President's address

Nursing Diagnosis, Apr-Jun 2002 by Lavin, Mary Ann

It is indeed a privilege and an honor to be writing as President of NANDA International. I owe very special thanks to Kay Avant, for her mentoring during the past two years and her friendship. I want to thank the NANDA Board of Directors and extend a very sincere farewell to those whose terms are complete: Marjory Gordon, Meridean Maas, and Judy Warren. I want to warmly welcome to the Board, Martha Craft-Rosenberg, Rona Levin, Heather Herdman, and Dickon Weir-- Hughes. They are a forward-thinking, invigorating, and dedicated group of language developers and informaticists. I also want to thank the

* NNN Conference Co-Chairs, Dorothy Jones and Joanne McCloskey Dochterman

* Planning Committee Members, Anne Perry, and Sue Moorhead

* Conference Implementation Committee Members, Rosalinda Alfaro-LeFevre, Linda Carpenito, Victoria Cole-Schonlau, Geralyn Meyer, and Peggy Wetsch.

It is impossible to thank the Conference Chairs, Planning Committee, and Implementation Committee members without expressing my deep graditude to Ken Cleveland of Nursecom and Joe Braden, Nursecom's CEO, who underwrote this first NNN Alliance Conference, and to Margo Neal for her work with the journal and Diagnosis and Classification Book.

I owe a great deal to the NANDA International membership. I cannot think of a group with whom I would rather be associated. You are leaders in nursing, organizationally and socially competent, and technologically advanced.

I would like to share something I read recently about the emergence of homo sapiens as the dominant (competent) people and the demise of the Neanderthals. According to Professor Bar-Yosef, the MacCurdy Professor of Prehistoric Archeology at Harvard, the tools and social organization of homo sapiens led to their survival (Shaw, 2001).

The homo sapiens advantage was not language per se. The Neanderthals had no anatomic impediment to language and may have possessed language. Nor was their advantage symbolic thinking and behavior. Neanderthals had these also. Rather, Professor Bar-Yosef believes the difference lay in the tools they developed and their application. A technologic and organizational revolution occurred among homo sapiens. Bar-Yosef makes an analogy between this early revolution occasioned by bows, arrows, spears, snares, traps, nets, and resultant increase in food supply and heightened social organization, and today's technical revolution occasioned by computers and their output and the resultant increase in the number of scientific journals and publications and heightened social organization via the Internet.

As if to validate Bar-Yosef's analysis, we can point to the initial question that led to the First National Conference on the Classification of Nursing Diagnoses in 1973 (Gebbie & Lavin, 1975): How is nursing going to enter its data into a hospital computer system? The answer was by using nursing diagnoses. We had no nursing diagnoses in 1973, certainly not like the International Classification of Disease. The answer then was to create a list. We convened a competitive national conference of leaders representing practice, education, and research and representing every region of the United States. Professor Bar-Yosef's point is made: Technologic change lead to enduring social and organizational change.

The development of NANDA and subsequent classification systems were not a function of language per se. The term "nursing diagnosis" was used as early as 1947 (Lesnik & Anderson). The forward leap into taxonomic thinking began as a function of technologic advance (computers and information management systems in hospitals) and social and organizational changes, the formation of groups of interested professionals devoted to classification. Thus, from its inception, NANDA's purpose was twofold: to ensure nursing information was preserved and included in the healthcare system's computerized records, and to establish the social organization mechanism needed for experts in the field to gather together to develop and classify the terminology of the nursing profession. Each aim was integrally related to the other. Each was essential for the survival of the nursing profession in the information age.

This twofold purpose is as valid today as it was 29 years ago. If the profession of nursing is not to go the way of the Neanderthal, if the profession of nursing is to survive, then nursing must continue to advance in the field of informatics and must have a place where experts in the field may come together to ensure the development and advancement of nursing terminologies. The twofold purpose of NANDA International is as essential to nursing today as in 1973.

Keeping this background in mind, I make the following proposals. The number of technological advances being made are many and NANDA is involved, specifically in developing

* Standards for health vocabularies (e.g., HU, the Reference Information Model).

* Terminology models (e.g., SNOMED)

* Software development and utilization (e.g., the several models being developing and operating within healthcare and educational systems)