Need to vent. Diagnose that.

[SeeTheMoon]

Alright. I'm a fairly new student, and I know these threads are a dime a dozen. But it's my turn to lay it on the table.

Why, oh why, must nursing be so pretentious? Why must we wade through pages and pages of "nursing theories" and "paradigms" and "nursing diagnoses" when most of it is completely irrelevant to what we will be doing every day of our lives? (At least, that is what all the experienced nurses are telling me.)

Is it really really necesarry to have a nursing diagnosis of "acute pain related to pressure on the spinal nerves" when "acute pain related to herniated disk" would not only be much shorter but more than sufficient?? Yes, I know. We don't give a medical diagnosis. But we didn't give the medical diagnosis of herniated disk!! The doctor did!! Why the #!@%$! can't we just say "herniated disk"???!!

And further more, we all know that nurses "diagnose" all the time anyway. How many times have you experienced nurses offered up a differential diagnosis to the MD who was stumped and oh, it just so happens you were right, maybe because you have been doing this and staring it in the face for 10 years or more. But no, don't expect to get the credit for it.

AND.....do we really need for someone to set up this long complicated "theory" to *guide* us through and give us an *angle* to point our nursing care that states that "self care" is the most important? Or that compassion is important? Really?? Certainly, man has not been doing this since the first child was born and the mother and father had to teach it how to feed itself, walk, etc. Uh, we are kinda centered around self care already, when we are able. And compassion? Let me just say, if you are a cold hearted ***** you probably won't do well with nursing, and if you need a theory to tell you that, or offer that compassion can be the "focus" of your care, you probably need to quit now.

Whew. Ok. I'll probably get a little beat up for this. But I just needed to get that off my chest. Back to the books to hone my *nursing* diagnosis skills.

[NurseKellyH]

AND.....do we really need for someone to set up this long complicated "theory" to *guide* us through and give us an *angle* to point our nursing care that states that "self care" is the most important? Or that compassion is important? Really?? Certainly, man has not been doing this since the first child was born and the mother and father had to teach it how to feed itself, walk, etc. Uh, we are kinda centered around self care already, when we are able.

LOL! Wow. I totally and completely understand what you are getting at. The way I've always looked at this started when I took my first psychology class so many years ago. Couldn't help but notice how many theories parallel each other in so many ways. I decided then that it was this way for one simple reason; PhDs. What I mean is, people have to write new theories and break ground to get certain degrees. It's as though the take the basics of one theory, reword it to suit their particular angle, and viola! Here is another new theory and another new name you will be asked to recall for a test, even though it is practically identical to every other theory on the topic

Some of it is just silly. I guess as far as being a student forced to learn all of these, the main focus is getting through it. A lot of it is unnecessary gibberish, but it does provide a foundation of knowledge and critical thinking to professionals.

[Bob_N_VA]

You'll get no argument from me. I have yet to see where a nursing diagnosis is used in an actual clinical setting. If it is, somebody please enlighten me, I've only been a student now for 4 semesters out of 6 so I may have missed it or just havent seen it yet.

Just like all the theorists, they make you learn them in school, but there is no real application in the job.

[llg, PhD, RN]

I notice that some of you are confusing "Nursing Diangnosis" and "Nursing Theory." They are 2 totally different things.

If your school does not distinguish between the two, that's probably part of the problem. If someone doesn't understand what these things are well enough to distinguish between the two, they probably aren't doing a very good job of teaching students about them.

[jesskidding, LPN]

I notice that some of you are confusing "Nursing Diangnosis" and "Nursing Theory." They are 2 totally different things.

If your school does not distinguish between the two, that's probably part of the problem. If someone doesn't understand what these things are well enough to distinguish between the two, they probably aren't doing a very good job of teaching students about them.

I couldn't agree more. Great point.

[SeeTheMoon]

Oh no, my school is doing very well to distinguish between Nursing Diagnosis and Nursing Theory. Two totally different things, I get that. I just don't see the application as other posters have said. I also don't really see where my statement or their responses show an overlapping of the two??

But it's no matter, only a venting thread. We will all find something that pushes our buttons along the way. :)

[0402]

If your pt is at "risk for alteration in skin integrity d/t decreased mobility and poor nutritional intake," and you implement a nursing intervention, such as turning q2h and assist with meals, are you using a nursing diagnosis? What about risk for falls?

[srobb11]

I hate care plans with a passion. I was the same way, thought they were useless and would get seriously po'd anytime I had to do one and was po'd that it was taking time away from studying for exams....the things that really affected my grade. Not stupid care plans that accounted for 1% of my grade.

However, I will admit....after doing more care plans than I care to ever count, when I am caring for a patient now, it's almost become kind of second nature to know what to do without having to really think too hard about it. While they seem useless and annoying as heck, they do serve a purpose in getting you to learn what you need to do and organize your care. Will you ever do an actual care plan in real life? Most likely not. Just smile and get through them and know that it does end some day.

[srobb11]

I just realized you were complaining about diagnoses and not necessarily care plans....eh, care plans are still a big pain in the booty.

[EricJRN, MSN, RN]

I hear ya. It's frustrating when you have a limited time to absorb a lot of info and it feels like precious time is being wasted with fluff. Your vent is most definitely a valid one. Here are some thoughts that I hope might make you feel a little better at some point.

I know it's hard to see right now, but for some of your classmates who struggle with connecting patho, signs/symptoms and priorities, the care planning process will actually be a benefit, even after they've graduated and taken their scary selves into the working world.

When I got too frustrated with nursing theory, I tried to think about how bad other health professions had it. In traditional medical school programs, there isn't much theory about caring, but there are two full preclinical years with very minimal actual patient contact. These guys are taking courses like biochem, and that knowledge turns out to be basically unnecessary in 99% of clinical situations.

I think you'll see in the real world that it is all too easy for patients, families and physicians to treat nurses like a doctor's handmaiden. I applaud the efforts of people who try to advance nursing by creating a specialized body of knowledge unique to us, but I agree with you that the process for that isn't exactly on point.

[akulahawkRN, ADN, RN, EMT-P]

I can see where the frustration is about nursing Dx. Mind you, I'm still learning this stuff... but where you have a problem related to a medical Dx, we should be able to use that medical Dx in the nursing Dx. Acute pain is acute pain whether it's R/T pressure on nerves or it's R/T herniated disc.

I think that people get overly freaked out when we write in a medical diagnosis within a nursing diagnosis because it just might make it appear like nurses are diagnosing something medically. IMHO, if you do not have a medical Dx at the time you're doing a nursing Dx... that's OK. Go with what you know.

But that's just me... Since I'm still learning, I'll learn to do it the formal way because there's some value in learning it... even if the ultimate goal is to teach me to organize and prioritize my thoughts and nursing practice... same with care plans....