndrome
Health-seeking behaviors (the horror!)
Impaired home maintenance (I'm guilty of that one! If only I could do a collaborative intervention with Merry Maids)
Ineffective protection
Noncompliance
Wandering
Some of these just made me chuckle, and made me wonder about the people who come up with them.

Are those NANDA approved nursing diagnoses? I never heard those (of course I ahev been away from school for 20 years now). We nurses would all agree with you: you rarely ever run into nursing diagnoses after you graduate!

RN4NICU, LPN, LVN · Feb 27, 2005

Charting noncompliance is not being judgemental, it is an observation of fact and legally necessary (IMO). You get some shmuck that is not compliant with the treatment regimen that decides to sue when serious complications occur - the only leg you have to stand on when said shmuck tells the court "I didn't know any better - I'm not a doctor or a nurse" is documentation that the patient DID know what he/she was supposed to do but refused to do it. Otherwise, some dumb-a**ed jury will hand them over a settlement out of sheer ignorance. Yet if there is documentation in the legal record, the patient no longer gets the benefit of the doubt because there is no longer any doubt - the teaching WAS done and the patient WAS noncompliant and DID cause his/her own complications.

I will continue to use it. But again, just my opinion (and my license to protect).

BETSRN · Feb 27, 2005

Charting noncompliance is not being judgemental, it is an observation of fact and legally necessary (IMO). You get some shmuck that is not compliant with the treatment regimen that decides to sue when serious complications occur - the only leg you have to stand on when said shmuck tells the court "I didn't know any better - I'm not a doctor or a nurse" is documentation that the patient DID know what he/she was supposed to do but refused to do it. Otherwise, some dumb-a**ed jury will hand them over a settlement out of sheer ignorance. Yet if there is documentation in the legal record, the patient no longer gets the benefit of the doubt because there is no longer any doubt - the teaching WAS done and the patient WAS noncompliant and DID cause his/her own complications.
I will continue to use it. But again, just my opinion (and my license to protect).

You can chart all your teaching without using nursing diagnoses.

jnette, ASN, EMT-I · Feb 27, 2005

Charting noncompliance is not being judgemental, it is an observation of fact and legally necessary (IMO). You get some shmuck that is not compliant with the treatment regimen that decides to sue when serious complications occur - the only leg you have to stand on when said shmuck tells the court "I didn't know any better - I'm not a doctor or a nurse" is documentation that the patient DID know what he/she was supposed to do but refused to do it. Otherwise, some dumb-a**ed jury will hand them over a settlement out of sheer ignorance. Yet if there is documentation in the legal record, the patient no longer gets the benefit of the doubt because there is no longer any doubt - the teaching WAS done and the patient WAS noncompliant and DID cause his/her own complications.
I will continue to use it. But again, just my opinion (and my license to protect).

I wholeheartedly agree with you.. I was merely pointing out that in several of my nursing school books it was mentioned that the term "non compliant" is no longer going to be considered appropriate, as it bears negative/judgemental connotations. Still haven'y gone back to see just what acedemai was replacoing it with, but I do know that it either is ALREADY or is BEING revised/reworded.

So what happens to patient accountability? :confused:

Guess it's now every one's responsibilty but the patient's to improve his/her health status. :uhoh3:

mariedoreen · Feb 27, 2005

Who won't let you use the word noncompliant? I truly hope that there is a better rationale than "it is too negative"!
That is a dangerous limitation to put on you. Documentation of noncompliance is what protects nurses legally. It shows that we are doing we are supposed to do, but that the patients (or "clients" ) are cooperating. That shifts the legal responsibility for any negative outcome from the nurses back to the patient, which is where it belongs if the patient is noncompliant with the plan of care. I would look into having that side of things addressed. It is not a good precedent to set. The chart is a legal document - not a newspaper article. The focus should be on documenting what is actually happening, not keeping up appearances. If student nurses are being taught otherwise, they will graduate and enter the profession not knowing how to (or realizing that they should) protect themselves, legally. That is just unacceptable.

There's supposed to be another word for it, because non-compliant is not considered PC anymore. Our instructors can't remember what this other word is however... :)

michelle95 · Feb 27, 2005

Ineffective therapeutic management or something like that is used for "noncompliance". I'll have to look up in my notes what my teacher said.

Yeah. :rolleyes:

BunnyBunnyBSNRN, ASN, BSN · Feb 28, 2005

Klone,

Cheer up! I thought they were funny too! :chuckle

Last semester, our instructor told us she wanted us to be creative with our NANDAs, so I used the "Disturbed Energy Field"...I got the star for being creative that day! (between you and me, I didn't really understand it then, and I don't think I do now, but it was fun working out interventions and evaluations for it! ) :chuckle :rotfl: :chuckle

Claver · Feb 28, 2005

In home care we use nursing diagnoses on our oasis and plans of care. However, since in the DD field nursing diagnoses are not used. I often wonder why are they called by such long boring names - we can not use medical terms - so constipation becomes "ineffective bowel evacuation "YIPES!!!!!

:uhoh3: :uhoh3: :uhoh3: :uhoh3:

HappyNurse2005, RN · Feb 28, 2005

I often wonder why are they called by such long boring names - we can not use medical terms - so constipation becomes "ineffective bowel evacuation "YIPES!!!!!

But Constipation is a nursing diagnosis, according to my Ackley/Ladwig book. Unless you are just using constipation as a random example, I dont understand why you couldn't say it.

In regards to using medical words, we were told we couldn't use a medical dx as the r/t part, but could use it as the secondary to. For ex : "risk for infection r/t hyperglycemia secondary to diabetes mellitus"

helpinghands, BSN, RN · Feb 28, 2005

We were also told not to use the term "compliant" because it sounded to negative. The new pc term we were told to use is "does not adhere"