Making the Difference Visible

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  • International Journal of Nursing Terminologies and Classifications Volume 18, No. 4, October-December, 2007 119

    Blackwell Publishing IncMalden, USAIJNTInternational Journal of Nursing Terminologies and Classifications1541-5147XXX Editorial



    Making the Difference Visible

    I recently received an interesting and important e-mailfrom a NANDA International member, Dr. KathleenPerry, who is currently President of the Illinois NursesAssociation. She was alerting our organization thatCNN had released an item saying that caregiversyndrome is not officially recognized in the medicalliterature but has a real effect on those looking afterthe ill. She pointed out that the author of the item hadnot reviewed the literature that indicates nurses andother healthcare providers have been describing andtreating this phenomenon for years and asked that thisknowledge deficit be treated.

    I shared this communication with our President,Dr. Heather Herdman, who subsequently provided ascholarly response to the CNN piece. She shared thatthe diagnoses of Caregiver Role Strain and Risk forCaregiver Role Strain have been in nursing scienceand in the nursing literature since 1992, with revisionsin 1998 and 2000. She clarified what a nursing diagnosisis and the relationship of diagnoses, interventions, andoutcomes and made reference to a nursing publication(Ackley & Ladwig, 2007) that references 81 publishedarticles dealing with Caregiver Role Strain.

    This incident brought a recent editorial in a nursingjournal to mind in which Hegyvary (2007) identifiedfive themes that have influenced nursing in the last5 years: evidence-based practice, globalization of know-ledge, progress in the focus on nurses versus nursing,concerns and claims about nursing knowledge, andthe dramatic rise in scholarly productivity of nurses inmany countries. She goes on to reflect on the fact thatno one owns knowledge except that which is classifiedas intellectual property and that nurses contribute toknowledge for themselves and for others. Hegyvaryfurther states that this mindset can enhance theposition of nurses in the mainstream of professionaland scientific communities by showing how nursingpractice can make a difference in individual, family,and population health.

    Where then were the 81 published articles dealingwith Caregiver Role Strain? Is this but one example ofnursing making a difference which is not widely

    recognized? And is recognition of the science and practiceof nursing important?

    Recognition is important because, as the example ofCaregiver Role Strain and Risk for Caregiver Role Straindemonstrate, unless the knowledge base and practicedeveloped and implemented by nurses are movedinto the mainstream of health care, there is limited recog-nition of the knowledge base, and the implementationin practice and the diffusion of knowledge are alsolimited.

    Nursing groups have at times appeared to be ambi-valent about becoming involved in electronic medicalrecords systems; however, it seems to be essential thatwe make our science and our nursing language a partof these systems if we are to be visible and to continueto facilitate our becoming more visible. It is critical thatnursing diagnoses, interventions, and outcomes aredocumented both in terms of defining the practiceof nursing and of demonstrating the contributionsof nursing care within the healthcare system. The docu-mentation of nursing is not only critical to the advance-ment of practice but also carries important financialimplications for the largest professional discipline inhealth care.

    NANDA International has consistently contributedto how nursing makes a difference through the develop-ment and testing of nursing languages and classifica-tions. This is accomplished in activities both broad andnarrow in scope. The languages and classifications arebroad in scope and help to define the discipline whilethe components of the languages and classificationsare focused and help to define the elements of practice.The articles in this issue demonstrate these con-tributions with two focused on caring for specificpopulations, one focused on quantifying interventions,and another on further validation and revision ofcurrent diagnoses. Yes, we are making a differencebut we must not lose sight of the importance of makingthat difference very visible.

    Georgia Griffith Whitley, EdD, RN

  • 120 International Journal of Nursing Terminologies and Classifications Volume 18, No. 4, October-December, 2007



    Ackley, B. G., & Ladwig G. (Eds.) (2007).

    Nursing diagnosis handbook:An evidence-based guide to planning care

    (8th ed.). St. Louis, MO:Mosby.

    Hegyvary, S. T. (2007). To make a difference [Editorial].

    Journal ofNursing Scholarship



    (1), 12.