Use of Nursing Diagnosis

BrandonLPN, LPN · Jan 21, 2014

As an addendum to my long winded post, I'll add that I do feel nursing schools spend too much time on care plans and nursing dx at the expense of other subjects.

And I think it's a stretch to call nursing dx the cornerstone of our profession. Has it helped nursing to create a distinct identity? Sure. Is it the end-all, be-all? No. But of course NANDA is going to claim it to be so. As before, they have a vested financial interests.

When people question stuff like nursing diagnosis or NANDA or academia in general, they are not necessarily being anti-education or anti-intellectual. There are perfectly valid reasons to be wary and skeptical of the academic elite.

From Wikipedia's article on academic elitism:

Critics of academic elitism argue that highly-educated people tend to form an isolated social group whose views tend to be overrepresented among journalists, professors, and other members of the intelligentsia who often draw their salary and funding from taxpayers. Some argue that the academic culture is pyramidal, not polycentric, and resembles a closed and genteel social circle. Meanwhile, academia draws on resources from taxpayers, foundations, endowments, and tuition payers, and it judges the social service delivered. The result is a self-organizing and self-validating circle.

Another criticism is that universities tend more to pseudo-intellectualism than intellectualism per se; for example, academicians may be charged with over-complicating problems and expressing them in obscure language.

NuGuyNurse2b · Jan 21, 2014

^ Very good points. I think he makes many good points here in this video that mirrors some of your thoughts.

nurseprnRN, BSN, RN · Jan 21, 2014

In most states LPNs cannot plan or direct nursing care; only RNs may do this. So I am not surprised that an LPN student doesn't know much about it and isn't being taught much about it in school.

BrandonLPN, LPN · Jan 21, 2014

I haven't been a PN student for a number of years.

LPNs routinely function as MDS coordinators and are responsible for care planning and MDS assessments.

I can only speak anecdotally, but I know I functioned just as well in that position as any of my RN colleagues that I work with.

What made you think I wasn't educated in the planning if nursing care?

nurseprnRN, BSN, RN · Jan 21, 2014

I don't know about you, but it seems the OP hasn't learned much about it. :)

It's not a matter of anecdote (which is not, as we all know, the singular of "data"), it's a matter of the nurse practice act. You and other LPNs may be doing those MDS forms but somewhere along the line an RN has to sign for them, because according to the nurse practice act the RN develops the plan of care and can delegate it as appropriate.

Dranger · Jan 22, 2014

Ok let me me restate my answer, nursing diagnoses are important (not in the written sense but with the idea it brings) and you use them without even even thinking. As you gain experience they become muscle memory. However,my main beef with them revolves around the idea that we need more crap to chart. I seriously (like any hospital nurse) spend a good amount of my day charting. I get the legal implication but if a nurse is even halfway competent nursing diagnoses shouldn't even have to be written down except for quick notes on a report form....ugh

nurseprnRN, BSN, RN · Jan 22, 2014

The most important function of making nursing diagnoses for students is to develop that muscle memory. However, in professional practice, having developed it at least at the beginning level, it's how you demonstrate your worth to the patient care gestalt. Otherwise all of nursing would be only robotically carrying out physician prescriptions, and just imagine for a moment, if you can, what a disastrous result that would be for the patient. Imagine what would be lost, what would not happen. Makes me shudder.

And just as there are are excellent physician diagnosticians, so there are expert nursing diagnosticians and practitioners. Our patients need more of both, don't they?

grandmabutterfly · Mar 25, 2014

Thanks for the citation from Wikipedia especially for learning the term "academic elitism." This is what I complained about while my husband was working on his Master's degree while I was working for a professor in the science field at a MAJOR university in California. I didn't know the official term, but I used the term "self perpetuation."

nurseprnRN, BSN, RN · Mar 26, 2014

From Wikipedia's article on academic elitism:
Critics of academic elitism argue that highly-educated people tend to form an isolated social group whose views tend to be overrepresented among journalists, professors, and other members of the intelligentsia who often draw their salary and funding from taxpayers. Some argue that the academic culture is pyramidal, not polycentric, and resembles a closed and genteel social circle. Meanwhile, academia draws on resources from taxpayers, foundations, endowments, and tuition payers, and it judges the social service delivered. The result is a self-organizing and self-validating circle.
Another criticism is that universities tend more to pseudo-intellectualism than intellectualism per se; for example, academicians may be charged with over-complicating problems and expressing them in obscure language.

Do I sound too much like an academic elite if I point out that there's a reason that Wikipedia is not considered a reliable source on anything? I occasionally check it, but I look at the references it cites (which you have not given me here) to make sure that they are reliable, peer-reviewed, and use solid statistics, or else I say, as I did to this quote ...."Meh. Another opinion. Like you-know-what, everybody has one, and some of them stink."