thank you for sharing your experience and perspective.
maybe you can clarify this for me... what you describe is indeed valuable and differentiated from medical diagnosis and treatment planning. however, if a nurse developing such a 'big-picture' care plan is "practicing nursing" then when a social worker develops a life care plan for someone with special needs, are they then practicing nursing without a license? or perhaps both nurses and social workers are qualified to practice "life care planning" in different scenarios - and when the nurse does it, it's nursing and when the social worker does it, it's social work? - i hope i don't come across as argumentative. i truly wonder about questions like this! if clinical nursing experience is required for certain life care plans, then that situation doesn't call for nursing care, it calls for life care planning from a reputable, credentialed person with relevant clinical nursing experience and with relevant life care planning experience as well. is that being too nitpicky with words?
to me, this gets back to the very basic question of "what is nursing?" (which is a very different question than what do licensed nurses do)? a very large percentage of practicing nurses rarely utilize the broader 'nursing' assessments and plans of care. in both outpatient and inpatient settings, a nurse's primary function is to do *physiologic* assessments and provide *medical* care. thus, taking into consideration and working with the psychsocial aspects of the situation, reassuring and providing understandable explanations, is not 'nursing' in my perspective. good nurses do it, definitely! so do good doctors, good accountants, good lawyers, etc. if the crux of nursing care is the psychsocial and long-term qol aspects (as opposed addressing immediate medical needs), i could go so far as to argue that many of today's nursing jobs involve relatively little nursing.
i just think that if we define "nursing" as anything that nurses (have been cross-trained or co-opted) to do or have done, it ends up being meaningless as it would encompass great swaths of psychotherapy, physical therapy, health education, public health, infection control, health informatics, and medicine itself, of course (nurse practitioners, anyone?)
definitely a fav subject of discussion for me... and it really does relate back to nursing diagnoses somehow, really, it does!