Why understanding the difference between medical diagnosis and nursing diagnosis important

[Patrick Villamor]

I know the difference between them but I wonder why we need to know the difference as nursing students or nurses?

[amoLucia]

Look at it this way - you have 2 pts, both with an admission dx of open leg fracture. One pt is 25 y/o; the other is 75 y/o. You have NOT met either pt yet. They both have the same MEDICAL dx, but what will be the focus when providing care to these 2 pts?

Will you be doing all the same things exactly the same for both in exactly the same way, same sequence? Why or why not? How will you find out and be somewhat prepared when you meet the pt?

Nursing dx is based on the pt and what is affecting him/her in this admission. As you can see, there is an ocean of different 'alteration in' and 'potential for' possible nsg diagnoses. All 25 y/o wants is his pain med and to sleep; 75 y/o takes minimal pain med, works to his max with therapy and wants to go home to his wife.

Do you see the difference? Without even meeting the pts and by reading the care plans, you can get a picture of the 2 pts. Now reverse the ages, will they be different? What about the differences in 'alteration in' and 'potential for'?

I'll admit that sometimes care plans with nsg diagnoses seem to be only an exercise in writing. But it does present a picture of the pt to those who have yet to care for the pt.

I also sneaklly believe that it's a way for surveyors to check out & see if we know what we're doing for the pt.

After a while you get good at writing them.

[MunoRN, RN]

You need to learn the difference as a nursing student because it's part of the hazing/initiation process. Other than that, no, there's not much purpose.

The difference between how medicine categorizes and describes patients is significantly different from how nursing does. Medicine describes patients in broad categories that only reflect uni-dimensional disease processes and symptoms. Nursing views patients as a complex story, not a limited set of data points. What the NANDA nursing diagnosis system tries to do is make nursing more like medicine in how we view patients, which is unfortunate.

[akulahawkRN, ADN, RN, EMT-P]

I have a pretty reasonable understanding of the medical diagnosis process. My most recent past has been spent learning Nursing diagnosis. Here's a little secret: they're identical in methodology. How they differ (very important) is the approach taken. Both depend heavily upon gathering data. Both allow that data to drive the practitioner to the appropriate diagnosis. Once that's done, the appropriate corrective actions can be taken and both require reassessment to determine the if the diagnosis was correct and the effectiveness of the corrective actions.

As I alluded to earlier, they have different approaches. The main drive of the medical model is to fix the underlying problem and once that's done, the body will then repair itself. There's not much of an emphasis in supporting the body's responses to the problem. The main drive of the nursing model is to support the body's responses in disease states to help it return to homeostasis, regardless of the actual disease process underway, but not much of an emphasis is placed in fixing the underlying problem.

Here's why you need to understand both models (and good physicians also understand this). Neither model is entirely adequate in restoring a patient to health. You can have fantastic physicians and horrible nurses and patient outcomes will not be all that great. You can have horrible physicians and fantastic nurses and patient outcomes also won't be that great. In both cases, the patients would likely get better in spite of the care provided. When both work well together, then you have patients that are well-supported from both ends. The underlying problem gets addressed and the body's healing processes are also supported, leading to (hopefully) an optimum physiological environment through which the patient recovers from disease.

The above is NOT an in-depth study of both, rather it's a fairly simplified view that should get the basic point across as to why you need to understand the differences between the two models and how they can compliment each other.

[NurseGirl525, ASN, RN]

The doctor treats the problem, the nurse treats how the person responds to the problem. Does that make sense?

The doctor says oh you have hypertension, I'm going to treat the hypertension with this pill. They are just treating the hypertension.

The nurse looks at the patient and how the hypertension is affecting them. What does this patient need right now? Are they dizzy? Are they retaining fluids? The nurse comes up with interventions to treat the patient as a person. How do we help them combat this? How can we make them more comfortable at this moment? Would a change in diet help? Do we need a nutritionist? Could we educate them on the benefits of exercise and hypertension?

I hope this helps. The medical model treats the disease. The nursing model treats how the patient responds to the disease.

[sherri64]

I disagree that learning nsg dx and care planning is part of a hazing process for nursing students. By researching the resident and their charts, this enables the student to put the nursing process into practice. As for NANDA-I, their purpose is to provide a basic language set that can be understood by everyone. When combined with NOC/NIC, it is a different language altogether, but again, an attempt to solidify common terminology that can be utilized and recognized by all nurses. That one takes some getting used to for those of us who have been around 30+ years. My advice to students and others is to check out careplans.com (my preferred choice) for accurate data about care plans and how to write them. For NANDA/NOC/NIC, there are books on Amazon, including one that links them all. A care plan should allow any discipline to read it and know the care that the resident it is written for needs and is being given. Without knowing the resident, how else do you know what that person needs, besides what the doc ordered? And how do you know how to meet those needs without the nursing assessment that leads to the care plans? Care plans are important.

[SoldierNurse22, BSN, RN]

If you already know the difference, I'd think answering the question "why is it important" would be self-evident. But anyway...

Why is it important for you to understand medical vs nursing diagnoses?

For the same reason it's important for you to understand the difference between your scope of practice as a nurse and the role of the physician in patient care. They are two very different disciplines, but they must work together. Same goes for medical and nursing diagnoses.

[elijahvegas, ASN, RN, EMT-P]

simple; we dont make medical diagnoses, an MD does that. we make nursing diagnoses because those are things that we can actually use the nursing process to address, within our scope of knowledge and practice.

[BittyBabyGrower, MSN, RN]

If you ever go to court you have to be able to know the difference. We can't diagnosis a medical condition. You can say "He has something neurological going on as evidenced by the seizures etc" You can not say " Yeah he had an aneurysm" That is the docs call not yours.

[twozer0, NP]

I've never been a fan of nursing diagnoses and I'll explain why. Most nursing diagnoses are based off of medical diagnosis. Ohh your patient has pneumonia? Impaired gas exchange is a NANDA nurse diagnosis that you could use. There are others, I just picked one off the top of my head (I havent looked at the NANDA book since school). Now you would think that if you A. Knew the patho of pneumonia and B. knew the anatomy affected by having pneumonia than you should easily be able to paint a picture of what you should do for this patient. Coughing, Deep Breathing, Incentive Inspirometry, Antibiotics, Secretion management, supplemental oxygen, etc. Do we really need nursing diagnoses to effectively take care of patients?

I've been a nurse in the hospital for going on 9 years now, I have never written a care plan or written/used a NANDA nursing diagnosis. In my honest opinion, nursing needs to change the way they are teaching students, not because the knowledge is bad, but because it is antiquated.

So to the OP. Know your patho, know your anatomy and you should easily figure out what to do for any situation. I"m pretty sure NANDA wouldnt approve of that!