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  Nursing’s 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 www.nanda.org  http://www.nursing.uiowa.edu/center s/cncce/ http://www.nursing.uiowa.edu/center s/cncce/  http://www.nursingworld.org/nidsec/i ndex.htm http://www.nursingworld.org/nidsec/i ndex.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

11. 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

12. 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!