April 17, 2009

NANDA: Suicide by Greed?

I was sent a document by NANDA-I outlining their fees for use their diagnostic labels in publications. I was stunned by the fees. For example, just to create a list of terms is $250. But wait, there's more. If you want to create a textbook using the diagnoses be prepared to fork over anywhere from $3500 to $65,000! These numbers do not even include their use in software. I asked last summer for the cost and was quoted $3000 plus $2.50 for every copy of the program sold.

Nursing is in great danger of being left behind as electronic health records go online. We need a way to communicate what we do. While many have complained about the circuitous language and downright silly labels of some NANDA nursing diagnoses, they at least provide a common language for documentation until something better is developed.

If NANDA-I and Wiley-Blackwell Publishing insist on taking this usurious tack then we should let NANDA-I diagnoses die a quick death. Many of the terms they use could be challenged as in the public domain. Only a list of diagnoses and definitions that are in the public domain will provide us with the common language that can be used freely for practice, documentation, research, and billing.

9 comments:

Anonymous said...

Well said, Brent. In all the years I have been writing textbooks, I have never encountered anything that approaches this. It appears that Wiley-Blackwell, who now publishes the NANDA diagnosis book, wishes to put out of business all the handbooks that might compete with their diagnosis handbook. The diagnosis handbook is merely a list of terms with definitions, defining characteristics, risk/related factors, and references. The "competing" handbooks are comprehensive care-planning books that include assessment, goals, and interventions. Much will be lost if these disappear from the market.

Brent Thompson, PhD, RN said...

The whole concept of copyright of a diagnostic label boggles my mind. Will patient records with nursing diagnoses be claimed as copyright infringements? Can any nursing text ever print the word "pain" without owing Blackwell money??

Anonymous said...

I agree, much will be lost if the careplan handbooks are driven out of business. I remember, as a new nursing student, not havinga clue what interventions were appropriate for the multitude of diagnoses. Now, as an educator, I rely on these handbooks to be a valuable resource for my students, not to replace critical thinking, but to enhance their grasp of the content. Shame on Wiley-Blackwell trying to make it impossible to inform and teach the future generations of health care providers.

takingcareofnurses said...

What cracks me up is that many of the Nursing Diagnosis textbooks contain non-NANDA approved nursing diagnoses. It seems that one can easily create their own nursing diagnosis along with supporting criteria and format!

RNSpeak! said...

Excellent commentary Brent - thank you. As a nurse educator, I also wonder the same things that you mentioned in your writing. I think nursing needs a standardized language that defines us as a profession, but to be held financial prisoner by Wiley-Blackwell is crazy.

Thanks for making this issue more readily public. I also agree that if indeed Wiley-Blackwell is trying to drive other publishers oput of the nursing diagnosis business, the entire nomenclature should die a quick death. But collectively as a profession, we would need something to replace it.

ICS said...

hi all, im a developer and tried to talk with elsevier (owner of nanda in spain) for developing an application for iphone, but their price was expensive, i dont remember now but say 10.000 $, if i sell my application at 10 $, i have to sell 1000 applications to earn something, its very expensive, we have to look for a solution...

Misa-Chan said...

Its a business I don't expect anything for free, after all the dream of business people making money off of consumers is to keep them a slave to their products. I only wish that people could see the true value in offering information like this to the general medical public. Of course with people like Blackwell in the world, don't expect any good graces coming to humanity in the future "in general".

Brent Thompson, PhD, RN said...

Misa-Chan: You're right it is a business. The question for nursing is "should standardized language be a business?" I don't expect Blackwell to give away content; what I really expect is our nursing organizations to not be in the business of copyrighting standard language for profit.

KBetts said...

Brent,
I have to agree with your comments. As a nursing faculty member, my foundational students really need the nursing care plan books. I also use them to help with grading my clinical papers. It is too bad that this information that is internationally used in nursing programs can't be provided as a public service to everyone.

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