Nursing Classification: What's in a Name?
February 3, 1999
in response to Nursing Nomenclature and Classification System Development
In response to the article "Nursing Nomenclature and System Classification Development" by Marjory Gordon, I'd like to add a few thoughts "from the floor." As a med-surg RN, I've become aware of just how far we have to go when it comes to developing a common vocabulary among nurses, and among all health care professionals.
Our hospital recently introduced a new Patient Profile in which all the involved patient care disciplines are supposed to document their goals and outcomes. Unfortunately, no one but nursing uses it. Why? Because we don't use the same language! The care plans incorporate two different classification systems, namely, NANDA nursing diagnoses, for the purpose of communicating about independent nursing activities, and Medical Diagnoses, for the purpose of communicating about interdependent nursing activities. Furthermore, the standards for care, developed by our institution to accompany both classification systems are difficult to use. They are written in tiny print, are very "busy" in appearance, and require an extended length of time to read. I suspect that a Respiratory Therapist would not even know what these standards are, let alone where they are located. These standards are written in respect to nursing care only, and are written in terms that only nurses would likely understand. They are much too general for practical use by specialized caregivers such as Respiratory Therapists, Occupational Therapists, Physical Therapists, etc.
Furthermore, even RN's themselves are far from agreement when it comes to "common" terminology. For example, to some, the word "lethargic" represents a patient who is medically oversedated or unresponsive. To others the word means "sleepy."
I applaud the efforts of Marjory Gordon and others who are working toward developing a common language for nurses. Perhaps if we can come to some agreement as to how to speak to one another, then we can hope to extend that experience to other disciplines.
John Hewes, RNC, BA