i've been an adn for 16 years. recently, i finished my bsn and now am through my first year of a dnp program. like most students, i struggled with learning to understand a nursing diagnosis during my adn schooling. since that time the term has cropped up in various situations but usually as a passing comment. it has in no way benefitted my practice as a nurse. in fact, when i bring up the subject with colleagues i often get a smirk or an eye-roll!
the subject of nursing diagnoses happened to come up in one of my grad school classes the other day. i decided to take a stab at this sacred cow and suggest that maybe they are burdensome and irrelevant to a working nurse that they simply aren't utilized. my professor's response was a textbook explanation that i've only heard repeated on a college campus. "if you say your patient has pneumonia, you are using a medical diagnosis which is outside your scope of nursing practice. you must have a nursing diagnosis to be able to implement and evaluate your interventions." i may be wrong, but i'm pretty sure i've been able to implement and evaluate my nursing interventions without needing a nursing diagnosis.
personally, i believe the idea for a nursing diagnosis comes from the ongoing and hard-won independence from the thumb of the medical community. i am all for the continued growth of nursing science. however, on this point we overshot the mark. there is simply no justifiable rationale for calling pneumonia something like
"impaired gas exchange related to effects of alveolar-capillary membrane changes. or
ineffective airway clearance related to effects of infection, excessive tracheobronchial secretions, fatigue and decreased energy, chest discomfort and muscle weakness. "
why not just say the patient has pneumonia? because it a medical diagnosis and we don't practice medicine? baloney! its a pathologic condition. call it what it is. we dont need to reinvent the wheel.
why do we hang on to this? we need to eject it from nursing and maybe realize we don't use it like we thought we would. a lot of time and energy is wasted on this topic in nursing programs that could be better spent elsewhere.
Rob72 it was directed at Nursel56 who deleted the portion of her comment that I was responding to- essentially how we need more men in nursing because of the femaleness resulting in these issues.
There are a lot of possibilities for a better system. If we look at the World Health Organization WHODAS-II scale of disability we could cross reference interventions with something like it. Maslow is great- has never failed me in my thinking and prioritizing, but it is not built with nursing interventions and multiple health needs in mind. It is only a framework for prioritizing. Erickson I don't see as useful across the board, but it gives us food for thought when we look at our patients.
With all the brainpower on this forum I bet we could come up with some great stuff, but then again we want it user-friendly and applicable to all areas of nursing. Or do we? Has the time come that we need to recognize that the specialty takes priority? Could we better meet the needs of the nurse by recognizing that specialties have different needs? Is that the root of the problem? Maybe there is no one size fits all anymore. Isn't nursing like medicine becoming vastly complex and highly specialized?
I suppose these things are best left to academia to figure out, while the rest of us just do what we need to do to jump through the hoops for our patients.
Specializes in Clinical Research, Outpt Women's Health.
Yes, recognize the different needs, make it practical and useful, and not time consuming, and not full of a bunch of high faluting ivory tower language........
And then you will have something worth doing. Practical, concrete, quick and helpful tool. That is what nurses need.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Rob72 it was directed at Nursel56 who deleted the portion of her comment that I was responding to- essentially how we need more men in nursing because of the femaleness resulting in these issues.
My original contribution was a paragraph at the end of my longer post. Basically it was an extension of the theme of my entire post about cultural factors influencing language styles. It was never set up as a battle of the sexes, but without my words to compare to the "whoa" response I can see how people might think it was. I didn't respond to that post point by point because I hoped it would just go away from benign neglect and to respond in an argumentative fashion would only add fuel to it. There's a lot to be said about gender stereotyping that goes on here on allnurses in it's own thread.
I'm doing it now because I would prefer such a flat wrong impression of my attitudes not be made. I removed it not because I thought it was inappropriate but because if cxg74 missed the point maybe others would, too. Now it seems to have morphed to an emphasis on the false impression and my intention re-interpreted by the person who misunderstood it in the first place.
I never said nursing was "screwed up" or that men needed to come in and rescue us from our nursing diagnoses. I specifically said that in some cases they may be better as in msn10's rape trauma/abuse care plan. or whether or not men or women are better qualified to run nations. To think that is what I meant would require someone to surmise that I feel men in general are superior to my own gender.
quotecdsga
Everyone has something to bring to the table. Males have much better negotiation skills and confront things in a more "to the point" way, less emotion in the arguments.
This is more like what I meant. I've noticed that here. And we do have a lot to learn from each other.
It is cultural expectations that make the difference. By repeating and propagating ideas such as this- the idea that there IS a difference, you are making it so. We are all the same and have the same capacity for compassion, caring, negotiation, corruption, whatever.
I agree we need a mix. In all fields. Just as we need a racial mix. Workplaces should reflect the general population. Only then can gender and cultural bias become a non-issue as it should be. It is cultural expectations that lead to women being less likely to enter certain jobs, and the same with men. It is not fair to either sex. No task should be gender specific. Just as I enjoy helping my son take out a windshield of a car, so should he feel free to enjoy baking a batch of pepperoni rolls which he does!
So let's figure out how to fix nursing diagnosis together as nurses, not as men and women but as people.
It is cultural expectations that make the difference. By repeating and propagating ideas such as this- the idea that there IS a difference, you are making it so. We are all the same and have the same capacity for compassion, caring, negotiation, corruption, whatever.
I agree we need a mix. In all fields. Just as we need a racial mix. Workplaces should reflect the general population. Only then can gender and cultural bias become a non-issue as it should be. It is cultural expectations that lead to women being less likely to enter certain jobs, and the same with men. It is not fair to either sex. No task should be gender specific. Just as I enjoy helping my son take out a windshield of a car, so should he feel free to enjoy baking a batch of pepperoni rolls which he does!
So let's figure out how to fix nursing diagnosis together as nurses, not as men and women but as people.
Yeah. You guys stop acting like I'm not a good nurse just cause I'm a guy. Being a girl don't make you a better nurse. IN FACT........................
I'm willing to be I'm more girly that the whole lot of ya. I probably have more girl in my little pinky than you guys have.............................
<_>
>_>
Ewwww, got my "inside" and "outside" voice mixed up there for a second. N/M. Upon further review you weren't saying that anyway.
I don't really care what Harvard says when it comes to my personal observations. I stated it in my perspective not research data bases, which don't always see the same things the way I do. If women can negotiate better salaries, then why don't we get them? If women are less emotional in their responses to differences of opinions then why do people see them as argumentative rather than holding a discussion or stating their beliefs, or breaking down into tears when angry or upset? Face it there are gender differences and that is the truth. The more we understand it and embrace our differences the better we'll be. We are not all androgynous, homogeneous, or unbiased. Nor should we want to be. That is what makes decision making an adventure and productive.
I don't really care what Harvard says when it comes to my personal observations. I stated it in my perspective not research data bases, which don't always see the same things the way I do. If women can negotiate better salaries, then why don't we get them? If women are less emotional in their responses to differences of opinions then why do people see them as argumentative rather than holding a discussion or stating their beliefs, or breaking down into tears when angry or upset? Face it there are gender differences and that is the truth. The more we understand it and embrace our differences the better we'll be. We are not all androgynous, homogeneous, or unbiased. Nor should we want to be. That is what makes decision making an adventure and productive.
My CNA can beat up your CNA.
Lets see ya negotiate outta that.
<_>
>_>
Oh, you said they can't negotiate as well. I'm so confused. N/M.........again.
You win-I'm a woman, I give up, you can have it, it's not worth it, I'm weak and tired, can't we just get along, don't you like me? Sorry, I'm so sorry. Love you and have a nice day:)
You win-I'm a woman, I give up, you can have it, it's not worth it, I'm weak and tired, can't we just get along, don't you like me? Sorry, I'm so sorry. Love you and have a nice day:)
I think I'll use that line with my demanding pt. tonight...........well, except the "I'm a woman" part.
Hmmm. Deny the difference? Embrace the difference? Maybe it is the era that you were brought up in? Me, I never give up. I never give in. I am woman, hear me roar (LOL). I am a product of the 60s and 70s. Equality and liberation and all that good stuff. Let's all join hands and sing Kumbaya or something!
Eriksoln- you are too much!!! Bet you are a hoot to work with. Come work with me!
Hmmm. Deny the difference? Embrace the difference? Maybe it is the era that you were brought up in? Me, I never give up. I never give in. I am woman, hear me roar (LOL). I am a product of the 60s and 70s. Equality and liberation and all that good stuff. Let's all join hands and sing Kumbaya or something!
Eriksoln- you are too much!!! Bet you are a hoot to work with. Come work with me!
I might, if you work in the ICU. I'm tired of M/S. Its NOT my niche.
cdsga
391 Posts
And I mean arguments in the most professional discussion type situation.