DIAGNOSIS-when most of us hear this word, it conjures up doom & gloom. It may bring to mind a loved one, or even ourselves when we were told something we didn’t want to hear. Or in some instances, it brought welcome relief to know a certain disease was now being “ruled out.” Whatever your experience with this term, chances are you are thinking of a medical diagnosis.
Medical diagnoses are formulated around disease processes-which then give the MD, as well as the patient an idea of how treatment plans will be navigated. Nursing diagnoses however, plainly name what is happening to the patient, and illustrate how to treat that response. It’s part of the nursing care plan; and what separates our discipline from medicine.
An example would be a woman who is diagnosed as having metastatic CA of the breast (breast cancer which is spreading). Her MD would initiate a treatment plan; while nursing follows up with a plan of care, including a nursing diagnosis. If a mastectomy were in order, a nursing diagnosis may read “Alteration in body image r/t (retaining to) upcoming mastectomy.” Nursing would then incorporate the next phase–PLANNING, into her care. Part of PLANNING would incorporate physician follow-up for reconstructive surgery (if she so desired). However, it may mean involving another woman–one who faced the same road, speaking to this patient. It is NURSING oftentimes, which anticipates as well as orchestrates this–involving social work, patient advocacy, discharge planning, as well as foreseeing the need for follow-up care, through the nursing care plan. Nursing is the frontline, follow-through, and many times the follow-up, in assuring successful team based patient care.
Yet, what does this scenario have to do with lifestyle intervention or personal training?
How many times have you been assessed, or told “this isn’t possible for you,” or “I’m sorry, you don’t seem to be a fit for this position?” The person telling you this may have meant well. Maybe their ASSESSMENT however, as well as their rush to diagnose, was incomplete; or inept.
It might be helpful then, to take a step back–and plainly name what you see; just as nursing diagnoses illustrate. Is it a perceived lack of time–r/t work, school, family (or any combination of these) which appear to be keeping you from reaching your fitness goals? (they really do have to be your goals, to sustain change)
Noncompliance r/t ineffective planning. Now here’s a loaded nursing diagnosis. Noncompliance/compliance is one of my least favorite terms to use; mostly because it tells me nothing of what makes someone appear this way. However, this diagnosis may preview and present a little food for thought; especially when it comes to initiating meaningful change. It also leads us into PLANNING–the next phase of the nursing process. That’s really what effective ASSESSMENT and DIAGNOSIS should do, lead you towards effective PLANNING.
All for now. Keep up and keep at it.
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