What Are We Bringing to the Table?

1
What Are We Bringing to the Table?

• Margaret Lunney, PhD, RN
• College of Staten Island

2
WHY Should Nurses Be At the Table?

• Nursing is a unique service
• Nursings mission to help

3
What ARE We Bringing to the Table?

• Unique service of nurses is mostly
• invisible, e.g.,
• Perceived as only following physician orders
• Society views nursing as a subsystem of medicine
• Constant use of the term medical professionals
  instead of health care professionals

4
Unique Service is Mostly Invisible (cont.)

• Generally, the unique services of nurses are not
  named or described
• Medical diagnosis is still the primary language
  used in health care, even by nurses
• When nursing is named and described, nursing
  science does not get the credit, e.g., CMS
  quality indicators were derived from nursing

5
What ARE We Bringing to the Table?

• NYS Nurse Practice Act (1972)
• Diagnosis of Human Responses
• Treatment of Human Responses

6
What ARE We Bringing to the Table?

• Described in nursing models, philosophies
  theories
• Problem Narrative descriptions are not practical
  for most health care settings
• Solution Practical, clinically-based nursing
  concepts are available in standardized nursing
  languages (SNLs)

7
What Are We Bringing to the Table?

• Question can be answered using concepts from
  NANDA, NOC NIC (NNN)
• NANDA International (NANDA) Diagnoses
• Nursing-Sensitive Patient Outcomes Classification
  (NOC)
• Nursing Interventions Classification (NIC)

8
FYI Websites

• www.nanda.org
• http//www.nursing.uiowa.edu/centers/cncce/
• http//www.nursingworld.org/nidsec/index.htm

9
Opportunity is Knocking

• The Electronic Health Record (EHR) is imminent
• Computerization means that file names will be
  used to represent nursing
• Which file names are important for use with
  specific populations?

10
Research-Based Example Experiences of Battered
Women (Carlson-Catalano, 1997)

• Altered Thought Processes
• Stress Overload
• Social Isolation
• Sleep Pattern Disturbance
• Self Esteem Disturbance
• Ineffective Coping
• Decisional Conflict
• Fatigue
• Ineffective Denial
• Hopelessness
• Altered Role Performance
• Powerlessness
• Ineffective Parenting

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Example Long Term Care Diagnosis of Human
Responses

• Self care deficits
• High risk for pressure ulcers
• Self esteem disturbance
• Powerlessness
• Hopelessness
• Anxiety
• Ineffective breathing pattern
• Chronic Pain

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Example Long Term Care Nursing Interventions

• Bed Rest Care (0740)
• Positioning (0840)
• Nutrition Management (1100)
• Exercise Management (0180)
• Environmental Management Comfort (6482)
• Self Care Assistance (1800)
• Behavior Management (4350)
• Spiritual Support (5420)

13
Conclusion

• Nurses need to know what they are
• bringing to the table and let others know as
  well.
• The Standardized Nursing Languages of NANDA-I,
  NOC and NIC can be used to describe the
  contributions of nurses.
• Happy Nurses Week!