Learning disabilities nursing: a model for wellness diagnosis

Abstract

The idea that nursing diagnoses confirm the relevance of the medical model of nursing has been proposed by many authors, who argue that it is solely another approach to the categorisation and reductionism said to be inherent in that model (Stolte 1996, Reed and Watson 1994, Holden 1990, Gleit and Tatro 1981). This has been refuted by Gordon (1994) who has alluded to the need for nursing to reaffirm its ownership of activities such as 'diagnosis' and 'intervention'. Whereas the clarification which nursing diagnoses have offered to problem identification is indeed welcome (Gordon 1994), it must be acknowledged that their relevance is based on the premise that there is a problem which requires intervention, such that the outcome will represent a development perceived by the patient and nurse to be positive. This has, however, been potentially alienating for nursing subgroups that do not have their grounding in problem-focused care. Learning disabilities nursing is one such subgroup. Apart from the fact that it i s decidedly different from the more traditional clinical nursing groups in that it is n either illness-focused nor hospital-based, it is firmly grounded in qualitative rather t hat quantitative aspects. In addition, its relevance from a health-care perspective is recognised in only a handful of countries. In this paper the historical basis for the adoption of a nursing diagnostic approach is recounted. This, in association with a discussion of th e development of nursing within Irish learning disability services, is then examined within t he context of Sheerin and Sines' (1999) 'developmental potentials' approach to personhood. The implications of such an approach are presented, and the potential for addressing the concept of 'wellness diagnosis' across all areas of nursing is discussed